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PROPOSER APPLICATION <br />Agency Legal Name <br />City of Santa Ana <br />Agency DBA <br />Santa Ana WORK Center <br />Program Name <br />STEM Career Awareness Program <br />Program Address <br />1000 E. Santa Ana boulevard, Suite 200 Santa Ana, CA 92701 <br />Corporate Office Address <br />Contact Person & Title <br />Oberman Linda — Economic Development Manager <br />Email <br />LOberman@santa-ana.org <br />Telephone # <br />(714) 565-2622 <br />Fax # <br />(714) 565-2602 <br />Federal ID Number <br />95-6000785 <br />AGENCYSTATUS <br />Public Non -Profit <br />Co oration <br />Private Non -Profit <br />Years in Operation? <br />30 <br />Private for Profit <br />Government <br />I X <br />Other <br />PRIMARY FUNDING SOURCES <br />Funding Source <br />WIA-Youth <br />WIA-Adult <br />SSA <br />Amount <br />$321,355 <br />$2,650,000 <br />600,000 <br />HOURS OF OPERATION AND DAYS <br />Days <br />Monday <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />Sunday <br />Hours <br />7:00am- <br />5:30pm <br />7:OOam- <br />5:30pm <br />7:OOam- <br />5:30pm <br />7:OOam- <br />5:30pm <br />8:00am- <br />1.5:00pm <br />Closed <br />Closed <br />TARGET POPULATION <br />Older Youth ✓ Younger Youth ✓ Out -of -School ✓ In -School ✓ <br /># of Youth to be Served in 2013-2014 20 Total WIA Funds Requested $170,000 <br />In compliance with the RFP noted above, and subject to the conditions thereof, the undersigned offers to furnish <br />the services stipulated and certifies he has read, understands, and agrees to all terms, conditions, and <br />requirements of tlhiis,RFP and is uthorized to contract on behalf of the agency named above. <br />4Ai� WAND N Economic Development Manager ( /:3 <br />Signature Title Date <br />