2019-04-12 Ophelia Project Scholarship LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name
City of Pa lm Spring s
Date Stamp California 802
Form
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Shari Wrona , Executive Services Administrator
Area Code/Phone Number
760-322-8632
E-mail
shari .wrona @ palmspringsca.gov
2019 n:~Y 11+ Pd 4: 50 For Official Use Only
0 Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:--,---,,,---,-----,-
(month, day. year)
2. Function or Event Information
Does the agency have a ticket policy? Yes [8l No • Fac e Value of Each 17 ckeUPass $ _8_5_.o_o _____ _
Event Description : Ophelia Project Scholarsh ip Luncheon Date(s ) ~____!3.__J~
Provide Title/ Explanation
__}__} __
17cket(s)/Pass(es) provided by agency? Yes~ No O If no: _________________ _
Name of Soun:;e
Was ticket d istribution made at the behest Yes • No 18] If yes: ------------------
Official's Neme (Last , First)
of agency official?
3. Recipients
4.
• Use Section A to identify the agen cy's department or unit. • Use Section B to identify an i.ndividual. • U se Section C to identify an out side organization.
Number
A. Name of Agency, Department or Unit of T icket(s)/ Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of Ticket(s)/ Identify one of the following:
(Last. First) Passes
Moon, Robert Ceremoni al Role 0 Othe r 0 Income 0
If che<;k,ng 'Ce,emomal Role" or ·other descnt>e below 1 Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(vii)(viii)(x i)
Ce rem onial Role 0 Other 0 Income 0
If che<;kmg ·ceremoll!al ROie· or "Other descnoe below
Name of Outsi de Organization Number
C . ofTicket(s)/ Desc ribe the public purpose made pursuant to t he agency's policy
(include address and description) Passes
I
Verification / [/
I have road and -::;:,~ PPC Rag u/ahon, 18944.1 and 18942. I have verified that the dlstribulion ,et forth above,;, In acconJance
with the requirem en .
Y'I, David Ready City Manager
Signature of 7 cy ~7 Des ignee Prin t Name
Comment:
Title (month, day. year)
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)