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29A - AGMTS DONATION
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29A - AGMTS DONATION
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Last modified
1/14/2019 10:00:35 AM
Creation date
12/13/2018 8:28:58 PM
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City Clerk
Doc Type
Agenda Packet
Agency
City Council
Item #
29A
Date
12/18/2018
Destruction Year
2023
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City of Santa Ana City Manager's Office - td -81 <br />City <br />20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />Santa Ana, CA <br />92702 <br />(714) 647-5200 <br />lNam' —e, Pe b Johnson itle, <br />Adele:e: 12618 San Miguel Drive #284 <br />(City, State, zip: I Newport Beach, CA 92660 Phone: <br />Emalr l: idebjll@icloud.com Fax: <br />o , <br />Name: <br />SECOND CHANCE Orange County <br />Tax -Exempt Status: Is your organizationa non-profit or public tax-exempt organization as Select One: <br />defined under Section 501(c)(3) of the Internal Revenue Code? I <br />If <br />I Yes ❑ No <br />It No, you will only qualify for a cmdd for Cily-related costs for your request it. e, permit tees, lyes, <br />Istafftime, rental rates tar facilities or equipment etc.). for City services vary and i7 <br />81-1224869 <br />,approvetl, credit mayor maynorwver /u8 cost olrequestetl City services. ax ID A: <br />I, <br />. <br />@yServicC� ssCredd I jI� �— Vllle aS <br />a[e Needed: g <br />Pmount Requested: IS i Mayor/Councllmember: I <br />Amount F$5-001 <br />Event Date: Event Time: <br />:Directayment <br />Requested: <br />FEvent Location: <br />Atltlress. City, State. Zip 1 <br />He1p augment our CDBG grant in-S.A. to pay e for thgap in the program budget, <br />Description of we applied for more than twice the mount we received, and we have already <br />a <br />Event I Purpose: reached the number of S.A. residents in 4 months that we can serve. <br />Economic value, these S.A. homeless or or �ecovenng rugrug a ca -o -o addicts no <br />community Benefit: longer use public services, we provide training, coaching/mentoring and we get <br />jthem jobs, they pay taxes and they are no longer on the streets. They become <br />� � <br />�r- <br />ApplicantSignature �)Date: (NOVEMBER 1, 2018 <br />Mall: City Manager's Office -M-31 Email: donationrequest@sanua na.org <br />20 Civic Center Plaza Fax: (714) 647b954 <br />P.O. Box 1988 <br />j Santa Ana, CA 92702 <br />j Donation Request�R- <br />en, .. n r. Council Meeting Date: 12 <br />j <br />Eligibility Met: YES INO Yes Approved Amount$5O' 0 <br />City Manager Signature: — - - -- _ - — -- - - — Data. <br />Revised 0110512017 <br />EXHIBIT 7 <br />29A-32 <br />
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