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Wit' City of Santa Ana <br />Donation Request <br />%14111644 <br />city Meneger's office -- M-31 <br />20 Civic Center Plaza <br />P.D. Sox 1900 <br />Sante Ana, CA 82702 <br />1714) 647-6200 <br />e a <br />Name: Cub Johnson <br />_.. <br />Title: <br />CEO <br />Addross: 2518 San Miguel #2$4 <br />city, Siattt. zip: Newport Beach, CA 92660 <br />Phone: <br />714-476-8.151 <br />Line" debilI@icloud.coin <br />',Fax: <br />Name Second Chance Orange County <br />Tax-Exaroipt status: m your n-rofit or public tax-exetngt organization as <br />otgan,rabon a nop <br />' 9eleCt Ofle. <br />� <br />yes I I No <br />oecrvo umter Section. 501(c)(3) of Ine Interim Revenue Codev <br />� <br />rr<Vo. you ,III utygeaLiYto, acred,t for City -misted er>.vts for your ragGesflio permit tees. <br />If Yes, <br />staff time. renta"Tter, is, laCtl fres or egmPrtent etc 1 Costs hl Cory services vary ant d <br />z� ^ ^ w 224 39.�y <br />cmvea cilvdr 7a, or may not cover full cost of requesied Cty senaces <br />lax ID #:811224869 <br />; <br />ser <br />Cory ices Credit <br />tunt Requested: <br />Date Needed; MayortOnuncilmornber. 5010110 - I <br />Requested: <br />Direct Requested: $500 3500 Event Date. 9(12117 'Event Timo: r5Pt-Bpm-Bpr�m <br />Rigtustid: Y Y" <br />I Event Location; Lincoln Experience Center 199 Newport Center Drive, Newport Beach, CA 92660 <br />caress cosy State. Zip , <br />;Annual "More Second Chances" dinner to celebrate, honor, and recognize successful youth & <br />Description of <br />Event Purpose: ;adults that have overcome barriers, secured employment, and/or entered higher education. <br />I <br />FSecond Chance Orange County will continue to provide on-going services to youth and aduits in the <br />Community benefit: !following areas: job skills interview skills, coaching job placement, which will benefit the community by <br />providing financial sta ility. <br />JAppn:ant$tgnainrd b1 Date: 7131 f17 <br />i Ma1C City Menagerie Ofbca M-31 Email: donatianraquast@santa•ana.erg <br />20 Civic Center Plaza j Fax: (714) 647.6964 <br />P.O. box 1968 i ` <br />Santa Ana, CA 82702 1 l <br />donation Request #t <br />fFo(ararrtei 0 carr our forst, <br />EUglpilityMgt: <br />City Manager Signature; <br />DR- <br />YES/NO YES <br />Council Meeting Data: <br />Approved Amount <br />I <br />� trate: <br />Exhibit 1 <br />29A-3 <br />