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City of Santa Ana City Manager's Office-M-31 <br />+ 20 Civic Center Plaza <br />r_ Donation Request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />r . . <br />Name: Marta Rodriguez <br />Itle: (Office Administrator <br />Address: 11510 N. Parton Street <br />Iclty, stat", Zlp: Santa Ana, CA 92706 Phone: 714-542-6781 <br />[Em—aO..---Im—arta@saintpeterlutheran.net J Fax: <br />Name: Willard Nieghborhood Task Force - account with Charitable Ventures of OC (501c(3) - CVOC <br />`Ta*Exempt Status: Is your organization a non-profit or public tax-exempt organization as Select One: �❑ <br />(defined under Section 501(c)(3) of the Internal Revenue Code? ✓ Yes No <br />If No, you will only qualify fora credit for City-related costs for your request (le. permittees, If Yes, <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if Fcvoc-20-8756660 <br />approved, credit may or may not cover full cost of requested City services. ax ID M: <br />ServicesCredit c <br />Cmount Dte Needed, <br />Villegasity I . I <br />Requested: <br />Direct Payment Amount rIS � 500 <br />T %%^—T <br />Event Date: 9/13/2018 Event Ti,,.'v 1:00 rrl <br />Requested: <br />Event Lo"often: <br />St. Peter Evangelical Lutheran Church <br />Address, City, State, Zlp <br />1510 N. Parton St. Santa Ana, CA 92706 <br />announcement / ribbon cutting / celebration to kick off project for street topper <br />ooption of <br />F_ <br />signage for the Willard community. <br />)Purpose: <br />The Willard neighborhood is located next to beautiful Floral Park —&Washington Square both of which have <br />street topper signage. With Willards proximity to downtown, having their own street topper signage would <br />community Benefit: bring a sense of ownership and pride to the Willard residents. It would also help advance the city's efforts in <br />the "Love Where You Live" campaign and bring uniformity of style to this Santa Ana neighborhood. <br />A licant Signature: i <br />Mall: City Manager's Office-M-31 <br />20 Civic Center Plaza <br />Email: donationrequest@santa-ana.org <br />Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #: DR- <br />re(elarlOpVs council Meeting Date: <br />Roferonc¢ fl nu all _ _ <br />September 18, 2018 <br />Eligibility Met: YES / NO YES Approved Amount: <br />$1,500 <br />City Manager Signature; -'— Date: <br />/47 '_ Cf+....- J <br />Revised 01/05/2017 <br />EXHIBIT 4 <br />