2019-02-15 PS Air Museum GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable)
2019
Designated Agency contact (Name,Tltle)
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 christina.chartier@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy?
Event Description: PS Air Museum Gala
Provide TitterExplanaton
Tickets)/Pass(es) provided by agency? Yes ❑ No El
Yes® No❑
Was ticket distribution made at the behest Yes ❑ No
of agency official?
A Public Docum
Date Stamp
For Official Use Only
20 ANII: 13
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 395.00
Date(s) 02 1 15 l 19
If no: Palm Springs Air Museum
Name of source
If yes:
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)I
Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual
B. N
Number
of Tlcket(s)/
Identify one of the following:
(Last, First)
Passes
Middleton, Lisa
Ceremonial Role ❑ Other ❑x Income ❑
2
Itchwking'Cemmonial Role"or-Other' descdbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii
Kors, Geoff
Ceremonial Role ❑ Other ❑x Income ❑
2
It checldng'Cen:mmial Rde-or'Olher' eescnbe beow.
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii
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
4. Verification
I have read and understand
with the requirements.
Comment:
18944.1 and 18942. I 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: 866/ASK-FPPC (86612753772)
Agency Report of: California 802
Ceremonial Role Events and Ticket/Pass Distributions Form
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 71cket(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
Smith, Mike
Ceremonial Role ❑ Other El Income ❑
2
11 checking 'Ceremonial Role" or 'Other describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Young, Les
Ceremonial Role ❑ Other ® Income ❑
2
11 checking 'Ceremonial Role" or 'Other describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)(xi)
Woods, Dennis
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 vii xi
Vines, Janet
Ceremonial Role ❑ Other ® Income ❑
1
11 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)i
Describe the public purpose made pursuant to the agency's policy
(Include address and description) p )
Passes
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Form 802 — Additional Tickets for Palm Springs Air Museum Gala 02/15/19
Kolbeck, Staci —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x)