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HomeMy WebLinkAbout2017-03-09 Boys and Girls Club Ensuring Great FuturesAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs , or Region (if applicable) Designated Agency Contact (Name, Title) Cindy Cairns, Executive Services Administrator Area Code/Phone Number E-mail 760-322-8362 1 cindy.cairns@palmspringsca.gov A Public Document IT Y OF PALM SP Form — Wot Official use Only 2611 APR 24 Phi S i+3 OFFICE OF Trfc-- Cj f y ji E%pit ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 75.00 Event Description: Boys&Girls Club Ensuring Grt Futures Date(s) �09 1 17 f I Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no: Name of source Was ticket distribution made at the behest Yes ❑ No ® If yes: Official's Name (Last, First) of agency official? 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section B to identify an individual. • Use Section C to identify an outside organization. Number A. Name of Agency, Department or unit of Ticket(sy Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual of Tlekst(au Identify one of the following: (Last, First) Passes Ceremonial Role ❑ Other © Income ❑ Moon, Robert lfchecking'Ceremonial Role" or'Orher' describe below: Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other X❑ Income ❑ Mills, Chris t If checking 'Ceremonial Rde"or'Othee'describebebw. Public Purpose as defined by PS Resolution No. 22454 Name of Outside Organization Number C. of'ftckegau Describe the public purpose made pursuant to the agency's policy (include address and of Passes 4. Verification 1 have read and understand ff Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance with the requirements_ Z 1 Comment: (/ G David Ready City Manager ee Print Name Title (month, day, year) FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions Continuation Sheet Agency Name A Public Document City of Palm Springs 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section B to identify an individual. • Use Section C to identity an outside organization. Number A. Name of Agency, Department or Unit of Ttcket(sl/ Passes Describe the public purpose made pursuant to the agency's policy B. Name of Individual (Last, First) Number of Tlcket(sN Passes Identify one of the following: Mills, Dawn I Ceremonial Role ❑ Other El Income ❑ lfchecking "Ceremonial Role"or'Otherdescribebekow: Public Purpose as defined by PS Resolution No. 22454 Keane, Jeff t Ceremonial Role ❑ other El Income ❑ lfchecking 'Ceremonie!Role"or"Other"describe below: Public Purpose as defined by PS Resolution No. 22454 Keane, Barbara 1 Ceremonial Role ❑ Other ® Income ❑ ifchecking"CeremoniakRoie"or "Othee'descnbebeiow: Public Purpose as defined by PS Resolution No. 22454 Greenwood, John 1 Ceremonial Role ❑ Other El Income ❑ if checking "Ceremonial Role" or "Omer descnbe below: Public Purpose as defined by PS Resolution No. 22454 Noma of Outside Organization IC.of (include address and description) Number ber s)1 Pa Describe the public purpose made pursuant to the agency's poll policy FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Form 802 — Additional Tickets for Boys & Girls Club Ensuring Great Futures Luncheon, March 9, 2017 Greenwood, Heather —1, Public Purpose as described by PS Resolution No. 22454 McLean, Kelly —1, Public Purpose as described by PS Resolution No. 22454 Bloomer, Kristin —1, Public Purpose as described by PS Resolution No. 22454