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City of Santa Ana Donation Request City Manager's Office - M -31 20 Civic Center Plaza P.O. Box 1986 Santa Ana, CA 92702 (714) 647 -5200 Family /Community- oriented Movie Night. As Hoover is not a neighborhood .Description of school, this will foster postive relationships with our parents. Event I Purpose: Bridge the connection between the school community and the Santiago Park Community Benefit: neighborhood community. Applicant signature: Date: November 23, 2016 �etum completed form via: Mail: City Manager's Office -M -31 Email: donationmquest@santa- ana.org 20 Civic Center Plaza Fax: (714) 647 -6954 P.O. Box 1988 Santa Ana, CA 92702 _ Donation Request N� DR - - Council Meeting Date: Eligibility Met: YES I NO Approved Amount: City Manager Signature EXHIBIT 1 Date: Revised 11/16/2015 29E -3 Contact information Armando Gutierrez Title, Principal _ Name: 408 E. Santa Clara Ave. Address: Santa Ana, CA 92706 Phone: (714) 564 -2103 city, state, zip: armando.gutierrez @sausd.us Fax: (714) 564 -2199 Email: • .. Name: Hoover Elementary School Tax - Exempt Status: Is your organization a non -profit or public tax - exempt organization as Select One: Code? ❑ Yes No defined under Section 501(c)(3) of the Internal Revenue 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 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. Tax ID 9: Donation city Services Credit s 300.00 Date Needed: 02/02/2017 MayorlCouncilmember. Amezcua Amount Requested: Direct Payment Amount $ Event Date: 02/02%2017 Event Time: 6:00 - 8:00 p.m. Requested: Hoover Elementary School Event Location. 408 E. Santa Clara Ave., Santa Ana, CA 92706 Adtlrcss, City, State, Zip Family /Community- oriented Movie Night. As Hoover is not a neighborhood .Description of school, this will foster postive relationships with our parents. Event I Purpose: Bridge the connection between the school community and the Santiago Park Community Benefit: neighborhood community. Applicant signature: Date: November 23, 2016 �etum completed form via: Mail: City Manager's Office -M -31 Email: donationmquest@santa- ana.org 20 Civic Center Plaza Fax: (714) 647 -6954 P.O. Box 1988 Santa Ana, CA 92702 _ Donation Request N� DR - - Council Meeting Date: Eligibility Met: YES I NO Approved Amount: City Manager Signature EXHIBIT 1 Date: Revised 11/16/2015 29E -3