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City Manager's Office- M31 <br />cltr) <br />City of Santa Ana 20 Civic Center Plaza <br />Donation Request Santa P.O. <br />n , ca e27oz <br />(714) 047-5200 <br />M e q a a <br />$000 Date Needed: JUNE 2017 "Mayor/councnmember. Sarmiento <br />Name: Ot2ANGE COUNTY COMMUNITY FOUNDATION (for SAPAAL) <br />Tax -Exempt Status: Is your organizatlon a non-profit or public tax-exempt organization as <br />,defined under Section 501(c)(3) of the Interval Revenue Code? <br />selectone: � <br />YJ Yes ❑ <br />No <br />If No, you will only qualify for a credit for Ciry-related costs for your request ii. e. permit fees, <br />'If Yes, <br />staff time, rental miss for facilities or equipment, etc.). Costs for City services vary and if <br />�i 7 Q �? Q <br />3 <br />33-0378778 Q <br />approved, credit may or may not cover full cost of requested City services. <br />Tax ID #: J _O J 18 / v <br />city services credit <br />;Amount Requested: <br />$000 Date Needed: JUNE 2017 "Mayor/councnmember. Sarmiento <br />:Direct <br />e uestod ®fit Amount <br />__.. .. <br />(y 500.00 'Event Date: ;CONTINUOUS Event Time: :CONTINUOUS; <br />q <br />''.Event Location <br />12627 W. MCFADDEN AVE., SANTA ANA, CA 92704 <br />Address, Clty, State, Zip <br />Supplemental Santa Ana Police Athletic & Activity League program service <br />Description of <br />EventlPurpose: <br />delivery. (SAPAAL) <br />Direct service delivery of school, art, and program project supplies to <br />Community Benefit <br />approximately 200 at -risk Santa Ana youth. <br />Applicant Signature; ..�..-� Moate: -6/5/2017 <br />Mail: City Manager's Office -M-31 'Email: donationrequestssamaana.org <br />20 Civic Center Plaza "I Fax: (714) 047-0954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Dovt flkm Reqwst DR,. c., it„etingf4_r< JUNE 20, 2017 <br />F imp , tp M"L Y11 --S i N1C YES r4idq., .eQ,n'rso,tnt $5500 <br />. <br />laY t( ti Cr ll}t'£Lff9- Dal, <br />Revised 11/18/2015 <br />29-A111 <br />