2019-02-06 Guide Dogs of the Desert FundraiserAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable) r1019
Uesignated Agency contact (Name, Title)
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 chdstina.chartier@palmspringsca.gov
A Public Document
Date Stamp
13
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 $ 175.00
9 Y P Y� Yes ® No ❑
Event Description: Guide Dogs of the Desert Fundraiser Date(s) 02 ) 06 ) 19
Provide TitterExplanaffon
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no:
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.
A. Name of Agency, Department or Unit
Number
of Ticket(s)I
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Lest, First)
Number
of Tickeds)I
Passes
Identify one of the following:
Moon, Robert
,�
Ceremonial Role ❑ Other I] Income ❑
Il checb'ng'CRremonial Rde-or'Olher'dsscnbe Delow'
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii
Roberts, J.R.
Ceremonial Role ❑ Other ❑x Income ❑
1
it cbecking-ceremonial Rde'or-other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii
Name of Outside Organization
C. (include address and description)
Number
of ncket(s)I
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
1 have read and
with the require)
Regulations 18944.1 and 18942. 1 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 (8661275-3772)