HomeMy WebLinkAbout2025-05-05 DBA Impact AwardsAgency Report of:
Ceremon ial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name
City of Palm Spri ngs
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Ll ub i Rios , Ex ec uti ve Servi ces Admini strator
Area Code/Phone Number
760-322-8362
E-mail
Llubi .r ios@pa lmpspri ngsca .gov
Date Stamp
RECEIVED
California 802
Form
For Official Use Only
JU N 2 4 2025
D Amendment (Must Provide Explanation in Part 3.)
Date of Origi nal Filing:--,--,,-~---,.-
(month, day. year)
2. Function or Event Information
Does the agency have a ti c ket policy? Yes ~ No • Fa ce Val ue of Each Ti c ket/Pass $ _1_2_5 _.o_o _____ _
Event Description : OBA Impact Awa rds _j_j __
Provide Title/ Exp lanation
Ti cket(s)/Pass(es) provi de d by agen cy? Yes • No I&) If no : Dese rt Bu siness Asso ci ation
Name of Source
Was ticket distributio n made at the behest Yes • No 18) If yes: ------------=---------Official's Nam e (L ast, F irst)
of agen cy official?
3. Recipients
• Use Sect ion A to identify the agency's d epartment or unit . • Use Section B to identi fy a n indiv id ual. • Use Section C to ide nUfy a n out si d e orga nization .
Number
A. Name of Agency, Department or Unit ofTicket(s )/ Describe the public purpose made pursuant to the agency's policy
Passes
Number B. Name of Individual of Ti cke t(s)/ Id entify one of the following :
(Last, First) Pa sses
Ceremonial Role D Other IBJ Income D
deHart e, Ron 1 If checking "Ceremomal Role" or "Other' descn"'3 below
Publi c Purpose as de fi ned by PS Reso lu tion No. 22454,
Sectio n 1 (d)(vii)(viii )(ix)
Ceremonial Role D Other 18) Income D
Ga rn er, Grace 1 II chec/<Jng "Ceremon,al Role " or "Other' descn"'3 be/OW'
Pub lic Purpose as d efi ne d by PS Resolution No . 22454,
Section 1 (d)(vii)(vi ii)(ix)
Name of Outside Organization Number
C. of Ti cket (s)/ Describe the public purpose made pursuant to the agency's policy
(Include address and descripti on) Passes
4. Verification
I have read and understand FPPC Regulations 18944.1 and 18942. I have ve rified that the distribution set forth above, is in accordan ce
with the requi ments .
Scott C . Stil es City Manager
Prin t Name Trtl e
Comment:-------------------------------------------
FPPC Form 802 (2/2016)
FPPC To ll-Fr ee Helpli n e: 866 /ASK-FPPC (866/275-3772)
Agency Report of:
Ceremonial Role Events and TickeUPass Distributions
California 802
Form
Continuation Sheet A Public Document
Agency Name
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 identify an outside organization.
Number
A. Name of Agency, Department or Unit of Ticket(s)/
I Passes
Number s. Name of Individual of Tlcket(s)f
I (Last, First) Passes
Ready, David 1
Bernstein, Jeffrey 1
Soto, Naomi 1
Stiles, Scott 2
I Name of Outside Organization Number
G. of Ticket(s)/
(include address and description) ! Passes
Describe the public purpose made pursuant to the agency's policy I
I
. .
I
Identify one of the following:
Ceremonial Role D Other~ 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@ Income D
If checking "Ceremonial Rare· or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 /d)(vii)(viii)(ix)
Ceremonial Role D Other@ Income D
If checking "Ceremonial Rafe• or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(ix)
Ceremonial Role D Other@ Income D
If checking ·ceremonial Rote·or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(ix)
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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Form 802 -Additional Tickets for the DBA Impact Awards 05/05/25
Olson, Wayne -1, Public Purpose as defined by PS Resolution No. 22454, Section 1
( d)(vii)(viii)(ix)
Grubl, Dean -1, Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(vii)(viii)(ix)
Mills, Andrew -1, Public Purpose as defined by PS Resolution No. 22454, Section 1
( d)(vii)(viii)(ix)