HomeMy WebLinkAbout29A - DONATION AGMT VAR ORGam.011
• 09 -0
CITY COUNCIL MEETING DATE:
AUGUST 1, 2017
TITLE:
DONATION AGREEMENT WITH VARIOUS
ORGANIZATIONS TO SUPPORT
COMMUNITY EVENTS AND PROGRAMS
(STRATEGIC PLAN NO. 5,4)
CITAIIAGER
IaxKe]LnIT, I:Ik,1�]��7_[��C�TrI
CLERK OF COUNCIL USE ONLY:
❑ As Recommended
❑
As Amended
❑
Ordinance on 1" Reading
❑
Ordinance on 2nd Reading
❑
Implementing Resolution
❑
Set Public Hearing For
CONTINUED TO
FILE NUMBER
Authorize the City Manager and Clerk of the Council to execute agreements with various
organizations in support of their community events and programs, subject to nonsubstantive
changes approved by the City Manager and the City Attorney, as follows:
1. AltaMed Health Services Corp to support their annual free health screening and resource
event, in the amount of $500 (Mayor Pro Tem Martinez);
2. Charitable Ventures of Orange County to support the Heninger Park Neighborhood
Association Summer Street Fair event, in the amount of $320 (Mayor Pro Tem Martinez);
3. Community Engagement Inc. to support two introductory Coding workshops at the Garfield
Community Center, in the amount of $1,500 (Mayor Pro Tem Martinez);
4. Orange County Children's Therapeutic Arts Center to support the Youth Employment
Program in the amount of $500 (Mayor Pro Tem Martinez);
5. American Youth Soccer Organization Region 517 to support the All-Star League of
Championships Playoffs in winter of 2017, in the amount of $1,000 (Councilmember
Solorio);
6. Casa de la Familia to support the on-going mental health services, in the amount of $500
(Councilmember Solorio);
7. Hispanic 100 Foundation to support the Youth and Government program's on-going
activities, in the amount of $1,500 (Councilmember Solorio);
29A-1
Donation Agreement with Various Organizations to
Support Community Events and Programs
August 1, 2017
Page 2
8. Morrison Park Neighborhood Association's to support the neighborhood summer event
and movie night, in the amount of $385 in city service credit (Councilmember Solorio);
9. AltaMed Health Services Corp to support their annual free health screening and resource
event, in the amount of $500 (Councilmember Benavides);
10. Charitable Ventures of Orange County to support Artesia Pilar Neighborhood Association's
summer event, in the amount of $1,000 (Councilmember Villegas);
11. Charitable Ventures of Orange County to support Santa Anita Neighborhood Association's
movie night event, in the amount of $1,000 (Councilmember Villegas);
12.Santa Anita Neighborhood Association to support the Cesar Chavez Campesino Park
Graffiti Paint Out and Community Clean Up event, in the amount of $500 in city service
credit (Councilmember Villegas).
13.Templo Calvario Community Development Corporation to support the Love Santa Ana
initiative to beautify the Santa Anita Park, in the amount of $2,000 (Councilmember
Tinajero)
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.
The donation agreements listed above are in response to the Donation Requests (Exhibits 1-13)
submitted by various community organizations or neighborhood associations to the specific
Councilmembers, seeking sponsorship for community events and/or programs. The
Councilmembers, respectively, reviewed and agreed to sponsoring the programs or events
through the Special Event Sponsorship funds. Upon approval by City Council, the respective
donation agreements (Exhibit 14) will be executed.
29A-2
Donation Agreement with Various Organizations to
Support Community Events and Programs
August 1, 2017
Page 3
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).
FISCAL IMPACT
Funds to support the City Council Sponsorship Policy are available in the Fiscal Year 2017-18
General Non -Departmental account (01105015-62300) as appropriate from each of the following
Councilmember's appropriated amounts for Fiscal Year 2017-18:
Mayor Pro Tem Martinez $ 2,820
Councilmember Solorio $ 3,385
Councilmember Benavides $ 500
Councilmember Villegas $ 2,500
Councilmember Tinajero $ 2,000
APPROVED AS TO FUNDS AND ACCOUNTS:
Finance and Management Services Agency
EXHIBITS: 1-13. Donation Request Forms
14. Standard Donation Agreement
29A-3
City of Santa Ana CiManager's00 Civic Center Plaza
31
�'� Donation Request P.O. Bon 1988
4 Santa Ana, CA 92702
(714) 647.5200
r
(Name: IMariaPazties: Policy Analyst
llAddress: 12040 Camfield Ave
City, State, zip: LOS Angeles CA 90040 Phone: i323-889-7892
;Email: mpmoreno@altamed.org Fax: 1323-889-7855
IName: 'AltaMed Health Services Corp
Tax-Exempt Status: Is your organization a non-profit or public tax-exempt organization as 'Select One:
!defined under Section 501(c)(3) of the Internal Revenue Code? FV_1 Yes ElNo !
