HomeMy WebLinkAbout25R - AGMT - SENIOR CITIZEN FAIRREQUEST FOR
COUNCIL ACTION
CITY COUNCIL MEETING DATE:
JUNE 21, 2016
TITLE:
DONATION TO SUPPORT A SENIOR
CITIZEN RESOURCE FAIR
(STRATEjGIC PLAN NO. 5,4)
I
CITY MANA
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
QW00067AWD
❑ As Recommended
❑ As Amended
❑ Ordinance on 1s` Reading
❑ Ordinance on 2 r Reading
❑ Implementing Resolution
❑ Set Public Hearing For_
CONTINUED TO
FILE NUMBER
Approve a donation request from the California Department of Health Care Services for a one-
time donation in the amount of $375.80.
DISCUSSION
On August 4, 2015, City Council adopted Resolution 2015 -042 establishing a City Special Event
Sponsorship Policy and Guidelines for Disbursement of Discretionary Funds. This resolution and
policy outlines the eligibility criteria for neighborhood associations and eligible non - profit entities
for consideration of City Council sponsorship.
In accordance with this policy, each Councilmember is allowed to appropriate up to $10,000 per
fiscal year to support eligible organizations, including neighborhood associations and non - profit
organizations. Eligible organizations that are not tax exempt under section 501(c)3 of the Internal
Revenue Code are eligible for in -kind funding for City Services.
Councilmember Tinajero recommends appropriating $375.80 in donation funds to support a
senior citizen resource fair that took place on Saturday, June 4, 2016, in response to a donation
request submitted by the California Department of Health Care Services (Exhibit 1). Upon
approval of the donation request, funds in the amount of $375.80 will be appropriated to pay for
City fees, including facility reservation fees, staff fees, and liability insurance fees. These costs
are outlined in the PRCSA Rental Contract/Permit (Exhibit 2).
STRATEGIC PLAN ALIGNMENT
Approval of this item supports the City's efforts to meet Goal #5 - Community Health, Livability,
Engagement & Sustainability, Objective #4 (support neighborhood vitality and livability).
25R -1
Donation to Support a Senior Citizen Resource Fair
June 21, 2016
Page 2
FISCAL IMPACT
Funds to support the City Council Special Event Sponsorship Policy are available in the FY 2015-
16 General Non - Departmental account (01105015- 62300). The $375.80 will be spent from
Councilmember Tinajero's appropriated amount for FY 2015 -2016.
APPROVED AS TO FUNDS AND ACCOUNTS:
�N c .cvor', to T�
Francisco Gutierrez
Executive Director
Finance and Management Services Agency
Exhibits: 1. Donation Request Form
2. Rental Contract/Permit
25R -2
City Manager's Office - M-31
City of Santa Ana 20 Civic Center Plaza
Donation Request P.O. Box 1988
Santa Ana, CA 92702
(D (714) 647-5200
Name: 1 RITA CRUZ GALLEGOS
Address: 1400 K Street, Suite 204
city, State, 7jp:
Sacramento, CA 95814
jPhomn
1951.468.5712
Email:
rita@harbageconsulting.com
Fax:
:916.662.7982
Name:
California Department of Health Care Services
Tax-Exempt Status: Is your organization anon -profit or public tax-exempt organization
rga as
defined under Section 501(c)(3) of the Internal Revenue Code?
iselect One:
❑ Yes
(Direct Payment Amount
Requested;
No
If No, you wig only qualify for a credit for City-related costs for your request (i.e. permit to
Yos'
sslaff time, rental rates for focliffles or equipment, etc.).Costs for City services vary and if
of
approved, credit may or may not cover full cost of requested City servica&
Tax to
City Services Credit
Amount Requested:
i f I
375.80 Date Needed: MayoriCounclimembor: Tinajero
(Direct Payment Amount
Requested;
Event Data: 06.04.16 Event Timoz ;Sam 'I pm
!EventLocation:
The Salgado Community Center, 706 N. Newhope St., Santa Ana, CA 92703 i
Address, City. State, Zip
�Descrlptlon
!Town Hall Resource Fair for The Senior Community
of
!Event/ Purpose:
Educational Seminar on The Coordinated Care Initiative/OneCare Connect for
I
CommunityBorlefit:
Medicare & Medk al Services For The Senior Community
Applicant Signature:
DOW May 17, 2016
!Mail: City Manager's Office --M -31 Email: done I tionrequest I @son - to-ana.or 11 g
20 Civic Center Plaza Fax: (714) 647-6954
P-O. Box 1988
Santa Ana, CA 92702
Donation Requestit: DR Council Meeting Date:
4'f'd"dVr1V�; I
Eligibility Mot: YES I NO Approved Amount:
City Manager Signature: Date:
Revised 1111612016
25R -4
aG i,dN ,e CI'I'ij OF SANTA, ANA
.Parks, Recreation and
Community Services Agency
26 Civic Center Plaza,
{ P.O Box 1988, SantaATla,CA92702
Rental Contract / Permit - v.2
Printed. 07 Jun 2016, 12:29 PM
User: mballeza
Contract #: 18312 User: mballeza
Date: 07 Jun 2016 Status: Tentative
Parks, Recreation and Community Services Agency, 26 Civic Center Plaza, 2nd Floor, P.O. Box 1988, Santa Ana, CA 92702 - M -75
hereby grants City of Santa Ana & OCCORD (hereinafter called the "Licensee ") represented by Julie Castro - Cardenas, permission
to use the Facilities as outlined, subject to the Terms and Conditions of this Agreement contained herein and attached hereto all of
which form part of this Agreement.
