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City of Santa Ana <br />Donation Request <br />City Manager's Office - M-31 <br />20 Civic Center Plaza <br />P.O. Box 1986 <br />Santa Ana, CA 92702 <br />(714) 647-5200 <br />Family/Community-oriented Movie Night. As Hoover is not a neighborhood <br />.Description of school, this will foster postive relationships with our parents. <br />Event I Purpose: <br />Bridge the connection between the school community and the Santiago Park <br />Community Benefit: neighborhood community. <br />Applicant signature: Date: November 23, 2016 <br />�etum completed form via: <br />Mail: City Manager's Office -M-31 Email: donationmquest@santa-ana.org <br />20 Civic Center Plaza Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 _ <br />Donation Request N� DR - - Council Meeting Date: <br />Eligibility Met: YES I NO Approved Amount: <br />City Manager Signature EXHIBIT 1 Date: <br />Revised 11/16/2015 <br />29E-3 <br />Contact information <br />Armando Gutierrez Title, <br />Principal _ <br />Name: <br />408 E. Santa Clara Ave. <br />Address: <br />Santa Ana, CA 92706 Phone: <br />(714) 564-2103 <br />city, state, zip: <br />armando.gutierrez@sausd.us Fax: <br />(714) 564-2199 <br />Email: <br />�Organization <br />Information <br />Name: Hoover Elementary School <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as Select One: <br />Code? <br />❑ <br />Yes No <br />defined under Section 501(c)(3) of the Internal Revenue <br />if No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, If Yes, <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if <br />approved, credit may or may not cover full cost of requested City services. Tax ID 9: <br />Donation <br />city Services Credit s 300.00 Date Needed: 02/02/2017 MayorlCouncilmember. <br />Amezcua <br />Amount Requested: <br />Direct Payment Amount $ Event Date: 02/02%2017 Event Time: <br />6:00 - 8:00 p.m. <br />Requested: <br />Hoover Elementary School <br />Event Location. <br />408 E. Santa Clara Ave., Santa Ana, CA 92706 <br />Adtlrcss, City, State, Zip <br />Family/Community-oriented Movie Night. As Hoover is not a neighborhood <br />.Description of school, this will foster postive relationships with our parents. <br />Event I Purpose: <br />Bridge the connection between the school community and the Santiago Park <br />Community Benefit: neighborhood community. <br />Applicant signature: Date: November 23, 2016 <br />�etum completed form via: <br />Mail: City Manager's Office -M-31 Email: donationmquest@santa-ana.org <br />20 Civic Center Plaza Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 _ <br />Donation Request N� DR - - Council Meeting Date: <br />Eligibility Met: YES I NO Approved Amount: <br />City Manager Signature EXHIBIT 1 Date: <br />Revised 11/16/2015 <br />29E-3 <br />