2020-08-05 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name CITY 0
City of Palm Springs
Division, Department, or Region (if applicable) 28H -Ai
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? Face Value of Each Ticket/Pass $ 30.00
9 Y P Y� Yes® No
Event Description: PSHA Member Luncheon Date(s) 02 / 20 / 20 02/ 20 If 20
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes I@ No ❑ If no:
A Public Document
P A L PKMIN G S 1111M..
- 5 AM 9: 54 1 For Official Use Only
THE CITY CLU
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
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 Ticket(s)t Describe the public purpose made pursuant to the agency's policy
Passes
N
B. Name of Individual
Number
of Ticket(s)I
Identify one of the following:
(Last, First)
Passes
Ceremonial Role ❑ Other ❑ Income ❑
Middleton, Lisa
1
If checking "Ceremonial Role"or"Other" describe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Ceremonial Role ❑ Other ❑ Income ❑
Garner, Grace
If checking "Ceremonial Role" or'Other' describe below
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Name of Outside Organization
C.
Number
of Ticket(s)/
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
l have read and understand
with the requirements. n
Comment:
Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (866/276-3772)
Agency Report of: i Calitornia
Ceremonial Role Events and Ticket/Pass Distributions Form A
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
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:
Woods, Dennis
2
Ceremonial Role ❑ Other El Income ❑
If checking"Ceremonial Role"or"Other" describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1(d)(vii)(viii)(xi)
Ceremonial Role ❑ Other ❑ Income
If checking "Ceremonial Role' or "Other" describe below:
❑
Ceremonial Role ❑ Other ❑ Income
If checking "Ceremonial Role' or "Other" describe below:
❑
Ceremonial Role ❑ Other ❑ Income
if checking "Ceremonial Role" or "Other" describe below:
❑
C.
Name of Outside Organization
(include address and description)
Number
of Ticket(s)I
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)