i
I If No, you will only qualify for a credit for City-related costs for your request file, permit fees, i
i
!staff time, rental rates for facilities or equipment,etc.). Costs for City services vary and if If Yes, jg52810095 1
reproved, credit may or may not cover full cost of requested City services !Tax 10 0:
80 M-1 ^r
'City Services Credit '$
Date Needed 108/17/2017 Mayor/Councilmember: Martinez
Amount Requested: ;
Direct Payment Amount 0$/17/2017 Event Time;
,Requested: I$+I+dew— 1Even4 Date: I 12pm-spm
_.. $500 approved _
(Event Location: '.1400 N. Main St Santa Ana CA 92701
(Address,, City, State, Zip
Nglonally theemnd weok M August is dedicadef to mcoanerng the senno and Contdbutionof health eenlrs Ntlal Health Cater Vessel, (August 1110201 alflowa us (a unlearned the
!long ossund ofoucaevo and delvaly slash quality Cort agodlva ntl olble cpreor smo natlon. Am hH IIM1C mors 9 r25 mIWO Ind!Itl I hr 9.000 11 In
IDeseriptlon of Iha Oallotl Slolao MCludlnOlha Gkidcl of Columbia, Pusan Rleo, LLB targln Islands and Guam This y.a,.$be.leC.O.W.lig Amercn4 Health Centers. Th.la"WHouniluConeoushlorl
i Event Purpose: As pad argue week long oolobradon, AIWMad Wil behaells, on Olson House In our Santa Ano, Main dlnie(locarsd at 1400 N. Main St Santa Ann, CA 92701) home pm to S pm on Thurs&y.
i Augud 17th. TFiv event WII bo upon to the publicnnd IndWe free health scraonings, rpmoa and pnxos, antl heollh etlucallvn matenale end Inlormalion,
i
Provide free health screenings to the Santa Ana community, provide information about the health and
community Bennet: wellness services AltaMed offers to the community, and encourage and motivate Santa Ana residents to
engage in healthy activities as well as healthy eating.
Applicant Signature:IN
�r 'Date: I7117
I Mail: City Manager's Office - M-31 Email: donationrequest@santa-ana.org
20 Civic Center Pima I Fax: (714) 647-6954
P.O. Box 1988
Santa Ana, CA 92702
Donation Request: rs: DR AUGUST 1, 2017
- CouncilMaetfncq Dat'o:
Eligibility Nlet: YEs l Rio YES Approved Amount: $900
City Manager signature: Date:
Revised 01/05/2017
29A-4
C)
City Manager's Office- M-31
i City Of Santa Ana 20 Civic Center Plaza
fii Donation Request P.O. Box 1988
-p' Santa Ana, CA 92702
(714) 647-5200
';Name: Ginelle Hardy
Address: 822 S. Van Ness Ave.
,city, State, zip: Santa Ana, CA 92701
Email: ginelleann@gmail.com
Phone• 714-905-6951
Fax; —
(Nama: Heninger Park Neighborhood Association
Tax -Exempt Status: Is your organization anon -profit or public tax-exempt organization as ISelect One:
'd'defined under Section 501(:)(3) of the Internal Revenue Code? Yes
If No, you will only qualify fora credit for City -related costs for your request (i.e. permit fees, -"-
'staff time, rental rates forfacrtlities orequipment, ets).Costs for City services vary and If iif Yes, j
;approved, ctedit may or may not cover hill cost of requested City services. Irax ID M i 20-8756660
i I i
Fiscal Sponsor: Charitable Ventures of OC
(City Services Credit
Amount Requested: i$-i-,$f5�i'8�' (Date Needed: June 22, 2017 (Mayor/Counciimember, Michele Martinez
'Direct Payment Amount I
Event Date: Event Time:
!Requested: $320.00 July 22, 2017 j 11:00 am - 3:00 pm
_ _- _
!Event Location:
Addross, City, Stafe, Zip 700 block of South Ross Street
i ,
;Description of , Heninger Park Neighborhood Summer Street Fair
Event/ Purpose: "An afternoon to meet neighbors and make new friends"
Community Benefit: An event to celebrate the neighborhood - not a fund raiser
Applicant Signature: g,�... ' _. _ _.... Date:.... .June 13, 2017
a a m
Mall: City Manager's Office -M-31 Email: donationrequest@santa-ana.org
20 Civic Center Plaza Fax: (714) 647.6964 !.
P.O. Box 1988
Santa Ana, CA 92702
I
Donation RCque$R 8:. _. DR
Eligibility Met: YES I NO YES
City Manager Signeture:
Council Meeting Date:
Approved Fvnount
Date:
August 1, 2017
$320
Revised 01/05/2017
City of Santa Ana
Piarene;
Ma( lele rte SpelIc?t
}ddMc �40291ete_4eity Place n lt}t _...
poy, a„ zip 'Newport (ach, CA 92660
Emr#; ;;pet}e, 3��st}ei.l c3n,�(�*tsaa} etlaE
City ManEger s On' cci f,"31
20 Civic Cente+Maty
f° 0 Box 198E
SatCc Ana CA 5310`,
vm) 687-E14V
Gree: �78A-A�iLta's8.?E
Fax.
