2021-05-01 PS Air MuseumAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name CITY OF p ~~ t~RINO California 802
Form City of Palm Springs
JUL -8 PM 12: 56
=-,---____,....,,......--,,,,...,_....,____,...-----------.....~ OF THE CITY CL E11 ~ Designated Agency C~ntact (Name, Title)
Division, Department, or Region (if applicable) For Official Use Only
Shari Wrona, Executive Services Administrator
Area Code/Phone Number
760-322-8632
E-mail
shari.wrona@palmspringsca.gov
D Amendment (Must Provide Explanation in Part 3.)
Date 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 TickeUPass $ _2_32_·_4 _1 ____ _
Event Description: PS Air Museum -25th Anniversary
Provide Title/ Explanation
Ticket( s )/Pass( es) provided by agency? Yes~ No D If no: _________________ _
Name of Source
Was ticket distribution made at the behest Yes • No 18) If yes: ------------------Official's 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(s)I Describe the public purpose made pursuant to the agency's policy
Passes
Number B. Name of Individual of Ticket(s)I Identify one of the following:
(Last, First) Passes
Middleton, Lisa Ceremonial Role D Other [81 Income D
If checking "Ceremonial Role" or "Other" describe below: 1 Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vi)(vii)(viii)
Ceremonial Role D Other D Income D
If checking "Ceremonial Role" or "Other" describe below:
Name of Outside Organization Number
C. of Ticket(s)I Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
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 requirements.
Justin Clifton
Print Name
City Manager (Xp / / 4 J 2-/
-----=Ti"""""tle____ l(rnonffi;biiy, yeaf')
Comment:------------------------------------------
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)