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2019-05-08 CA Preservation Foundation Conf.Agency Report of: Ceremonial Role Events and TickeUPass Distributions A Public Document 1. Agency Name 7ateStamp City of Palm Springs Division, Department, or Region (if applicable) � For OKraal Use Only Designated Agency Contact (Name. Title) Shari Wrona, Executive Services Administrator ❑ Amendm - s Provide Explanation in Part 3.) 760-322-8632 I shari.wrona@palmspringsca.gov I Date of Original Filing: (month day year) 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Event Description: CA Preservation Foundation Conf Provide Title/ Explanaton Ticket(s)/Pass(es) provided by agency? Yes ❑ No El Was ticket distribution made at the behest Yes ❑ No of agency official? Face Value of Each Ticket/Pass $ 100.00 Date(s) 05 f 08 / 19 If no: CA Preservation Foundation Name of Source If yes: Official 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 TickeUsy Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Ticket(s)1 Identity one of the following: (Last, First) Passes Moon, Robert Ceremonial Role ❑ Other ® Income ❑ 2 n c"ciung-Ceremomal Roe or'0(her' dascnte telaa Public Purpose as described by PS Resolution No. 22454, Section 1 d vii viii xi Roberts, J.R. Ceremonial Role ❑ Other 18 Income ❑ 2 Il checking'Ceremon,al Rote-or'other' hesitate below Public Purpose as described by PS Resolution No. 22454, Section 1 d vii viii (xi Name of Outside Organization C. Number of Ticket(s)t Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 4. Verification 1 have read and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance with the requirements. David Ready City Manager re of Apgp eatl or Designee Print Name Title (month, day, year) Comment: FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866IASK-FPPC (8661275-3772) do Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions Continuation Sheet Agency Name A Public Document 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)/ Describe the public purpose made pursuant to the agency's policy Passes 1----'��� -- B. Name of Individual I (Last First) Number of Ticket(s)/ Passes -- -- l Identify one of the following: _ Holstege, Christy 2 Ceremonial Role ❑ other ® Income ❑ checkng'Cemmonial Ro'e'or'Oiherdescdbebelow: Public Purpose as described by PS Resolution No. 22454, Section 1(d)(vii)(viii)(A) Ready, David 2 Ceremonial Role ❑ Other ® Income ❑ /Iche Aing'Cemmonial Rde"or'Otherdescribebelow: Public Purpose as described by PS Resolution No. 22454, Section 1 d (vii)(viii)(A) Ceremonial Role ❑ Other ❑ Income ❑ Ilcheckng-CemmonialRde"or-Omerdescdbe below: Ceremonial Role ❑ Other ❑ Income ❑ 11 checkbg'Cemmonial Rde"or "Other descdbe below: Name of Outside Organization C. I (include address and description) Number of aet(s)1. Ps Passes Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)