i iax, xamgt St"o is Y atlan a #vxtgarOt or Pubtf 0 taK�e)avn C ce wizatwn as
}iatseeS--. �
dunder 501(OX3)e;lftWongRevsnue%de? `taciQne: �j,/�Yt% � iNo
tift, you stNONY - theaCsatfHOfCatf'.ertaretltwsswycxwmquest(10,Perm*Fees, I
b."+'tkre.rernnFraraasFbrPer32leaar .alaLadtuCdynsRkRavmyaendX FY's• i
#pPeov0d, CMM may ormaynor ookw U east rAraq~ C#yser3lcas. Yaz#U m. $
(>�#tg 8arv!¢ea Caadit
("F^�� Roxi os
_... .._ , A_ t �4
! tB Noe*d: 'August t dyk7tr v'4lSdnavn@mtt@l:'Ma
Pay> n#Anwsat1
sated:
1500 ', ugust 19,262 �vantTime:
(gam-12pFi
Event Loaadat:
'Garfield Community Center 01 North Lacy Santa Asia CA 92701
iaar<sz Cser �,,,sa
E WO intro..itxtcry Coding MKKr shop!3 wish Fortner Student for �Ad3S€`s t ?sts5 t., nr, . •.-4 v: i i:.
Most#Ft n of
11eaCiihiC a closS d c(3mpille"r boot Comp to, `t9AUrA--i Snident$ tms ss njQ)cf.
!Evert t putpoaa.
Wder CiltlidS unity c` cce-is to lechriolooy EllFod h t'1t1 itlSdiStluCtlC?r• nCE �? fLAt .1
Ca+nrt-aun#tY�anatt#:
t_iiucation in t Int'�oductoryr' Coding YYoi ksltrops
29 Civyi�c Gender Maza
Far 17#41847{OS4
PZ� e0z t
I
1 Santa Ana,CA 927`42
Rvo,ied A PAW2o i l
29A-6
ori ry City of Santa Ana
f' Donation Request
City Manager's Office - M-31
20 Civic Center Plaza
P.O. Sox 1988
Santa Ana, CA 92702
(714) 647.5200
Name: Dr. Ana Jimenez-Hami
Title: Executive Director
iAddress: 12215 North Broadway
1
;City, State, Zip: 'Santa Ana
;Phone: 714-296-2191
Email: lana@occtac.org
;Fax:
1714-564-9690
Name: !Orange County Children's Therapeutic Arts Center
Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as
1Select One: Yes No
defined under Section 501(c)(3) of the Internal Revenue Code? l
If No, you will only qualify for a credit for City -related costs for your request i e. permit fees, !staff time, rental rates for facilities or equipment, etc.). for Cify services vary and if If Yes,
33-0930891
'approved, credit may or may not cover full cost of requested City services. Tax ID #:
r___.___..
City Services Credit $ Date Needed. 06-26-2017 1Mayor/Councilmember Martinez
'Amount Requested:
.Direct Payment Amount
Requested:
!$500 1Event Date: (06-30-2017 Event Time: pm
! !4:30-7:30
!Event Location:
i OCCTAC
'Address, Clty, State, Zip
2215 North Broadway, Santa Ana, CA 92706
! Once a year we celebrate the students enrolled In our "Youth Employment Program" that completed all the requirements of the
Description of
! program. We invite the parents and family members to celebrate their accomplishments and do a "GRADUATION" ceremony at our
!Event / Purpose:
agency. The funds we are requesting would allow us to purchase food to give to the families on that day since the grant does not allow
I for us to purchase food for the program. Since this is a special celebration we would love to treat the families and students on that day,
j
! Our Santa Ana Youth deserve to celebrate their accomplishments with their parents and family members This event celebrates our youth and all the efforts
Community Benefit:
! they have invested in improving their current life situation, including getting a job and enrolling in college. Many of our youth have great challenges, such as a
! disability, parenting teens, basic skills deficiencies, and others. Despite these challenges, they have learned to overcome these barriers, and have improved
!
significantly. By celebrating their accomplishments we motivate them to continue to pursue bigger and greater things in their lives, especially their education?
Applicant Signature:
Date: 16-26-2017
Mail: City Manager's Office - M-31 I Email: donationrequest@santa-ana.org
! 20 Civic Center Plaza 'Fax: (714) 647-6954
P.O. Box 1988
Santa Ana, CA 92702
i
Donation Request DR
xe,v, a rce t? +, Nt ,t to -xv N,"Vc Council Meeting Date:
Eligibility Met: YES I NO Approved Amount:
City Manager Signature: Date:
Revised 01/05/2017
JUN -2U -2U1'/ Ub:o/from:
'1o:1/7,409'/b9b4 Yage:1/1
i
e�
City of Santa Ana C1fyManagers Cf%co-M.31
20 CIVIC Cantor plaza
^'.. Donation R®QUBSt Ao. Box 1988
Santa Ana, CA 02702
(714) 047.5200
i
e , ,
ck Niedermayer Director
Area Dir,
.
