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PROPOSER APPLICATION <br />Agency Legal Name <br />Orange County Asian and Pacific Islander Community Alliance, Inc. <br />Agency DBA <br />OC Workforce <br />Program Name <br />Youth Employment Program <br />Agency Address <br />12900 Garden Grove Blvd., Suite 214A <br />Contact Person & Title <br />Mary Anne Foo, Executive Director <br />Email <br />mafoo @ocapica.org <br />Telephone # <br />714- 636 -9095 <br />Fax # <br />714- 636 -8828 <br />Federal ID Number <br />91- 2047245 <br />AGENCYSTATUS <br />Public Non -Profit <br />OC Health Care <br />Cor oration <br />OC Workforce <br />Private Non -Profit <br />x <br />Years in Operation? <br />17 <br />Private for Profit <br />Investment <br />Government <br />Foundation of <br />Other <br />FSP <br />PRIMARY FUNDING SOURCES <br />Funding Source <br />OC Health Care <br />US DHHS <br />OC Workforce <br />OC Health Care <br />College Access <br />Saturday <br />Agency MHSA <br />Office of <br />Investment <br />Agency PEI <br />Foundation of <br />9AM -6PM <br />FSP <br />Minority <br />Board <br />California <br />Health <br />Amount <br />$1,000,000 <br />$191,000 <br />$877,500 <br />$426,208 <br />$180,000 <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 />9AM -6PM <br />9AM -6PM <br />9AM -6PM <br />9AM -6PM <br />9AM -6PM <br />TARGET POPULATION <br />Older Youth 10 Younger Youth 1 15 Out -of- School 10 In- School 15 <br /># of Youth to be Served in 2013/2014 125 1 Total WIA Funds Requested 1 $136,400 <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 this RFP and is authorized to contract on behalf of the agency named above. <br />Signature Title Executive Director Date <br />EXHIBIT A <br />25A -22 <br />