2019-05-15 Harvey Milk Diversity BreakfastAgency Report of
Ceremonial Role Events and Ticket/Pass Distributi M A Public Document
1. Agency Name tvC to Stamp WU..
City of Palm Springsl �%' •Division, Department, or Region (if applicable) orO il
6 2019
Shari Wrona, Executive Services Administrator
Amendm (Must Provide Explanation in Part 3.)
760-322-8632 I shari.wrona@palmspringsca.gov I Date of Original Filing: (monthday, year)
2. Function or Event Information
Does the agency have a ticket policy. Yes ® No ❑
Face Value of Each Ticket/Pass g 65.00
Event Description: Harvey Milk Diversity Breakfast Date(s) 05 1 15 1 19 1 1
Provide Trde/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no:
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Official's Name (Las( First)
of agency official?
3. Recipients
• Use Section A to identify the agency's department or unit. , Use Section g to identify an individual. • Use Section C to identify an outside organization.
A. Name of Agency, Department or Unit
Number
of Ticket(s)f
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Timber )I
Identify one of the following:
(Last, First)
Passes
Moon, Robert
1
Ceremonial Role ❑ other �j Income ❑
If ebecking'Ceramomal Rde"or "Other' descriee b&ew.'
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Roberts, J.R.
Ceremonial Role ❑ Other Income ❑
1
checking'Ceremonial Roe" or rather oescnbe below
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi)
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with t men
David Ready City Manager
Sign gency Head or Designee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212l
FPPc Toll -Free Helpline: 866IASK-FPPC (8661276-3772)