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City Manager's Office- M -31 <br />City of Santa Ana 20 Civic Center Plaza <br />�r Donation e P.O. Box 1980 <br />Request Q Santa Ana, C 92702 <br />(714) 644 7 -5200 <br />Contact Information <br />same: (Cory Nelson - -- _Title: jPresident <br />�I <br />Address: 911 N. Olive Street <br />Vichy, Slate, Zip: ( Santa Ana, Ca 92703 (Phone: 1503- 490 -2445 <br />Emau: president @santaanapony.com (Fax: . <br />(Name: (Santa Ana Pony Baseball <br />Tax- Exempt Status: Is your organization a non -profit or public tax - exempt organization as Select One: <br />defined under Section 501(c)(3) of the Internal Revenue Code? Yes O No <br />If No, you wilt only qualify for a credit for City- rotated costs for your request (i.e. permit fees, IIf Yes, <br />staff time, rental rates for facetles or equipment, etc.).Costs for City services vary and# 46- 1054416 <br />approved, credit may or may not cover fu0cost orrequested C #y services. I7az ID #: <br />!City Services Credit <br />$ (Date Needed: <br />(M ayorlCouncllmember: <br />Amezcua <br />Amount Requested: <br />(Direct Payment Amount <br />Requested: <br />$700 lEvent Date: 11/12/2016 <br />(Event Time: <br />10800 <br />Event Location: <br />Riverview Park. 1817 W. 21 st St. <br />Santa Ana, Ca 92706 <br />Address, Cily, State, Zip <br />iSAPB Fall Ball <br />Description of <br />Event Purpose: <br />262 Santa Ana youth baseball players <br />participation. <br />Community Benefit: <br />(Applicant Signature: <br />( <br />[Dale: <br />11/1/2016 <br />(Mall: City Managers Office -M -31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #: DR- <br />)­ ,.I',,, n r :ie"I;w ,- <br />Eligibility Met: YES I NO <br />City Manager Siguature: <br />Email: donatlonrequest @sent"na.org <br />Fax: (714) 647 -6964 <br />Council Meeting Date: <br />Approved Amount: <br />Date: <br />EXHIBIT 1 <br />2901-3 <br />Revised 11116/2015 <br />