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RXHI BIT 1 <br />City of Santa Ana Clty Ma 2nager's Office - M-31 <br />0 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />a <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />Contact Information <br />Name: <br />Lee de Leon, Templo Calvario CDC (Love Santa Ana Initiative) <br />(Title: PresidentJCEO <br />Address: <br />12501 W. 5th St. <br />city, state, zip: <br />Santa Ana, CA 92703 <br />Phone: <br />1714.543.2399 <br />714.543.3711 <br />I---- <br />___F,l <br />a @tccdc.org <br />Pax: <br />Organizatio-n Information <br />Name: Templo Calvario Community Development Corporation <br />Tax - Exempt Status: Is your organization a non - profit or public tax- exempt organization as <br />defined under Section 501(c)(3) of the Internal Revenue Code? <br />�� <br />elect One: <br />W1 Yes ❑ No <br />If No, you will only qualify for a credit for City- related costs for your request (t.e, permit fees, <br />if Yes <br />staff time, remit rates for fay or equipment, etc.). Costs for City services vary and if <br />% 7-0601589 <br />not <br />approved, credit may or may not cover full cost of requested City services. <br />Tax ID #: . <br />r <br />Donation <br />is $ Date Needed: asap Benevidas <br />Cmounte I�' �� <br />IMaYorlCouncilmember: <br />mount Requested: I <br />Direct Payment Amount <br />$ 1 r� ®® <br />Event Date: <br />9/19/2015 <br />�� <br />Event Time: <br />7:30am- 12:OOprn��N <br />Requested: <br />Event Evans,City, on: <br />[Pico-Lowell Neighborhood <br />s, Clty, State, 21p <br />Ana Initiative mobilizes the faith community, residents non - profits and the business community to work <br />Description of <br />beauty, hope and transformation to some of the most challenged areas throughout the City. On Sept 19, <br />Funtd <br />Event /Purpose: <br />f volunteers will gather to help bring a community beautification serve day and resource fair to the <br />hborhood, <br />Community Benefit: <br />Neighborhood Clean U p, Learning Garden, Mural Restoration, Resource Fair <br />�A�t,l[cant Signature <br />" s Dtlte 5 <br />R , <br />. �(�0:�.0 <br />.., <br />Return completed form via: <br />Mall: City Manager's Office – M -31 <br />Email: donationrequest @santa - ana.org <br />20 Civic Center Plaza <br />Fax: (714) 647.6964 <br />P.O. Box 1986 <br />Santa Ana, CA 92702 <br />Donation Request* DR • <br />Council Meeting Date <br />kC'l0P OI,A� # Olt at7 lbidf ®i [)i� r'S <br />Eligibility Met YES / NO <br />Approved Amouni4 <br />City Manager Signature: <br />JJ Date: <br />- <br />25B-3 <br />-� — - <br />Revised 8/25/2015 <br />RXHI BIT 1 <br />