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City of Santa Ana <br />Donation Request <br />City Manager's Office - M-31 <br />20 Civic Center Plaza <br />Y.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647-,5200 <br />,Name: :Felipe Guerrero Inns: Mr. <br />Address: 204 N.Susan Street <br />city, state, zip: 'Santa Ana, CA 92703 Phone: (714) 265-2071 <br />;Email: godfnano@aol.com Fax: <br />_ -- - - <br />Name: (Santa Anita Neighborhood - account with Charitable Ventures of OC (501(c)(3) - CVOC <br />Tax•Exompt Status: Is your organization a non-profit or public tax-exempt organization as select One: <br />;defined under Section 501(c)(3) of the Internal Revenue Code? a Yes ® No <br />approved, credit may or may notcoveucostofrequestedCityservices, vary If Yes, <br />If o, you w l on y qua 1 ore credit or City -re ate costs ar your request (i.e. permit fees, <br />staff time, rental rates for facilities or equipment, etc. ,Costs for Cif services and if <br />Tax ID tt: CVOC-LO-$756660 <br />!city Services Credit <br />Amount Requested: <br />$ Date Needed: ,June 1, 2016 MayodCouncilmember: (Rayne <br />Direct Payment Amount <br />$1 000 !Event Date: :June 17, 2016 jEvent Time: 6 pm - 9 pm <br />(Requested: <br />, <br />!Event Location: <br />,Santa Anita Park - 300 S. Figueroa Street SA,CA 92703 <br />Address, City, State, Zip <br />i <br />iSeries of summer of 2016 movie nights for Santa Anita community inclulding borrowing city <br />of <br />!movie equipment when possible and / or renting movie equipment- including the Santa Ana <br />(�Description <br />Event t Purpose: <br />showmobile from Parks and Recreation.. <br />The Santa Anita Neighborhood Association has been working with community orgranizations in our area including the <br />!Community Benefit: <br />'parent group at Russell Elementary to bring residents together, A series of three summer movie nights are planned to <br />�provide <br />a wonderful opportunity forSanta Anita families to come out and get to know each other better. Our initial movie <br />;night is planned for June 17th with additional movie nights on July 15th and August 12th. <br />,Applicant Signature: <br />pate: <br />e e a• r <br />a <br />Mail: City Manager's Office —M-31 �Emall: donationrequest@santa-ana,org I <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />'.P.O, Box 1988 <br />, <br />Santa Ana, CA 92702 <br />Donation Racpwst fl DR ,. _ <br />L ,r «., k wr ,. r��ery cr fiPN Counad Meting Data: <br />FliglbUlcy Mete YES INO Appiovrd ,A,mou`c <br />ci+ y Mlanage r Sjgnatw'e; [iatN, <br />Exhibit, I <br />2 R A - S Revised 11/16/2015 <br />