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City of Santa Ana, CA
<br />Parks, Recreation, and Community Services Agency
<br />20 Civic Center Plaza, P.O, Box 1988
<br />Santa Ana, CA 92702
<br />714-647-5307
<br />CivleReoeA@aania.ana.org
<br />hitp://www.sante-ana.org
<br />Registration/Payment Receipt 11671433
<br />10/1712018 11:23 AM
<br />Account Information Payment
<br />Mountainviaw Real Estate Investment Check $104.96
<br />LLC. (#1005)
<br />Long Nguyen
<br />8821 Seaspray Drive
<br />Huntington Beach, CA 92646
<br />Received By
<br />Lllda Hernandez at Salgado Center
<br />Complex
<br />Item Quantity Amount Paid
<br />(01113002-57361) Salgado Center Complex Meeting Room A (Multi -Purpose 1.00 $80.78
<br />Room) Oct 16, 2018 5:00 PM-6:00 PM - Group 3: $60.781Hour- PERMIT #3828
<br />(01113002-53319) (1/2 fir) Staff Fees 2.00 - � $24„18
<br />Subtotal $104.96
<br />Total Payment $104.96
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<br />Facility Waiver
<br />Parks, Recreation and Community Services Agency, 20 Civic Center Plaza, 2nd Floor, P.O. Box 1988, Santa Ana,
<br />CA 92702 — M-23 herby grants (hereinafter called the "Licensee"
<br />represented by permission to use the Facilities as outlined, subject to Terms and
<br />Conditions of this Agreement contain herein and attached here to all of which form part of this Agreement.
<br />It Is the Permitte's responsibility to provide a copy of the this permit to each facility user or coach that uses the
<br />facility. The facility user or coach must present this permit to City representatives when requested to do so to
<br />Identify themselves as the authorized user of the facility.
<br />Permlttee agrees to and shall Indemnify and hold harmless the City, its officers, agents, employees, consultants,
<br />special counsel, and representatives from liability, (1) for personal Injury, damages, or restitution, arising out of
<br />claims for personal Injury, including death, and claims for property damage, which may arise from the negligence
<br />or willful misconduct of the permittee and guest or its agents, employees, or other persons acting on their behalf
<br />which relates to the Permit granted herein; and (2) form any claim that personal Injury, damages, or restitution, Is
<br />due by reason of the terms of or effects arising from this Permit. This Indemnity and hold harmless agreement
<br />applies to all claims for damages, or restitution suffered, or alleged to have been suffered, by reason of the events
<br />referred to In this Section
<br />75D-161
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