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City Managthr�s Office — M-31 <br />City of Santa Ana 20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />0 <br />Santa Ana, CA 92702 <br />(714) 647-5200 <br />IRev. Wesley M <br />,Namw. anke "Title. Pastor <br />lAddress; 11510 N. Parton Street <br />City, State, Zip: jSanta Ana, CA 92706 'Phone: 714-542-6781 <br />J <br />'Elarl . ....... loffice@saintpeterlutheran.net Fax: <br />Name: ISt Peter Evangelical Lutheran Church Charitable Ventures of CIC (fiscal sponsor) <br />1 Tax-Exempt Status: Is your organization a non-inclit or public tax-exempt organization as r <br />,4efined under Section 501(c)(3) of the Internal Revenue Code? Select One: Yes No <br />If No, you will only qualify for a credit for City-related costs for your request (i.e. pentrat fees, <br />Ffy-11. [;Q1 <br />staff time, rental rates for facilities or equipment, etc.).Costs for City semices vary and if I Gr- 41 Cl 9; Q1 R R <br />'approved, credit may or may not cover full cost of requested City services. I as I u a: a �Wwww <br />Charitable Ventures of OC TaxlD#20-8756660 <br />137 "117 Mirmr M, I <br />'City San dcas Credit $ Date Needed- <br />Me dC ... ilmember: <br />!Villages <br />Arr�ount Requested <br />Direct Payment Amount <br />S 1500 EventDate: 16/3/2017 Eventrime: !8:00 am - 12:00 pm <br />,�equested: i 11 <br />Event Location: <br />1510 N. Parton St, Santa Ana, CA 92706 <br />Address, City, Sf <br />n. is a large population of sucat chas and foodl�Ck vandurai in line lffilard community increasing to amount of trier deposited appeighout ffi. neignboahood. <br />VVilland Cl..-U, Day is hard 0 atc,port the cornmirt, Vokontseus am vi Mordants �alk through the Wilardi cammunity and Pick UP liner in M parlaso <br />Description of sid"alks. Roll off dumpsters WR be suelatte for [he comossurity for large balky item disposal. The IN11anal community has four trach Which words made available by <br />Event/ Purpose: lway at a Donation Romueat granted by council monatuar Rayne. The Mh cal have been a huge success. Addiflonal sponsors am requourtung to Manage <br />I additional inch cans. This doruvon �ld make it possible to purchase four additional vash cans for due Vvilind community. <br />— --- --- --------- <br />11-FUITIoting a litter-free neighborhood and encouraging the community to take <br />I <br />community Benefit: 'pride in a clean neighborhood will greatly benefit the community. <br />--A --,A-- <br />----------- <br />............ <br />Mall: City Marl Office —M-31 jErnail: donationrequest@santa-ana.org <br />al,210 <br />Civic Center Plaza Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />�Donatliimftqluo�t#: <br />Ratirarnie 4 Go all related opvs� <br />DIR-, _Mr <br />qo6ifell Meeting Date: ay'i 6, 2017 <br />Eli6ibility Met: <br />YES I NO YES <br />Approved Amount: - <br />$1.500 <br />City Manager Signature: <br />Date: <br />PYHIRIT I Revised 0110512017 <br />W1 M-isill <br />