2020-02-16 Nancy Sinatra Historic Plaza Theater FundraiserAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
or Region (if applicable)
Designated Agency Contact (Name, Title)
Shari Wrona, Executive Services Administrator
Area Code/Phone Number I E-mail
760-322-8632 1 shari.wrona@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: Nancy Sinatra Historic Plaza Theatre
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No El
ECEiV
2020 ApR 16 Phi
FFICE OF TH4 CIT
Document
For Official Use Only
CLET .1
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 12.00
Date(s) 02 t 16 i 20
If no: Modernism Week
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Official's Name (Last, First)
of agency official?
02 / 16 / 20
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)l Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of Ticket(s)/ Identify one of the following:
(Last, First) Passes
Ceremonial Role ❑ Other ❑x Income ❑
Woods, Dennis 2 Ifchecking"CeremonialRole" or"Other' describe below
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vi viii xi
Ceremonial Role ❑ Other ❑ Income ❑
Ready, David 1 Ifchecking"CeremonialRole" or"Other'describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vi viii xi
Name of Outside Organization Number
C. (include address and description) of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
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
requirements.
David Ready City Manager
Signatures a or esignee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
Agency Report of: uamornia 80A
Ceremonial Role Events and Ticket/Pass Distributions 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
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Tickos►I
Passes
Identify one of the following:
Ceremonial Role ❑ Other El Income ❑
Blaisdell, Amy
1
If checking 'Ceremonial Role" or"Other' describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role ❑ Other ® Income ❑
Pauley, Nancy
1
Ifchecking "Ceremonial Role" or"Other"describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role ❑ Other ® Income ❑
Goedhart, Veronica
1
Ifchecking"Ceremonial Role"or"Other' describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role ❑ Other ® Income ❑
Foat, Ginny
2
Ifchecking "Ceremonial Rote" or"Other' describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Name of Outside Organization
C.
(include address and description)
Number
of Tick s)I
es
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)