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City of Santa Ana City Manager's Office—M-31 <br />y 20 Civic Center Plaza <br />ry <br />!T^ Donation request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />,r„ <br />""`'-'""" (714) 647.5200 <br />Z,ontaitt Inforinn-at—lon <br />Founder <br />Name: Johanthan R. Hernandez tle: and Executive Director <br />(Address: <br />`422 E, chesut Ave, Unit # A <br />tn <br />1clty, <br />state, z1P: <br />( Santa Ana, CA 92701 (Phone: [ 657-261-1653 <br />Email: santanaunidos@gmail.com Fax: <br />Name: Santa Ana Unldos <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization asrr r <br />defined under Section 501(c)(3) of the Internal Revenue Code? Select One: 1 Yes ❑ No <br />If No, you will only qualify fora credit for City -related costs for your request (i.e. permit fees, If Yes, f <br />staff time, rental rates for facilities or equipment,etc.). Costs for City services vary and if ]47-5211563 <br />full City ID #: <br />r cost of requeservices. ax <br />approved, credit may or may not cover <br />Donation <br />City Services Credit '.. <br />Requested: <br />$ <br />(Date Needed: 10/28/2017 Mayor/co uncilmember. <br />Sarmiento <br />mount <br />Direct Payment Amount <br />Requests d: <br />$1,000 000 Event Date 10/28)2017 'Event Time: 6:00 PM -10:00 PM <br />( <br />[Event Location <br />505 E. Central, Santa Ana, CA 92705 <br />(Address City, State, Zip <br />To promote alternative and effective forms of youth rehabilitation programs to incarceration. <br />Description of <br />Event Purpose: <br />award ceremony to highlight positive Santa Ana role models who came from our local <br />neighborhoods and attain success and recognition for their achievements. <br />Emotional development for youth and engagement of community to address the <br />[Community Benefit: <br />underlying conditions that contribute to gangs and deteriorating neighborhoods. <br />APPlicant.Signature - �yp �p�y�y�Z _— — Date____—__ 110/19/2017 - - <br />_—___—_—____—__-__—.__.—._____..—___._ <br />Mail: City Manager's Office —M-31 Email: donationrequest@santa-ana.org <br />20 Civic Center Plaza Fax: (714) 647-6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />DonationryRequest#. ( DR - I NOVEMBER 7,2017 <br />Council Meeting ate: <br />h'eio-renc2:F an a(( 'e led OPVs D <br />I'E$ Approved Amount: <br />Eligibility Met: i YES MO- I $1,000 <br />I City Manager Signature: Date. <br />EXHIBIT 6 <br />