2019-03-21 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name Date stamp .'
City of Palm Springs
Division, Department, or Region (if applicable) 2012 11.til, 25 T.'i 10: 25 For Official Use Only
Designated Agency Contact (Name, Title)
Christina Chartier, Executive Assistant to Mayor and Council ❑ Amendment (must Provide Explanation in Part 3.)
Area Code/Phone Number E-mail
760-322-8366 christina.chartier alms rin sca. Date of Original Filing:
@p p g 9ov (month. day year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 30.00
Event Description: PSHA Member Luncheon Date(s) 03 y 21 y 19
Provide 77ffe/Explanadon
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.
Number
A. Name of Agency, Department or Unit
of Ticket(s)l
Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual
ofTlcket(su
Identify one of the following:
(Last, First)
Passes
Middleton, Lisa
Ceremonial Role ❑ Other Z Income ❑
1
Uchecking-Ceremonial Role" or'Other'descnbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii ix
Kors, Geoff
Ceremonial Role ❑ Other I] Income ❑
1
ll checking'Ceremonial Role'or-Olher' describe below..
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii ix
Name of Outside Organization
C.
Number
of Ticket(s)f
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
I have read and understand EPPC Regulations 18944.1 and 18942. 1 have verified that the disMbution set forth above, is in accordance
with the requirements
David Ready City Manager
Signature o Ah a He or Designee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212616)
FPPC Toll -Free Helpline: 866IASK-FPPC (8661276-3772)