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-`$` City Manager's Office M-31 y City of Santa Ana 20 Civic Center Plaza i Donation Request P.O. Box 1988 ,�.L_� Santa Ana, CA 92702 -- (714) 647.5200 Name: Centro Cultural de Mexico en el Condado de Orange Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as I,� ❑ ❑ I Select One: Yes No defined under Section 501(c)(3) of the Internal Revenue Code? � i If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, If Yes, staff time, rental rates forfacilities or equipment,etc.).Costs for City services vary and if F33-0614169 approved, credit may or may not cover full cost of requested City services. ax ID #:— -J Name:Karen Sarabia itle: Executive Director Address: 837 N Ross aty, State, zip: Santa Ana, Ca 92701 Phone: 949 205 3954 Email: karen@elcentroculturaldemexico.org IFax:- Event Location: 4th Street and Birch Name: Centro Cultural de Mexico en el Condado de Orange Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as I,� ❑ ❑ I Select One: Yes No defined under Section 501(c)(3) of the Internal Revenue Code? � i If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, If Yes, staff time, rental rates forfacilities or equipment,etc.).Costs for City services vary and if F33-0614169 approved, credit may or may not cover full cost of requested City services. ax ID #:— -J Mail: City Manager's Office -M-31 Email: donationrequest@santa-ana.org 20 Civic Center Plaza Fax: (714) 647-6954 P.O. Box 1988 Santa Ana, CA 92702 j Q� 71F�; tPlrjSit City Services Credit $ Date Needed: 11 /04/2017 Amount Requested: ,�� MaycrlCouncilmember.l Benavides - Direct Payment Amount g 800 Event Date: 11 /04/2017 Event Time: 1:00 PM 'Requested_ 'Fs �� - -- — _ — - YES / NO YES Approved Amount: Event Location: 4th Street and Birch Address, City, State, Zip Santa Ana.Ca-92701 _ Description of Noche de Altares is a community celebration of Day of the Dead that reflects Event/Purpose: Mexican tradition and how it lives on in our communities today. 0 For one night, community members, nonprofits, local vendors and artists are Community Benefit: invited celebrate the memory of loved ones or bring awareness social issues. 'Applicant Signature:`` Date: 10/04/2017 Mail: City Manager's Office -M-31 Email: donationrequest@santa-ana.org 20 Civic Center Plaza Fax: (714) 647-6954 P.O. Box 1988 Santa Ana, CA 92702 j Q� 71F�; tPlrjSit Donation Request ht: Reference fl on all related OPVs _ DR- Coun it Meeting Date: NOVEMBER 7, 2017 Eligibility Met: YES / NO YES Approved Amount: $800 City Manager Signature: Date: Revised 01/05/2017