It is the Permittee's responsibility to provide a copy of this permit to each facility user or coach that uses the facility. The facility user
or coach must present this permit to City representatives when requested to do so to identify themselves as the authorized user of
the facility.
1) Purpose of Use
ii) Conditions of Use
iii) Date(s) and Time(s) of Use
Facility/Equipment
Salgado Center Complex
Multipurpose Room A
(Multi- Purpose Room)
Meeting - Community Group
OneCare Connect Town Hall Meeting & Resource Fair
It of Bookings: 1
Day Start Date
Sat 04 Jun 2016
Starting: Sat 04 Jun 16 08:30 AM
Ending: Sat 04 Jun 16 11:00 AM
Start Time End Date
08:30 AM 04 Jun 2016
iv) Additional Fees
Extra Fee - Bookings Hours Quantity
Staff Supervision - Facilities (per 1 /2hr) 2.30 5
2:30 5
v) Payment Method
Rental Fees Extra Fees Tax Rental Total Damage Deposit
$92.80 $54.60 $0.00 $147.40 $0.00
Balance of rental due and payable immediately.
vi) Other Information
vii) Additional Notes
Multipurpose Room A (Multi- Purpose Room) - Salgado Center Complex
End Time
11:00 AM
Charge
$54.60
$54.60
Total Applied Balance Current
$0.00 $147.40 $0.00
Permittee agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel,
and representatives from liability: (1) for personal injury, damages, or restitution, arising out of claims for personal injury, including
death, and claims for property damage, which may arise from the negligence or willful misconduct of the permittee and guest or its
agents, employees, or other persons acting on their behalf which relates to the Permit granted herein; and (2) from any claim that
personal injury, damages, or restitution, is due by reason of the terms of or effects arising from this Permit. This indemnity and hold
harmless agreement applies to all claims for damages, or restitution suffered, or alleged to have been suffered, by reason of the
events referred to in this Section.
X:
Julie Castro- Cardenas
City of Santa Ana & OCCORD
20 Civic Center Plaza
Santa Ana CA 92701
USA
Intl
Name:
Title:
2W6
Page :1
Expected:0
Fee XFee
Tax Total
$92.80 $54.60
$0.00 $147.40
Tax
Total
$0,00
$54.60
$0.00
$54.60
Total Applied Balance Current
$0.00 $147.40 $0.00
Permittee agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel,
and representatives from liability: (1) for personal injury, damages, or restitution, arising out of claims for personal injury, including
death, and claims for property damage, which may arise from the negligence or willful misconduct of the permittee and guest or its
agents, employees, or other persons acting on their behalf which relates to the Permit granted herein; and (2) from any claim that
personal injury, damages, or restitution, is due by reason of the terms of or effects arising from this Permit. This indemnity and hold
harmless agreement applies to all claims for damages, or restitution suffered, or alleged to have been suffered, by reason of the
events referred to in this Section.
X:
Julie Castro- Cardenas
City of Santa Ana & OCCORD
20 Civic Center Plaza
Santa Ana CA 92701
USA
Intl
Name:
Title:
2W6
Page :1
Printed: 07 Jun 2016, 12:29 PM
User: mballeza
Rental Contract / Permit - v.2
Contract #: 18312 User: mballeza
Date: 07 Jun 2016 Status: Tentative
Home: () Business: (714)
Fax: (714) Parks, Recreation and Community Services Agency
Date:
Date:
MMI
Page:2