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s; City of Santa Ana <br />&Donation Request <br />City Manager's Office _ M•31 <br />20 Civic Center Playa <br />P.o. Box 1908 <br />Santa Ana, CA 92702 <br />(714) 647 -5200 <br />,Contact m <br />Name: Chris Schmidt Title: ':;President <br />'Address: 1;1117 S. Arapaho Dr. <br />'City, state, zip: Santa Ana, CA. 92704 Phone: 714- 724 -5466 <br />Email: chris714oc @gmail.com Fax: <br />iNamer ',Windsor Village Neighborhood Association (Charitable Ventures OC) <br />Tax - Exempt Status: Is your organization a non - profit or public tax - exempt organization as <br />'Idefined under Section 501(c)(3) of the internal Revenue Code? Selont One: W1 Yes ❑ No <br />i 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 20-8756660 G <br />approved. credit may or may not cover full cost of requested City services. Tax ID #: <br />,City Services Credit <br />Amount Requested: $ 'Date Needed; May 10, 2017.,Mayor /Counclimember: Pulido <br />`Requ sled: Payment Amount t500100 :Event Date: May 13,2017 ,Event Time: :9 cam - 12 am <br />;Requested: � . <br />Event Location: Windsor Village Neighborhood and Jackson Elementary School <br />IAddrass. City state. Zip ';1143 S Nakoma or, Santa Ana, CA 92704 <br />Orange County Fire Authority will be holding a free fire alarm installation event to install fire alarms In <br />Description of the 500+ house in our neighborhood. OCFA partners with Red Cross and other groups who volunteer <br />Event 1 Purpose: ! to participate in the event. We are requesting a donation to provide food to the volunteers. <br />Almost two- thirds of all home fire deaths occur in homes with no working smoke alarm. By providing and <br />'Community Benefit: !.. installing free film alarms, we will help reduce the amount of deaths in homes. - <br />Applicant Signature: „»pate: March 31, 2017 <br />Mail: City Manager's Office —M-31 Email donationrequest @ santa-ana.org <br />20 Civic Center Plaza Pax: (714) 647- 8954 '.. <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Oon;ittoa rr,tursat R <br />DR <br />May 2, 2017 <br />YES $500 <br />:iryr flan u, - 3ipnuiur¢. i;t£. <br />Revised 01/05/2017 <br />Exhibit 1 <br />29A -3 <br />