Address 14 W. Pendelton Ave #A
aly, , state, zip;'
Santa Ana, Ca. 92704 f-714
phone:
- --�^—
356.8960
Email:
rCksWorld Ilve.CA Ytl .... .,.,... Fax: _.. .'I
._
Name: AYS® Region 517
... ..
Tax•Exomp ellen anon- root ar ubllo l ----m tar anix tion as
P p p 9
66a�Qnl � your of
y( 1( ®
slim
definod under Section 501 a 3) Of the Intemel RaVanua Code!
golatl One:
®Vee � No
onde
IfNmatteas.
tredI (fill r0(mclaostodC o ra ue4t #.a, � d f�
rental rales Porfsslll(les or a u/ � f, e(o. ,Costs for C sewltovary p a
Ilan! uef may
staff flme,redR mayor CoservI. '�
approved, sro
11 Yea 1
au ID t€;
.,.
�+a�+'� {/�af/1 3 yn.�
9 �'1JL®���6!
Iljy
�.d't7
r
ity gervlceo CmdR
oust Requested; 1,0001Data Naedad.
Nov,27 2017
MayorlCouncinnomher. samdo
Pueenl Amount -�Eent.. D.am
,Requestd
•
,vtnm0:Direst
EAntLryacentennial
od,Ill
Park' Dan YoungSoccer': Complex, nezAthl.e..t.i.c,
Fields
and
csl
_G.,
AY will hold there League Championships on Dec, 2nd & 3rd, and there
of
All-Star Championship playoffs on Jain, 13th,14th,20th & 21st 2018. The winners
E°oatlP°rpae°'
EventI Pur
., .....
will advance to the Section 11 Cham' lonship In the middle of February 2018
.., . ...
�Appllnant
nefiit..
Comm°nity Benefit..
a
8lgnaluro: i
player participate P..
promotes team work, fairres respect of the volunteers and of the a
p f play,
AC Icer itself. We do not charge a sin IIee l layer t r rrttici ate these
amo earns with Medals,award.
but
reward half f th t y._. participation ........... playoffs, a of
I
-,
e e , �._ —. .... ..... ...._._. _ ........ • __ ......._. .,............
Math CItY_ Menaorg'o Was -M,31
Email: donatBonraquaet@aanta anp.org
20 Clvto Center Plaza
Fax: (714) 047.0954
p,o. Sax 1988
i
Banta Ana, CA 92701
DDnahen Ra ; -DR • Caumlil Meoun onto: i"�t. t`) 1-t'�1i�-•
RoI^renca R on aaft reladmated opus 9
„Eligibility Met: ES! 0 Approvod Amount: �I, •-°"'
City Mnnager SlgnaNmData:
Revised 01/0512017
29A-8
City of Santa Ana
Donation Request
Gonzalez
Address: 11650 E. 4th St., Suite 101
city, state, zip; iSanta Ana, CA 92701 _._.......,_„»_._ Phone: LL -
�Emalt iggonzalez@casadelafamilia.org IFax:
04171111=111W
net status: Is your organization a non-profit or public tax-exampt organization as
der Section 501(c)(3) of the Internal Revenue Code?
will only qualify for a credit for City relatod costs for your request (i.e. pomtft fees,
rental rates for facilities or equipment, ete.).Costs for City services vary and if
credit may or may not cover full cost of requested City services.
pity Services Credit
Amount Requested:
Direct Payment Amount
Requested:
iDate Needed: :7/24/17
i
500.00 Event Date 7/28/17
City Manager's Office — M -3f
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, CA 92702
(714) 847-5200
& Development
430-3751
select One; ' F Yes F No
�If Yes, 3_070478
flax ID #:
ayor/Councilmember:
,went Time:
Location: ;Sowers Museum: 2002 N. Main St., Santa Ana, CA 92706
1, cliy. Slate, TIP
Solodo
7:00pm
On Friday, July 28, 2017, CDLF will hold a benefit event at the Bowers Museum
rte lin association with the John F. Kennedy Library Foundation.
�Proce
{Cmnmumty Benefit:,Victim
'Applicant Signature:
Mail: City Manager's Office—M.71
20 Civic Center Plaza
P.O. Box 1968
Santa Ana, CA 92702
Js to CDLF will help us continue to provide mental health services to
of psychological trauma.
Date "7/ '
Email; donationmquest@santa-ana,org
Fax; (714) 6476954
Dontt'kinn ftequcst fk. . n3a .
tr .,,;_,r_.f.: GnUnrR Mmzttlr+g tr2Ee:
= EHg1b3tik,y Met: YES i No ,bpProved ,dRwUg1V _
Revised 01/05/2017
29A-9
City of Santa Ana
Donation Request
City Manager's Office — Nl
20 Clain Center Plaza
P.O, Box 1488
Santa Ana, CA 92702
(714) 647.6200
r—
Address:
t 'L�,,g
•'"\• (�� �,((
Cny State, Zip
���,.. �',.w•.v.�F t
�. 1'i .
