HomeMy WebLinkAbout2025-03-29 Steve Chase Humanitarian Awards 1Agency Report of:
Ceremonia l Role Event s and Ticket/Pass Distributions A Public Document
1 . Agency Name
City of Palm Springs
Division , Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Llubi Rios, Executive Services Administrato r
Area Code/Phone Number
760-322-8362
E-mail
Liu bi .rios@palmp springsca.gov
Date Stamp
RECEIVED
California 802
Form
For Official Use Only
MAY t 3 2025
OFFl ~~-+H~++.:t~IIIIM....,_ ___ ---l
0 Amendment (Must Provide Explanation in Part 3.)
Date of Ori ginal Filing:--,--,,---,----,.-
(month, day, year)
2. Function o r Event Information
Does the agency have a ticket policy? Yes 181 No • Face Value of Each TickeUPass $ _5_o_o_.o_o _____ _
Event Description: Steve Chase Humanitarian Awards
Provide Title/ Explanation
___J___J __
Ticket(s)/Pass(es) provided by agency? Ye s~ No • lfno: _________________ _
Name of Source
Was ticket distribution made at the behest Yes • No 18) If yes:-------------------
Offlciars Name (Last, First)
of agency official?
3. Recipients
• Use Section A t o identify the agency's department or unit. • Use Section B to identify an individual. • Use Section C to iden tify an o utside organization .
Number
A. Name of Agency, Department o r Unit of Ticket(s)/ Describe the public purpose made pursuant t o the agency's policy
Pa sses
Number
B. Name of Individual of Tlcket(sV Identify one of the following:
(L ast, First) Passes
Ceremon ial Role 0 Other IBJ Income 0
Bernstein , Jeffrey 1 If checking ·ceremon,a/ Role" or "Other" descnbe below
Publi c Purpose as defined by PS Resolution No. 22454 ,
Section 1 (d)(vii)(viii)(ix)
Ceremonial Role 0 Other (g:j Income 0
Soto, Naomi 1 If checking ·ceremon,a/ Role" or "Olher" descnbe below
Public Purpose as defined by PS Resolution No. 22454 ,
Section 1 (d)(vii)(viii)(ix)
Name of Outside Organization Number
C . of Ticket(s)/ Desc ribe the public purpose made pursuant t o the agen cy 's policy
(include address and description) Pa sses
4 . Verificat ion
ations 18944. 1 and 18942. I have verified that the distribution set forth above, is in accordance
Signa ture of Agency Head or Designee ~4: Scott C . Stiles City Manager
Print Name Titte
Comment: ________________________________________ _
FPPC Form 802 (2/2016)
FPPC Toll-Free Hel pline: 866/ASK-FPPC (866/275-3772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
Continuation SheetG~Vi::l~1~f :!
California 802
Form
A Public Document
Agency Name :\!l\, i' ,· J\ , ..•
City of Palm Springs _____ -··-
3. Recipients · '·""''•' ' • '' ,_;II, •• • ..(~l J I•-
• 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 .. · · . · ~ame of Agency, Department or Unit OfTlcket(sJ/
I Passe~
,-. --------Nllmber ' B. ,-.lame of Individual of Ticket(s)/
I (Last, First) Passes
Ready, David 1
Garner, Grace 1
I •. ·NIJmber
C. Name o_f Outside Organiz.iti_on of Tlcket(sV
i (include address and description) Passes
Describe the public purpose made pursuant to the agency's policy
---------------1 Identify one of the following:
Ceremonial Role D Other J&I Income D
If checking ·ceremonial RD/e" or -Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(ix)
Ceremonial Role 0 Other@ Income D
If checking ·ceremonial Role" or "Other"describe be/aw:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(viiil(ix)
Ceremonial Rote D Other D lnc6me D
If checking ·eeremonia/ Rnfe" or -Othe,-describe below:
Ceremonial Role D Other D Income D
If checking "Ceremonial Rn/e· or-Othe,-descn'be below:
Describe the pub_l_iC purpose made pursuant tQ t:tie agency's policy
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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