HomeMy WebLinkAbout2025-04-16 Eisenhower Health Annual MixerAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division , Department, or Reg ion (if applicable)
Designated Agency Contact (Name, Title)
Llubi Rios, Executive Services Admin istrator
Area Code/Phone Number
760-322-8362
E-mai l
Ll ubi .rios@palmpspringsca .gov
OFF EOFTHECITY
D A m e ndment (Must Provide Explana tion in Part 3.)
Da te of Original Filing:--,---,,.--,-----,-
(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes 181 No • Face Value of Each Ticket/Pass$ _2_o_.o_o _____ _
Event Description : Eisenhower Health Annual Mixer
Provide Title/ Explanation
__}__} __
Ticket(s)/Pass(es) provided by ag ency? Yes ~ No D If no: ________________ _
Name of Source
Was ticket distribution made at the behest Yes • No~ If yes : -----,---,----------------
Officia l's Name (Last, First) of agency official ?
3. Recipients
• Use Section A to identify the agency's d epartment or unit. • Use Section B to identify an i ndividual. • Use Section C to identify an outside organization.
A. Name of Agency, Department or Unit
Number
of Ticket(•)/ Describe the public purpoae made pur•uant to the agency"s policy
PH-
B. Number
Name of Individual of Ticket(•)/ Identify one of the following:
(Last, First) PH•N
Ceremonial Role D Other 1B) Income D
Stiles , Scott 1 If checl<Jng "Ceremonial Role" or "Other" describe bekM
Public Purpose as defined by PS Resolution No. 22454 ,
Section 1 ( d)(vii)(viii )(ix)
Ceremonial Role D Other lBJ Income D
Ready, David 1 If checking ·ceremonial Role· or "Other" descnbe below
Public Purpose as defined by PS Resolution No. 22454 ,
Section 1 (d )(vii)(viii)(ix )
Na me of Outside Organization Number C. of Tlcket(s)/ Dea cribe the public purpose made pur•uant to the agency's policy (include addresa and dftcrlption) P•H e•
4 . Verification
I have read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
with the requir, ents.
Scott C. Stiles
Print Name
City Manager l5/?-c;) ;z-~
-------'----:Ti:,,itl,-e--=-----I (mont/1,day, y ear)
Comment:-----------------------------------------
FPP C Form 80 2 (2/2016)
FPPC To ll-Free Helpline: 866/ASK-F PP C (866/275-3772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
Continuation Sheet
California 802
Form
A Public Document
Agency Name
City of Palm Springs
3. Recipients
• Use Section A lo identify the agency's department or unit. • Use Section B to identify an individual • Use Section C to identify an outside organization.
' Name of Agency, Department or Unit A. of Tlcket(s)I
Number
i Passes
r --------· ----------------.. ---.
Number B. Name of Individual ofTicket(s]/
I (Last, First) Passes
Soto, Naomi 1
i Name of Outside Organization Number
C. ofTlcket(sV
' (Include address and descriptlon) Passes '
Describe the public purpose made pursuant to the agency's policy
---------------I
Identify one of the following: ' I
I
Ceremonial Role D Other I&! Income D
If checking •ceremonial Role" or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(ix)
Ceremonial Role D Other D Income D
If checking "Ceremonial Role· or ·other" describe below:
Ceremonial Role D Other D Income D
If checking "Ceremonial Role" or "Other" describe below:
Ceremonial Role D Other D Income D
If checking •ceremonial Role" or "Other" describe be/Ow:
' Describe the public purpose made pursuant to the agency's policy I
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
i