2020-01-25 Black History Awards GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions RECEIVE[)A Public Document
1. Agency Name %.+ 1 t vrDratA4gWrAparnr ajitornia '
City of Palm Springs phh '
2(2
Division, Department, or Region (if applicable) � APR ' 6 �� 2' For Official Use Only
ON ICE OF THE CITY C Ef
Designated Agency Contact (Name, Title)
Shari Wrona, Executive Services Administrator
❑ Amendment (Must Provide Explanation in Part 3.)
Area Code/Phone Number E-mail
760-322-8632 1 shari.wrona@palmspringsca.gov Date of Original Filing: (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: 11th Annual Black History Award/Gala
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No 91
Face Value of Each Ticket/Pass $ 60.00
Date(s) 01 / 25 / 20 011 25 / 20
If no: Palm Springs Black History Committee
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® 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 T+cket(s)/ Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Number
B. of Ticket(s)/ Identify one of the following:
(Last, First) Passes
Ceremonial Role ❑ Other Q Income ❑
Garner, Grace 1 ifchecking"Ceremonial Role" or"Other"describe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vi viii xi
Ceremonial Role ❑ Other 0 Income ❑
Ready, David 1 /fchecking"Ceremonial Role"or"Other' describe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vi viii xi
Name of Outside Organization Number
of Ticket(s)1 Describe the public purpose made pursuant to the agency's policy
C. (include address and description)
Passes
4. Verification
1 have read and understand FPPC Regulations 18944.1 and 18942. l have verified that the distribution set forth above, is in accordance
he requiremynts.
David Ready City Manager
Signature of Agency Head or Print Name Title (month, day, year)
Comment:
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772)