2019-01-26 PS Art Museum GalaAgency Rdport of:
Ceremonial Role Events and Ticket/Pass Distributions
A Public Document
City of Palm Springs
Division. Department. or
2015
ueslgnateD Agency contact (Name, title) .. =
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 christina.chartier@palmspringsca.gov
Date Stamp
Ali II. 12 I For Official Use Only
Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Face Value of Each Ticket/Pass $ 750.00
Event Description: PS Art Museum Gala Date(s) 01 ) 26 / 1 gg
Provide 7ifle/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No El If no: Palm Springs Art Museum
Name of source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
Official's Name (Last, First)
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)f
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(s)/
Identify one of the following:
(Last, First)
Passes
Moon, Robert
2
Ceremonial Role ❑ Other Z Income ❑
Ifchecldng'Cemmonlai RWe' or'Other describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d iii vii viii
Roberts, J.R.
2
Ceremonial Role ❑ Other ❑X Income ❑
If checkng'Ceremonial RWe' or'Other' Mscnbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d iii vii viii
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand
with the requirements.
Comment:
Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Tide (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772)
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 rcket(s)l
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Ticket(s)l
Passes
Identify one of the following:
Kors, Geoff
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)(iii)(vii)(viii)
Holstege, Christy
2
Ceremonial Role ❑ Other ® Income ❑
If checking "Ceremonial Role" or 'Other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(iii)(vii)(viii)
Ready, David
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
Ceremonial Role ❑ Other ❑ Income ❑
If checking "Ceremonial Role" or "Other" describe below:
Name of Outside Organization
C' include address and description)
(� p )
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772)