HomeMy WebLinkAbout2025-03-20 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document ------------------------r--------1. Agency Name Ff~mED California 802
City of Palm Springs
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Llubi Rios, Executive Services Admi nistrator
Area Code/Phone Number
760-322-8362
E-mail
Llubi.rios@palmpspringsca.g ov
Form
MAY O 1 2025 For Official Use Only
CE OF THE CITY LERK
0 Amendment (Must Provi de Explanation in Part 3.)
Date of Original FIiing : _______ _
(month, day, year)
2. Function or Event Information
Does the agen cy have a ticket policy? Yes ~ No D Fa ce Value of Each TickeU Pass $ _4_o._o_o _____ _
Event Description : PSHA Member Luncheon ____J____J __
Provide Title/ Explanation
Ticket(s)/Pass(es ) provided by agen cy? Yes ~ No D If no: ________________ _
Name of Source
Was ticket distribution made at the behest Yes • No 181 If y es: ------------------
Official's Name (Last. First) of agency official?
3. Recipients
• Use Section A to identify the agency's d epartment or unit. • Us e Section B t o identify an individual. • Use Section C to identify an o utsid e organization.
A. Name of Agency, Department or Unit
Number
ofTicketJs)/ Describe the public purpose made pursuant to the agency's policy
Passes
Number B. Name of Individual of TicketJ1)/ Ident ify one of the following:
(Last , F i rst) Pa sses
Ceremoni al Role 0 Other ~ Income 0
Bernstei n, Jeffrey 1 If checking ·ceremonial Role· or "Other" descnbe below
Public Purpose as defined by PS Resolution No. 22454,
Se ct ion 1 ( d)(vii)(vii i)(ix)
Ceremonial Role 0 Other IE) Income D
deHarte , Ron 1 If checking •ceremon,a/ Role" or "Other" descnbe below
Publi c Purpose as defi ned by PS Resolu tion No . 22454,
Secti on 1 ( d)/vii)(viii )(ix)
Name of Outside Organization Number
C . ofTicket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Passes
4 . Verification
I have read an d understand FPPC Regulations 18944.1 and 189 42. I have verified that the distribution set forth above, is in accordance
with the r quirem ents.
Scott C. Stil es C ity Manager
Prin t Name Trtfe
Comment:-------------------------------------------
FPPC Form 802 (2/2016)
FPPC Toll-Fr ee He lpline: 866/ASK -FPPC (866/275-3772)