2019-03-28 10th Annual Runway Joslyn in BloomAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name Date Stamp California 802
City of Palm Springs
Division , Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Shari Wrona , Exec utive Services Ad ministra tor
Area Code/Phone Number
760-322-8632
E-mail
sha ri .wrona@ pa lms pringsca .gov
Form
For Official Use Only
0 Amendment (Must Provide Explanabon ,n Part 3.)
Date o f Original Filing : ______ _
(month, day. year)
2. Function or Event Information
Does the agency have a t icket policy? Yes 181 No O Face Value of Eac h Ti ckeUPass $ _1_2_5-_0_0 ____ _
Event Description: 10th A nnual Runway Joslyn in Bl o om
Provide Title/ Explanation
__J__j __
Ticket(s)/Pass(es) provided by agen cy? Yes~ No O If no: _________________ _
Name of Sourc:e
Was ticket distrib ution made at the behest Yes • No~ If yes: ------------------
Official's Name (Last, First)
of agency official?
3. Recipients
4.
• Use Sec tio n A t o i den tify the ag en cy's d epartment or unit. • Use Sec t i on B to identi fy an individual. • Use Sec tio n C t o identify an out.side or ganiu tion.
Number
A. Name of Agency, Department o r Unit of Ticket(s )/ Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of Tlcket(s)/ Identify o n e of the following:
(Last, First) Passes
Moon , Robert Ceremonial Role 0 Other ~ Income 0
1 If chedang 'Ceremonial Role-or ·other" descnbe below
Public Purpose as defi ned by PS Resolution No . 22454 ,
Section 1 ( d)(vii)(viii)(xi)
Ceremonial Role 0 Other 0 Income 0
II checking 'Ceremonial Role-or ·other" descnbe below
Name of Outside Organization Number
C. of Ticket(s)/ Describe the public purpose made pursuant t o the agency's po licy
(Include address and description) Passes
Verification
,.
I have read and understam ; I '1 i>C Regulations 18944 .1 and 18942. I have verified that the distribution set fo,th above, is in accordance
with the re quirements. I •~
' I
Signature of Agency HT or lflJli ee
Comment: I \ i
V V
Prin t Name Tid e (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll-Free He lplin e : 866/ASK-FPPC (866/275-3772)
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Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
Continuation Sheet
California 802
Form
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 Ticket{s)/
I Passes
r ---Number
8. Name of lndivldu.il ofTicket(s)/
I (Last, First) Passes
I Name of Outside Organization Number
C. of Tlcket(s)/
I (include address and description) Passes
Describe the public purpose made pursuant to the agency's policy_
---
I Identify one of the following:
Ceremonial Role D Other D Income D
If checking ·ceremonial Role" or·Other" describe below:
Ceremonial Role D Other 0 Income D
If checking "Ceremonial Role" or "Other" describe below:
Ceremonial Role D Other D Income D
If checking ·ceremonial Role" or"Other" describe below:
Ceremonial Role D Other D Income D
If checking ·ceremonial Role" or "Other" describe below:
Describe the public purpose made pursuant to the agency's policy l
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FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)