2020-01-12 PSIFF Closing Night ScreeningAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Shari Wrona, Executive Services Administrator
Area Code/Phone Number E-mail
760-322-8632 1 shari.wrona@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes IN No ❑
Event Description: PSIFF Closing Night Screening & Rec
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No El
Was ticket distribution made at the behest Yes ❑ No 99
of agency official?
Public Document
C I Y 0 FDfetsl[9 T 5 P R I Form i'
20 APR 16
PM 2: O For Official Use Only
ICE OF THE CITY CqE,
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 60.00
Date(s) 01 / 12 / 20 011 12 / 20
If no: PS International Film Festival
Name of Source
If yes:
Official's Name (Last, First)
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)/ Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Number
B. of Ticket(s)1 Identify one of the following:
(Last, First) Passes
Ceremonial Role ❑ Other ® Income ❑
Sanchez, Ramon 2 If checking"Ceremonial Role" or "Other" describe below.
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Ceremonial Role ❑ Other 10 Income ❑
Nalder, Kevin 2 If checking "Ceremonial Role" or "Other" describe below.
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Name of Outside Organization Number
of Ticket's)/ Describe the public purpose made pursuant to the agency's policy
C. (include address and description)
Passes
4. Verification
I have read and understand FPPC Regulations 18944.1 and 18942. l have verified that the distribution set forth above, is in accordance
14 uirements.
David Ready City Manager
Signature of Agency Hea esignee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions Form
Continuation Sheet A Public Document
Agency Name
City of Palm Springs
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.
Numh®r
A. Name of Agency, Department or Unit
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Ticket(s)/
Passes
Identify one of the following:
Cannady, Anglea
2
Ceremonial Role ❑ Other El Income ❑
If checking "Ceremonial Role" or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Lopez, Janice
2
Ceremonial Role ❑ Other ® Income ❑
If checking"Ceremonial Role" or"Other"describebelow:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Minjares, Rick
2
Ceremonial Role ❑ Other El Income ❑
If checking "Ceremonial Role" or "Other"describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Ceremonial Role ❑ Other ❑ Income ❑
If checking "Ceremonial Role" or "Other" describe below:
Name of Outside Organization
C. include address and description)
( P )
Number
of Tickegs►I
Passes
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)