L-��t„� .Phone: L �I L(1
Name: C_' Foundation
fax
Exempk Status Is your organization a non-profit or pub
lic tax -'exempt organization as �Select One; /
tellned under Sectlon 501(0)(3) of the Intornal Ravenua Cade? 1 Yes> No
Itsff time, rental rates for facilities or equipment, eta). Costs for City sere ccs vary and f fees,
Y Y qualify Y Y q i c FTayx
es,
'if ry
ippro led, credit may or may not cover full cost of requested City servicea. ID #:
City Services Credit $ Date Needed ` Ma or/Councllmember. ,-
rnountRequested. y.
lRoquosted: nt Amount $ IEvent ate: �""')n'-� ..01 [Event Time:
IRaquosted IJ �, Coca _( G� r I 1
._..._ .._...,._.._„__....w„_..
'. Event Location:
Address City, state y
14
h,�a
Description of '^ t4%u�h CnH"-L�
Event/Purpose: (r tt
CAVIu /
�::IQVt?f W�^�.vr I' (lYo�rUwS
y
Cammunit Benefit: 1 V
Applicant
City Manager's Office -- M-31
20 Civic Center Plaza
PA, Box 1988
Santa Ana, CA 92702
If an a{,
YES•r NO YES,._
City Manager Signature:
Email: donationrequest@santa-ana.org
Fax: (714) 6486964
I t
WeY,t�l, r
, ..,.d�_..ar ..... F '�u4V'5.5b:1
Az
Council Maatin -Data
5 Ih August 1 2017
Approved Amount $1,500
..... --
Data: _ ._.._.._. _.._.__
--,evisod 01/05120
017
City of
Donation Request
o r.
City Manager's Office - M-31
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, CA 92702
(714) 647.5200
(Name: ,Morrison Park Neighborhood Association
I Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as
Internal Code?
(Select One:
❑Yes No
(defined under Section 501(c)(3) of the Revenue
i
If No, you will only qualify for a credit for City -related costs for your request (i. e. permit fees,
'It Yes,
staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if
approved, credit may or may not cover full cost of requested City services.
ax ID #:
i
City Services Credit
is 385.00 !Date Needed: (Mayor/Councilmember: I Soloric
!Amount Requested:
(Direct Payment Amount i 5:30 Ill
$ Event Date: !July 22, 2017 (Event Time: n
Requested: I Y
Event Location: 2801 Westwood Avenue, Santa Ana, CA 92706
!Address, City, State, Zip
I
Neighborhood Summer Event and Movie Night.
(Description of Funds requested to cover costs of event (actual amount to be determined once City provides fees.
(Event l Purpose:
[Brings neighbors together for an afternoon of games and food followed by a
Community Benefit:
Imovie in the park.
i
Applicant Signature: ekuljtiara Dazaa-Srazt�t iDate: IJUnE 7 2017
11, it lillill'ililiol'Ill'i
Mail: City Manager's Office - M-31 Email: donationrequest@santa-ana.org
I 20 Civic Center Plaza Fax: (714) 647.6954
P.O. Box 1988
Santa Ana, CA 92702
Donation Request#. DR -- _ -- AUGUST 1, 2017
uAt rn-rc:e u,..r n.t rat,#ed uPv= Council Meeting Date:
Eligibility Met: YES I NO YES Approved Amount: $1,000
City Manager Signature:'',, Date:
Revised 01/05/2017
city manager's office -IW-31
City ®f Santa A��
20 Civic
oCe ionPlaza
I aza
Donation Request P.98
Santa Ana, CA 92702
(714) 647.5200
4 0
!IName: Maria Paz
Policy Analyst I
Iddress: 12040 Camfield Ave
ICdty, state, zip: I,I Los Angeles CA 90040 ;Phone: !323-889-7892
Einad: 'I�mpmoreno@altamed,org ;Fax: ;323-889-7855 '..
IName: 'AltaMed Health Services Corp
Tax -Exempt Status: Is your organization a non-pro0t or public tax-exempt organization as aelect One: I
(defined under Section 501(c)(3) of the Internal Revenue Code? 1 ® Yes ❑ No
If No, you will only qualify fora credit for City -related costs for your request its. permit fees, If Yes
;Staff time, rental rates for facilities or equipment, etc). Costs for City services vary and if 1952810095
;approved, credit may or may not cover full cost of requested City services, Tax ID M
I
City Services Credit
I I al„�„e.,
$ Aate Needed: !08/17/2017 Mayor/Counciimember. BENAVIDES
Amount Requested:
(Direct Payment Amount
$ [HventDate:
108/17/2017 Event Time; 2pm-5pl't1
Requested:
$500 approved
Event Location:
1400 N. Main St Santa Ana CA 92701
(Address, City, State, Zip
r,'bandfliy, the second week of August is dedicated to acognlvng the servlet and ctnthballont of had Ith tenders affect] Health Center Man, Sauguat 13-19, 2017) Micas us to detaches the '
!
