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2019-01-13 PSIFF Closing Night Screen & ReceptionW Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs Division, Department, or Region (if applicable) 2019 11i'l Christina Chartier, Executive Assistant to Mayor and Council 760-322-8366 1 christina.chartier@palmspringsca.gov A Public Document Date. Stamp 0 g i i I 1: 12 I For Official Use Only Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, tlay year) 2. Function or Event Information Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 60.00 9 Y P Y Yes ® No ❑ Event Description: PSIFF Closing Night Screen&Recept. Date(s) 01 ) 13) 19 Provide Tdle/Explanation Tickets)/Pass(es) provided by agency? Yes ❑ No El If no: Palm Springs International Film Festival Name o1 Source Was ticket distribution made at the behest Yes ❑ No ® If yes: of agency official? Official's Name (Last 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 neket(s)l Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Ticketts)l Identify one of the following: (Last, First) Passes Blaisdell, Amy Ceremonial Role ❑ Other Q Income ❑ -Ceremonial 2 It checking Role-or-OtheC describe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d x Kotkin, Edward Ceremonial Role ❑ Other I] Income ❑ 211 checking'Ceremonial Ro'e-or'Olher dewnbe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 d x Name of Outside Organization C. Number of Tlcket(s)l Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 4. Verification 1 have read and understand FPPC Reg ations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with the requirements. David Ready City Manager Signature of Agency Hg4 or Print Name Tiae (month, day, year) Comment: 6 FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276.3772) Agency Report of: California Ceremonial Role Events and Ticket/Pass Distributions 802 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)l Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Ticket(s)l Identify one of the following: (Last, First) passes Salizar-Wilson, Catherine Ceremonial Role ❑ Other ® Income ❑ 2 If checking "Ceremonial Role" or 'Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Hintz, Terri Ceremonial Role ❑ Other ® Income ❑ 2 1f checking -Ceremonial Role" or 'Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 d)(x) Lopez, Janice Ceremonial Role ❑ Other ® Income ❑ 2 if checking 'Ceremonial Role" or "Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Nelson, Caren Ceremonial Role ❑ Other ® Income ❑ 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 C• Number of Ticket(s)l Describe the public purpose made pursuant to the agency's policy (include address and description) Passes FPPc Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Form 802 —Additional Tickets for Palm Springs International Film Festival Closing Night Screening & Reception 1/13/19 Goedhart, Veronica — 2, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x)