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C) <br />City Manager's Office - M-31 <br />...,,,,+ City of Santa Ana 20 Civic Center Plaza <br />] r' Donation Request P.O. Box 1988 <br />u, ' Santa Ana, CA 92702 <br />(714) 647.5200 <br />Name: Felipe Guerrero <br />Address: 1204 N. Susan Street <br />_ _.__ <br />'City, state, zip: Santa Ana, CA 92703 <br />Email: 1 godfnano@aol.com <br />Title: President <br />Phone: 714-265-2071 <br />I <br />'Fax: <br />Name: (Santa Anita Neighborhood Association <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as select One:� <br />!defined under Section 501(c)(3) of the Internal Revenue Code? i I Yes V I No <br />l� <br />1 If No, you will only qualify for a credit for City -related costs for your request (1. e. permit fees, - - - - <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if <br />!if Yes, <br />approved, credit may or may not cover full cost of requested City services. iTax ID #: i <br />i <br />lCdy, Services Credit $ 500 !Date Needed (08/15/2017 EMayor/Councilmember Vlllegas <br />Amount Requested: <br />(Direct Payment Amount i$ Event Date. 109/16/2017 Event Time: 9am-1 1 a <br />1,Requested: <br />'Event Location. Cesar Chavez Campesino Park 3311 W. 5th Street, Santa Ana, CA 92703 <br />'Address, City, State, Zip <br />F..__ ..._ <br />(Description of ;Graffiti Paint Out and Community Clean -Up at Campesino Park and surrounding <br />Event I Purpose: 1 neighborhood. <br />I i <br />Approximately 50 volunteers will work together on 9/16/17 to paint out graffiti and clean the community <br />Community Benefit: Inear Campesino Park to show community pride. The City service credit will cover the cost of materials. <br />'Applicant Signature; Milne que17 aU, !Date; ; 07/1 420 1 7 <br />Mail: City Manager's Office - M-31 Email: donationrequest@santa-ana.org j <br />1 20 Civic Center Plaza 'I Fax: (714) 647-6954 <br />P.O. Box 1988 <br />1 Santa Ana, CA 92702 <br />Donation Re quest 4: OR-, AUGUST 1, 2017 <br />i +tae ear+:e7� r.rt ni ,etatatl Df"S'n <br />Council Meeting Date: <br />i <br />Eligibility Met: YES /NO YES ',, Approved Amount: $500'I <br />I City Manager Signature: onto: <br />Revised 01 /05/2017 <br />