!Description Of
long modal of focuses and delMory of high quality, spot offers ve, and acewdblt care..tufo the ovish. America§ Hough Contare newsav9 ovor2S million IhdlAduala In 9,000 cotmmllNllea in
IS United Status Including the D18oct alCalumbin Puerto Rlm,US,Vl Oinlslandsand G,Itrrt TblS....Slh.sc.In Itdfpbhdflafi Amada'. Hoollh Congo. The Key to financier G parunitlos,'
Event/Purpose;
As part the Wc.u.n, Wlabrepary AhaMedwill be bidding an Olen Heads In aur Septa And. Man dlnlc(located at 1400 N. Main St Santa Ane, GA 92701) fron12 pra to 5 pin oft Thuradfy, '
1
I August 17th. This oventwlll to stand to the public and llTaSM fee tooth teachings, nation and plans, and healta peace "In mal.'rWe tad infmmetlon.
Provide free health screenings to the Santa Ana community, provide information about the health and
'Community Benefit:
wellness services AltaMed offers to the community, and encourage and motivate Santa Ana residents to
engage in healthy activities as well as healthy eating.
;Applicant Signeturo:....
/
Date: '. 7117
r • ^ m
s
(Mail. City Manager's Office -M-31 Email: donationrequest@santa-ana.org
20 Civic Center Pima Fax: (714) 647.6954
J P.O. Box 1988
Santa Ana, CA 92702
Donatlon Request 4:
DF¢ -
Council Mi76tlnCq Date: AUGUST I, 20I %
Eligibility Met:
YES i Ado YES Approved Annotmt: $500
City Manager Signature:
Date:
Revised 01/05/2017
29A-12
City of Santa Ana
Donation Request
Woo
City Manager's Office– M-31
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, CA 92702
(714) 647-5200
President/Chair
Melrose: 12234 North Pacific Avenue
Cit, state, zip: Santa Ana, CA 92706 Phone: F714 -8i5-8925
by@yahoo.com
Name: jArtesia Pilar Neighborhood Association (APNA)/Charitable—Ventures of Orange County
Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as
oiecB t pne;
Iefined under Section 501(c)(3) of the Internal Revenue Code?
Yes No
®
If Na, you will only qualify fore crack for City -related costs for your request (i.e. permit fees,
If Yes
;tall time,. rental rates for facilities or equipment, etc.). Costs for Ctty servicas vary and if
208756660
ipproved, credit may or may not cover full cost of requested City services.
4 ax ID #:
Services Credit
unt Requested;
ct Payment Amount
(Event Location:
(Address, CiV State, Zip
ption of
I Purpose:
Benefit:
Needed: I. kw
1,000 jEvent oate: 1 12/30/17 (Event Time:
10 AM to 5:OOPM
EI Salvador Park & Recreation Center 1825 W Civic Center or; Santa Ana, California 92703
w,xnom
Community involvement of youth and residents that builds strong healthy
communities thrive.
{Applicant Signature,
I
Po. x.1-1
Reftirr�cnni iete'd r�i but -- �r.
Mali: City Manager's offico–M-31
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, CA 92702
Donation Request #: DR_
Eligibility Met:
City Manager Signature;
Email: donationrequest@santa-ana.org
Fax: (714)647-6984
j Council Meeting Date-
? Approved Amount:
Date:
EXHIBIT 10
29A-13
�\Uct .1( 201
Revised 11116/2015
Mar 291701:48p
714.265-2071 p.3
,
City of Santa Ana Ciy49anagers orrice-7yrsa
L��-I�,111`� Donation Request 20 Chit Center prare
'..; kti .,
--- P, O. Bax 9888
Banta Ana, CA 92702
(714) 647.5200
,Name: ---
,Felipe Guerrero
11(le President,
Address; 204 N. Susan Street _ — — --- Pity, State, Zipsl9 antaA@ ,Calif. 92703 71
—i
Phone: ,4-265.207T
!.cam __..._._.-.__,_._ -- ---65--...___.--
I
(Email: odfnano as
apt Status; Is your organization a non-pmflt or pu61rc tax-exempt organixappn as
lder Section 501(c)(3) of the Intemal Revenue Code?
`viii only querfry ror a credit for City-roiated posts for your request its pemrif fees,
fonfa! rates for faculh'as w equipment, Oft). for Cily servkes vary and ff
credit may ormay not cover full cost of requested City services,
!Direct Pa
yment AmounC
Requested: Event Date "August
';Event Location: ;Santa Anita Park
Address. Cily, stare. 7Jp
25,291Evens Time: '6.3f) PM
Movie Night Event Intended to bring the Community together and provide a tun
j Description of
Event/Purpose: !!night of Eneertainment.
community BeneFl4 will be our sec !
Neighbors come out of their homes and get to know each other better, this Event
and annual. Our Event last year was very successful and attracted
several hundred participants. !
ppicant.Sig
.. ...._' -.
A I Srgnatur.... .__..._._ _.._. ..
_.—._..._.-'— . .._ -_Date 1 1 t
-
'Mail: City Manager's Office -M31
� Email: donationroquast@santaana
29 Civic Cantor Plaza
org
P.A. Box 1989
Fax; (774) 647-6954
_
Santa Ana, CA 92792
Donztlen R"uost fi: DR.
