2019-05-16 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributiors'?
A Public Document
City of Palm Springs
Division. Deoartment or
Shari Wrona, Executive Services Administrator
760-322-8632 I shari.wrona@palmspringsca.gov
2. Function or Event Information
16 70 Jg - For Of4aal Use Only
❑ Amentlment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(monm, day year)
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 30.00
9 Y P Y Yes ® No ❑
Event Description: PSHA Member Luncheon Date(s) 05 1 16 1 19 _
Provide lif/e/Explanaeon
Tickets)/Pass(es) provided by agency? Yes ® No ❑ If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
(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 Ticket(sy
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(s)l
Identify one of the following:
(Last, Firs!)
Pas
Passes
IIys9�t�
Ceremonial Role ❑ Other IIncome ❑
Moon, Robert
1
checking'Cercnwnial Rde- or'Other descnae Eea
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Ceremonial Role ❑ Other ® Income ❑
Kors, Geoff
1
Itchecdng'C"monral Role'or'Otherdaaodoebefow
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii)(xi)
Name of Outside Organization
C.
Number
of Ticket(s)/
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
I have read and understand FPPC Fjegu/ations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance
with the requirements. _ ,� A
Comment:y
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)