2019-04-06 NCLR Palm Springs Garden PartyAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document ----------------------------------------1. Agency Name Date S tamp California 802
City of Palm Springs
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Shari W ro na, Executi ve Services Administrator
Area Code/Phone Number
7 60-322-8632
E-mail
s hari.wron a@palmspringsca.gov
Form
For Official Use Only
·-
D Amendment (Must Provide Explanation in Part 3.)
Date of Orig in al Filing :--,---,,.--,----,,-
(month, day, year)
2. Function or Event Information
Does the agency have a t icket pol icy? Yes ~ No • Face Va lue of Each Ticket/Pass$ _7_5._o_o _____ _
Event Description: NCLR Palm Springs Garden Party
Provide Tille/ Explanation
___}___} __
Tick et (s)/Pass(es) provided by agency? Yes ~ No D If no: ________________ _
Name of Source
Was t icket distribution made at the behest Yes • No ~ If yes : ------------------
Officiar s Name (Last, First)
of agency officia l?
3. Recipients
4.
• Use Section A to identify the agency's depanment or unit. • Use Section B to identify an i ndividual. • Use Section C to identify a n out side organi.za t ion .
Number
A . Name of Agenc y, Department or Unit of Ticket(sJ/ Describe the public purpose made pursuant to t he agency's policy
Passes
Number B. Name of Individual ofTicket(s)/ Identify one of the following:
(Last, First) Passes
Kors, Geoff Ceremonial Role D Other D Income D
1 If cneciung -Ceremon,aJ Role" or ·othet" descnbe be/OW
Pu blic Pu rpose as described by PS Resolution No. 22454,
Section 4(a)
Holstege , Christy Ceremo nial Role D Other D Income D
.1 If checking ·cemmonl8/ Role" or ·ornet" descnbe be/OW
Public Purpose as descri bed b y PS Resolution No. 22454 ,
Section 1 (d )(vii)(viii)(xi)
Name of Outside Organization Number
C . of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
Verification f:
I have read and understan~~ PC Regulations 18944. 1 and 18942. I have verified that the distribution set forth above, i s in accordance
with the requirements/
, ) J David Ready City Manager
Signature of Agency 7.d crvel ee Print Name
Comment: /
V
T,tte (month, day, year)
FPPC Form 80 2 (212016)
FPPC Toll-Free Helpl ine: 866/ASK-FPPC (866/275-3772)
•
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 SectiQn C to identify an outside organization.
A. N-ame of Agency, Department or Unit
Number
of Ticket{s)/
I Passes
----Number
B. Name of Individual of Ticket(s)/
' (Last, First) Passes
Roberts, J.R. 1
'
I Name of Outside Organization Number
C. ofTicket{s)/
I (include address and description) Passes
-
Describe the public purpose made pursuant to the agency's policy
I
-,
Identify one of the following: I
I
Ceremonial Role D Otl1er ~ Income D
If checking •ceremonial Role" or "Other" describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(xi)
Ceremonial Role D Otl1er D Income D
ff checking ·ceremonial Role" or"Other" describe below:
Ceremonial Role D Otl1er 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:
i
Describe the public purpose made pursuant to the agency's policy I
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
I