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City Manager's Office — M -31 <br />City of Santa Ana 20 Civic Center Plaza <br />` Donation Request P.O. Box 1988 <br />-` Santa Ana, CA 92702 <br />,y,_ <br />(714) 647 -5200 <br />Contact Information <br />Name, <br />rPaul Nagel title: Project Director <br />atlrass: <br />811 N. Main St. T <br />ity, state, zip: <br />Santa Ana <br />Pbone: (714) <br />213 -0654 <br />Email: <br />paul @thebicycletree.org <br />fFax: f <br />Organization <br />Name: Social and Environmental Entrepreneurs - The Bicycle Tree <br />Tax- Exempt Status: Is your organization a non - pro fit or public tax - exe organiza <br />mpt tion as <br />defined under Section 501(c)(3) of the Internal Revenue Code? <br />el <br />elect One: <br />W� <br />Yes ❑ No <br />If No, you will only qualify fora credit for City - related costs for your request (i.e. permit fees, <br />^T <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if <br />raxeO <br />95- 4116679 <br />approved, credit may or may not cover full cost of requested City services. <br />: <br />Donation <br />Ci ty Services Credit <br />mount Requested: <br />$ ]2Q,QQ Date Needed: <br />( <br />4/25/16 <br />�' <br />rIMa or /Councilmember: <br />l Y <br />Martinez <br />Direct Payment Amount <br />Ir� <br />Event Date: <br />l�6/11/16 <br />�r2 <br />Event Time: <br />6 m <br />p <br />Requested: <br />g -fT � Main St, Santa Ana, -C'A 927O'i <br />vant uocaeon: <br />[Address, <br />City, State, Z(p <br />We will be having a modestly -sized event with live amplified acoustic music and booths for <br />Description of <br />local organizations in celebration of The Bicycle Tree's ten year anniversary. The amount <br />Event 1 Purpose: <br />requested will go toward the Planning Division's Land Use Certificate fee (Category 2) and <br />Police /Fire Dept. fees. Music will be performed on enclosed patio, booths in parking lot. <br />�— <br />We are a volunteer - powered nonprofit working together to make Orange County a better place to be a bicyclist. We do <br />Community Benefit: <br />this is by helping bicyclists fix their own bikes, teaching bike repair, maintenance, and other bike - related subjects in our <br />classes, advocating locally for bike - friendly infrastructure, donating bikes to those in need, a variety of fun activities <br />it group rides, and our Wrench & Ride bike education program. <br />Applicant Signature. <br />�1,1LL �lQ� <br />(Date: 4 -19 -16 <br />Retum completed via- <br />Mail: City Manager's Office —M -31 <br />Email: tlonationrequest @santa- ana.org W <br />20 Civic Center Plaza <br />Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #:_ <br />Council Meeting Date: <br />Reference tt on aq related Ory <br />Eligibility Met: YES / NO Approved Amount: <br />__.- --- <br />City Manager Signature: ( _ Date <br />III <br />EXHIBIT 1 Revised 1 111 612 01 5 <br />'loll <br />