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'. City of Santa Ana <br />— Donation Request <br />City Manager's Office— M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />Contaetlnformatori -� - - - '- <br />• <br />Name: David Poole Itle: Treasurer <br />Pddres� s: PO Box 1256 <br />city, state, zip: I Santa Ana, CA 92701 (Phone: 714-558-1921 <br />Email: david@poolefosterdul.com Fax: 714-558-1626 <br />IName: ISanta Ana Kiwanis Club Foundation <br />Tax -Exempt status: Is your organization a non-profit or public tax-exempt organization as <br />efined under Section 501(c)(3) of the Internal Revenue Code? elect One:W] Yes ❑ No <br />will only qualify for a credit for City -related costs for your request (i.e. permit fees, f yes, <br />rental rates for facilities or equipment, etc.). Costs for City services very and if <br />credit may or may not cover full cost of requested City services. ax ID #: <br />956060395 <br />Donatitiri;Request�u� --s, —'-- —' '. _'_ ,�.'.y-e__ . -• _ _ __. _ _ - . _, <br />City Services Credit <br />mount Requested: <br />JOO Date Needed: <br />���� <br />10-15-17 <br />MayarlCouncilmemher: <br />Solaria <br />Direct Payment Amount <br />Requested: <br />Event Date: 12-13-17 Event Time: r� nnnn <br />9Atvt <br />Approved Amount: <br />$$00 <br />Event Location: <br />Address, City, State, Zip <br />Target Store 3300 S Bristol, Santa Ana, CA 92704 <br />Dale: <br />Description of <br />2017 Holiday Shopping Spree - Buying Holiday gifts for very needy children <br />Event/ Purpose: <br />F,imeenent: <br />We sponsor a holiday shopping event for needy children from several elementary <br />schools in Santa Ana. The children shop for family gifts, $100 each. <br />Applicant Signature: <br />F��i%t.(d d /(70 10-3-17 <br />Mall: City Manager's Office—M-31 Email: donationrequest@santaana.org <br />20 Civic Center Plaza Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />:; ru t1l-l�altl�` <br />Donation RequestP.Date: <br />Reference R on all total.I ed HPVs <br />DR - <br />il M <br />Council 9 <br />NOVEMBER 7, 2017 <br />Eligibility Met: <br />YES I NO YES <br />Approved Amount: <br />$$00 <br />City Manager Signature: <br />Dale: <br />Revised 01/05/2017 <br />29A-19 <br />