Caulict Meeting Date
y
--
,.Iigin7IIRY Met: YES NO
\'
ll
Approved Amount:
.1
City Manager Signature:-
'
..
Pate:
Revised 01/05/2017
C)
City Manager's Office - M-31
...,,,,+ City of Santa Ana 20 Civic Center Plaza
] r' Donation Request P.O. Box 1988
u, ' Santa Ana, CA 92702
(714) 647.5200
Name: Felipe Guerrero
Address: 1204 N. Susan Street
_ _.__
'City, state, zip: Santa Ana, CA 92703
Email: 1 godfnano@aol.com
Title: President
Phone: 714-265-2071
I
'Fax:
Name: (Santa Anita Neighborhood Association
Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as select One:�
!defined under Section 501(c)(3) of the Internal Revenue Code? i I Yes V I No
l�
1 If No, you will only qualify for a credit for City -related costs for your request (1. e. permit fees, - - - -
staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if
!if Yes,
approved, credit may or may not cover full cost of requested City services. iTax ID #: i
i
lCdy, Services Credit $ 500 !Date Needed (08/15/2017 EMayor/Councilmember Vlllegas
Amount Requested:
(Direct Payment Amount i$ Event Date. 109/16/2017 Event Time: 9am-1 1 a
1,Requested:
'Event Location. Cesar Chavez Campesino Park 3311 W. 5th Street, Santa Ana, CA 92703
'Address, City, State, Zip
F..__ ..._
(Description of ;Graffiti Paint Out and Community Clean -Up at Campesino Park and surrounding
Event I Purpose: 1 neighborhood.
I i
Approximately 50 volunteers will work together on 9/16/17 to paint out graffiti and clean the community
Community Benefit: Inear Campesino Park to show community pride. The City service credit will cover the cost of materials.
'Applicant Signature; Milne que17 aU, !Date; ; 07/1 420 1 7
Mail: City Manager's Office - M-31 Email: donationrequest@santa-ana.org j
1 20 Civic Center Plaza 'I Fax: (714) 647-6954
P.O. Box 1988
1 Santa Ana, CA 92702
Donation Re quest 4: OR-, AUGUST 1, 2017
i +tae ear+:e7� r.rt ni ,etatatl Df"S'n
Council Meeting Date:
i
Eligibility Met: YES /NO YES ',, Approved Amount: $500'I
I City Manager Signature: onto:
Revised 01 /05/2017
cI% taf5an#a Ana City Manager's office- M-31
-' 26 Civic Center Plaza
Donation Request P.O. sox fsea
Santa Ana, CA 92702
(714) 647.5200
!Lee de Leon
fora:
Address: '2501 W. 5th Street
rty, state, zip: I Santa Ana, CA 92703..!Phone: i 714-543-3711
Emau: Ilee@tccdc.org,Pax:.- .�.:�714-543-2399
77-0601589
�Wa
,fid, �� �IOata Noedad: 10$/20(2017 aynrlCouneilmemgne; � SlnaJgm s
Amount
1112,000 Eventuate: 19/23/2017 Pvantrime; 7; jQ ip-1:(j(jprp
Location:
t Cily. State. Ap
Anita Park and Community Center 300 S. Figueroa Street, Santa Ana, CA 92703
oasnripdon of ,The Love Santa Ana Initiative Is a program of Templo Calvarlo CDC that focuses on mobilizing
Evsntt Puipoas: "community to work together to beautify the area, bring hope and transformation to some of the
most challenged areas of the city.
iHundreds of volunteers will come together at Santa Anita park and Community Center on 8/23/1.7 to do
,Community Benoth: ivarious.beau6rication projects. Neighborhood clean-up and painting wilt bring pride to the community
Marl: city Manager's Office -M41 small: donatronrequo,
20 Civic Center Plaza Call:
(714) 647.6964
P.O. Box Igoe
Santa Ana, CA 92702
Revised 01t05t2017
29A-16
CITY OF SANTA ANA
DONATION AGREEMENT WITH
ORGANIZATION OR NEIGHBORHOOD ASSOCIATION
1. PARTIES AND DATE
This Donation Agreement ("Agreement") is entered into on AUGUST 14, 2017 by and
between the City of Santa Ana, a municipal corporation ("City") and ORGANIZATION OR
NEIGHBORHOOD ASSOCIATION, a California 501(c)3 NON-PROFIT ORGANIZATION
("Recipient"). City and Recipient are sometimes individually referred to as "Party" and collectively
as "Parties" in this Agreement.
2. RECITALS
2.1 Community Benefit. The City wishes to provide Recipient with funding to assist
Recipient in PROMOTING, DELIVERING, HOSTING XYZ PROJECT, PROGRAM,
EVENT, ETC ("Community Benefit"). The Parties wish to enter into this Agreement to establish
the terms and conditions under which the City will provide funding.
