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Name: Dr. Ana Jimenez -Hama hlo; Executive Director
<br />[ cldrose: 12215 North Broadway
<br />Iclty, state, zip: Isanta Ana, CA 92706 Phone; 714 - 547 -5466
<br />Eman; ana @occtac.org Fax: 714 - 564 -9690
<br />(Name: IOrange County Children's Therapeutic ARTS Center
<br />Tax- Exempt Status: Is your organization a non - profit or public tax - exempt organization as elect One:
<br />d' efined under Section 501(c)(3) of the Internal Revenue Code? � F'Z Yes �❑ No
<br />ll No, you will only qualify for a credit for City - related costs far your request 6.e. permit fees, f Yes, Q Q
<br />tall time, rental rates forfacllltfes or equipment, etc.), Costs for City services vary and if 3 e.? ®9 3 ®8 9
<br />+
<br />�
<br />Ipproved, credit may ormaynot coverfullcost of requested Cityservices. ax IDM
<br />City Services Credit ,I�
<br />ate Needed:
<br />[June 9, 2016
<br />5
<br />r °�,,
<br />4iity Of Santa Iona
<br />City
<br />City Managor's Office- M -21
<br />20 Civic Center Plaza
<br />,r { �`
<br />Donation Request
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
<br />,s
<br />�'�"
<br />Direct Payment Amount �—QOQ
<br />'41
<br />l 647.5200
<br />Name: Dr. Ana Jimenez -Hama hlo; Executive Director
<br />[ cldrose: 12215 North Broadway
<br />Iclty, state, zip: Isanta Ana, CA 92706 Phone; 714 - 547 -5466
<br />Eman; ana @occtac.org Fax: 714 - 564 -9690
<br />(Name: IOrange County Children's Therapeutic ARTS Center
<br />Tax- Exempt Status: Is your organization a non - profit or public tax - exempt organization as elect One:
<br />d' efined under Section 501(c)(3) of the Internal Revenue Code? � F'Z Yes �❑ No
<br />ll No, you will only qualify for a credit for City - related costs far your request 6.e. permit fees, f Yes, Q Q
<br />tall time, rental rates forfacllltfes or equipment, etc.), Costs for City services vary and if 3 e.? ®9 3 ®8 9
<br />+
<br />�
<br />Ipproved, credit may ormaynot coverfullcost of requested Cityservices. ax IDM
<br />City Services Credit ,I�
<br />ate Needed:
<br />[June 9, 2016
<br />IMayorlCOUnollmombor:
<br />Sarmiento
<br />mount Requested:
<br />Donation Request #:
<br />DR
<br />Direct Payment Amount �—QOQ
<br />'41
<br />Event Dato:
<br />Jun @9 2016
<br />,
<br />Event Time:
<br />6:00 pm
<br />Requested: +
<br />Eligibility Met:
<br />YES / NO
<br />Approved Amount:
<br />F t l.ocatloru
<br />ss, City, State, Zip
<br />The Estate Building In Downtown Santa Ana - 207 West Second Street, Santa Ana, CA 92701
<br />Date:
<br />A celebration of Santa Ana students Art work and professional artists in the heart of Downtown, Santa Ana Artist M(lagel
<br />Description of
<br />Elementary and Middle school students from the Santa Ana Unified School Dlstrictwlll exhibit their Artwork and share their
<br />Events Purpose:
<br />artlstic efforts throughout the yeanvlth their parents, family members, friends and the Santa Ana community. Professional
<br />Artists will also exhibit their work to motivate and Inspire students to continue learning and reach for higher standards.
<br />me cityof Santa Me laavibrantANstta mmmuni(yvAes many pmlesslw+et anisls. sanfa Ma also has many talented youth wdstsl This evontvAl celebrate Me An
<br />ammpilshm4nls of Snout Ana youth, and pobillvely hnpauthelr solhasteern, pride and self- confidenw. Students will be exated to share Near MwontwlW Vselr parents,
<br />Community Benefit:
<br />femdy members and the communib. In eddiabn, youN will lean nom pmfamlonalards1s and be Nsplred by Nalrwark tpo.F,nt,mwre, this is an exnelknt edurat.nal
<br />expedenm for parents not only to sea Nelr students work, but also vim professional anwark. Many famlllas Nat No N Santa Me havo Run eayosu a to pmfesslonal a hibits
<br />end Mll leamto value this Atl loan. nna ^y, Nis isa9r¢ aI OPPSMnllybinlogmt ®boN NO Pubstz wmmuruly with ouraanta Ma /amities)
<br />Applidant Signglura:
<br />°
<br />l r a:
<br />f_
<br />(Mal- City Manager's Office -M -31 Email: donalionreguest @sanfa- ana.org
<br />20 Civic Center Plaza Pax; (714) 647 -6964
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
<br />Revised 11/16/2015
<br />EXHI IT 1
<br />25-3
<br />r
<br />"'>Y
<br />iata`IRrM1l�
<br />. .,
<br />rdn, ate, 2a
<br />° r dare
<br />Donation Request #:
<br />DR
<br />Council Meeting bate:
<br />Reference 0 on all related OWs
<br />Eligibility Met:
<br />YES / NO
<br />Approved Amount:
<br />City Manager Signature:
<br />Date:
<br />Revised 11/16/2015
<br />EXHI IT 1
<br />25-3
<br />
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