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City Manager's Office — M-39 <br />Ana <br />City of Santa 20 Civic Center Plaza <br />0P.O. Box 1988 <br />®OYlaffOf9 frBG'Ue5% Santa Ana, CA 92702 <br />(714) 647-5200 <br />o a a <br />Name:arla SandOVal 'Iritle President '..I <br />[Address: 5009 W Sixth St. <br />Gity, state z,p: I Santa Ana, CA 92703 iPhone: (714-791-9274 <br />, <br />Fri 'm1 m sandova1201371@gmail.c0m jPax.� <br />Name: Rivervlew West N,A. (Charitable Ventures OC)I <br />Tax-Exempt Status; Is your organlzation a non-profit or public tax-exempt organization as Select One: <br />defined under Section 501(c)(3) of the Internal Revenue Code? Yes No <br />If No, you will only quality for a credit for Cit -related costs for our request (i.e. permit fees, <br />Y a q fl' Y Y IF Yes, <br />staff time, rental rates for fay not orequipment, fort' services, vary and if �20-8756660 <br />cost <br />approved, credit may or may not cover full cost of requested qty services. ax ID #: <br />KIM= <br />C,ty Services Credit .$500.00 <br />mount Requested: <br />Date Needed., .tune 30 (Mayor/Counciimember: Sotorio <br />Direct PaymentAmount� <br />Requested <br />Is IS Date: JUNE 30 (Event Time: AFTER-BUSK <br />FEvent Locatlon <br />Address, Gity State, Zip <br />[R�ta Park (Newhope and Hazard, Santa Ana, CA. 92703) _ <br />j <br />:, <br />Movie Night in the park for the community. Money will be used for park <br />Description <br />Description of <br />Purpose: - <br />reservation and movie licensing fees. <br />f c°mm°mtyBeneti°` <br />The community and local schools will be invited to attend the Movie Night and <br />enjoy Rosita Park. <br />lic t.Sr nature:.- <br />PP�ar-� r'4ar iw �(e�a S <br />S -k'4 ¢` r mt ,* xN s c?-,.n avr ,g• <br />a a e <br />Mail: City Manager's Office—M-31 Email: donatlonrequest@samo-ana.org <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />01 <br />Donation Request.#: OR -_ Connell Meeting Date: ,JUNE 20, 2017 <br />Reverence # on all.rehted 0PVs - - - <br />T <br />Eilgibllity Met YES I NO YES '- - Approved Amount $500 <br />1 <br />City Manager Signature. - bate: <br />Revised 01/05/2017 <br />29A147 <br />