2019-01-17 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
or Region (if applicable) H N I :
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 christina.chartier@palmspringsca.gov
2. Function or Event Information
A Public Document
Date Stamp
20 Ali 1 I . 12 1 For Official Use Only
❑ Amendment (Must Provide Explanation in Pad 3.)
Date of Original Filing:
(month. tlay year)
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) 01 / 17 l 199
Provide Me/Explanation
Tickets)/Pass(es) provided by agency? Yes ® No ❑ If no:
NameofSource
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)/
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Ticket(s)I
Passes
Identify one of the follovdng:
Moon, Robert
Ceremonial Role ❑ Other 17 Income ❑
ll checking'cem.onial Role-or-Othee'descnbebelow:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii ix
Ceremonial Role ❑ Other ❑ Income ❑
if checlang'Ceremonial Rde-or-OthW descnbe bNow.
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand
with the requirements.
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 $02 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)