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PROPOSER APPLICATION <br />Agency Legal Name <br />Taller San Jose <br />Agency DBA <br />James Irvine <br />Program Name <br />Workforce Training for At -Risk Youth <br />Program Address <br />801 North Broadway, Santa Ana, CA 92701 <br />Corporate Office Address <br />Foundation <br />Contact Person & Title <br />Shawna Smith, CEO /Executive Director <br />Email <br />ssmith@tallersaniose . ora <br />Telephone # <br />(714) 543 -5105, ext, 109 <br />Fax # <br />(714) 543 -5032 <br />Federal ID Number <br />59- 3816355 <br />AGENCYSTATUS <br />Public Non - Profit <br />Cedar <br />Corporation <br />James Irvine <br />Private Non - Profit <br />X <br />Years in Operation. <br />18 <br />Private for Profit <br />Foundation <br />Government <br />Chase <br />Other <br />8:30 -5:00 <br />PRIMARY FUNDING SOURCES <br />Funding Source <br />Cedar <br />Edna <br />James Irvine <br />REDF <br />JP Morgan <br />Saturday <br />Foundation <br />McConnell <br />Foundation <br />8:30 -5:00 <br />Chase <br />8:30 -5:00 <br />8:30 -5:00 <br />Clark <br />Foundation <br />Foundation <br />Amount <br />$225,000 <br />$220,000 <br />$150,000 <br />$150,000 <br />$95,000 <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 />8:30 -5:00 <br />8:30 -5:00 <br />8:30 -5:00 <br />8:30 -5:00 <br />8:30 -5:00 <br />TARGET POPULATION <br />Older Youth X Younger Youth Out -of- School X In- School <br /># of Youth to be Served in 2014 -2015 <br />10 <br />Total WIA Funds <br />$80,000 <br />Requested <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 />57 [/ <br />Signature Title Date <br />EXHIBIT A <br />