2.2 Public Purpose. The City, by recommendation of COUNCILMEMBER ,
believes there is a public purpose in supporting the Community Benefit because it will THE
FOLLOWING ACCESS OR RESOURCES FOR THE COMMUNITY ON SUCH
DATE/TIME AND LOCATION. The foregoing is a general description of the public purpose, and
is not necessarily the only public purpose to be gained from the Community Benefit.
3. TERMS AND CONDITIONS
3.1 Use of Funds. The City has chosen to provide Recipient with a one-time payment of
DOLLARS ($000), because the City has determined that there is a public purpose to be
served in supporting the Community Benefit. In executing this Agreement and receiving the funds,
Recipient agrees to use the funds only for the purpose described and subject to the terms and
conditions provided for in this Agreement. Should Recipient fail to use the funds for such purpose or
otherwise comply fully with the terms of this Agreement, City shall have the right to terminate this
Agreement and demand the return of the funds pursuant to Section 3.2 below.
3.2 Term; Termination of Agreement. This Agreement shall take effect on the date first
above written and remain in effect unless and until terminated by the City. The City has the right to
terminate this Agreement upon one day's notice, with or without cause. Should the City terminate
this Agreement, it shall also have the right to demand the immediate return of all funds provided to
Recipient pursuant to this Agreement, as well as interest at the rate of ten percent (10%) per annum.
Notwithstanding the foregoing, the indemnification provisions of this Agreement shall survive any
expiration or termination of this Agreement.
3.3 Waivers, Insurance or Other Obligations. For purposes of the City's protection, if the
City determines that the funds will be used for a purpose which may cause a significant risk of
injury, the City may, in its sole discretion, require Recipient to provide certain insurance and
EXHIBIT 14
29A-17
CITY OR SANTA ANA
DONATION AGREEMENT
Page 2 of 3
participant waiver/release protections. This right shall be on-going and may be implemented by the
City at any time, and all insurance and waiver/release forms shall be provided on forms, in amounts
and with provisions acceptable to City.
3.4 No Oversight by City. Nothing in this Agreement shall be implied or interpreted as
City establishing or providing oversight, control or approval of the Community Benefit or any
activities conducted by the Recipient.
3.5 Indemnification. Recipient understands, acknowledges and agrees that Recipient
shall assume all risks associated with the Community Benefit, including, but not limited to, the
possibility of death or serious trauma or injury. To this end, therefore, Recipient shall defend,
indemnify and hold City and its officials, officers, employees, agents and volunteers free and
harmless from and against any and all claims, demands, causes of action, costs, expenses, liabilities,
losses, damages or injuries, in law or equity, to property or persons, including wrongful death, in any
manner arising out of or incident to any and all acts, omissions, willful misconduct or other activities
of the Recipient or its officials, officers, employees, agents, guests, participants attendees, and
contractors, including the performance of the Community Benefit or this Agreement, including
without limitation the payment of all consequential damages and attorneys fees and other related
costs and expenses. The only exception to the Recipient's obligations hereunder shall be for claims,
demands, causes of action, costs, expenses, liabilities, losses, damages or injuries caused by the sole
negligence, sole willful misconduct or sole active negligence of the City. Recipient shall defend, at
Recipient's own cost, expense and risk, any and all such aforesaid suits, actions or other legal
proceedings of every kind that may be brought or instituted against the City, its officials, officers,
employees, agents, or volunteers. Recipient shall pay and satisfy any judgment, award or decree that
may be rendered against the City or its officials, officers, employees, agents, or volunteers, in any
such suit, action or other legal proceeding. Recipient shall reimburse City and its officials, officers,
employees, agents, and/or volunteers, for any and all legal expenses and costs incurred by each of
them in connection therewith or in enforcing the indemnity herein provided. Recipient's obligation
to indemnify shall not be restricted or limited by insurance proceeds, if any, received by the City, its
officials, officers, employers, agents or volunteers. The indemnification provisions of this
Agreement shall survive any expiration or termination of this Agreement.
3.6 Entire Contract/Modification. This Agreement contains the entire agreement of the
Parties with respect to the subject matter hereof, and supersedes all prior negotiations,
understandings or agreements. The terms and conditions of this Agreement may be altered, modified
or amended only by written agreement signed by both Parties.
3.7 Authority to Enter Agreement. The person executing below on behalf of Recipient
represents and warrants that the Recipient has all requisite power and authority to conduct its
business and to execute, deliver and perform this Agreement. Each Party warrants that the
individuals who have signed this Agreement have the legal power, right and authority to make this
Agreement bind each respective Party.
EXHIBIT 14
29A-18
CITY OF SANTA ANA
DONATION AGREEMENT
Page 3 of 3
RECOMMENDED FOR APPROVAL CITY OF SANTA ANA
Robert C. Cortez By:
Deputy City Manager Cynthia Kurtz
City Manager's Office Interim City Manager
Attest
By:
Maria D. Huizar
Clerk of the Council
Approved as to Form:
By:
Name of Attorney
City Attorney
ORGANIZATION OR NEIGHBORHOOD
ASSOCIATION
a 501(c)3 NON-PROFIT ORGANIZATION
By:
S ignature
Name
Title
EXHIBIT 14
29A-19
29A-20