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HomeMy WebLinkAbout2017-04-17 Guide Dog DayAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name 'Oil City of Palm Springs I F �; F' i e ' Division, Department, or Region (if applicable) O For Official Use Only ►�\ 1i MAY I $ PM 6� Designated Agency Contact (Name,TiNe) v iCE Gi= "i�- Cindy Cairns, Executive Services Administrator ❑ Amendment (Must Provide ExpranaSon in Pen 3.) Area Code/Phone Number E-mail l Filing: i i f Original ng: 760-322-8362 cindy.cairns@palmspringsca.gov Date o(month, day, year) 2. Function or Event Information Does the agency have a ticket policy? Yes® No ❑ Face Value of Each Ticket/Pass $ 150.00 Event Description: Guide Dogs Dog Day Afternoon Date(s) 04 1 17 1 17 —J f Provide Titte/Explanation Tickets)/Pass(es) provided by agency? Yes ® No ❑ If no: Name of Source Was ticket distribution made at the behest Yes ❑ No ® If yes: QflCiaPS 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 mber B. Name of Individual of Tickegs)/ Identify one of the following: (Last, First) Passes Ceremonial Role ❑ Other ® Income ❑ Moon, Robert 1 trchecmng-Ceremonial Rde"or'Other'describebelow: Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other X❑ Income ❑ if checking 'Ceremonial Rate" or'Other' describe below Number C. Name of Outside Organisation of Tickegs►1 Describe the public purpose made pursuant to the agency's policy (include address and description) Pass 4. Verification I have read and with the require) Comment: FPPC Regulations 18944.1 and 18942, I have verified that the distribution set forth above, is in accordance David Ready City Manager 5110 Designee Print Name Title (month, day, year) FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)