2019-06-01 88th PS Firefighter's Assoc. Fish Fry0
'Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributi
City of Palm Springs
or
Shari Wrona. Executive Services Administrator
760-322-8632 1 shari.wrona@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: 88th PS Firefighter's Assoc. Fish Fry
Provide Title/Erplanation
Tickets)/Pass(es) provided by agency? Yes ® No ❑
A Public Document
vjIs
1olq Far Onicial Use Only
r'.
Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
monm, day, year)
Face Value of Each Ticket/Pass $ 10_00
Date(S) 06 ) 01 1 19 _
If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Olhcial's Name (Last. First)
of agency official?
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.
A. Name of Agency, Department or Unit
Number
of Ticket(s)i
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Ticket(s)l
Passes
Identify one of the following:
Ceremonial Role ❑ Other Q Income ❑
Moon, Robert
1
checWnB-Cemmoolal Rode' or'Othel describe below
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Ceremonial Role ❑ other x❑ Income ❑
Roberts, J.R.
Il checlvng'Ceremanial Rde'or'Other'tlescnbe Delaw
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)/
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 the requiremen .
David Ready City Manager
Sign cy Head or Designee Print Name Title (month, day, year)
Con nt:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: I
Ceremonial Role Events and Ticket/Pass Distributions M
Continuation Sheet 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 Section C to identify an outside organization.
Number
A.
Name of Agency, Department or Unit
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
(---�
B.
Name of Individual
(Last First)
,Number
.of Ticket(s)/
'.Passes
---��
Identify one of the following:
Holstege, Christy
Ceremonial Role ❑ Other El Income ❑
checking'Ceremonial Role-or'Other'descdbe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1(d)(vii)(viii)(xi)
Ceremonial Role ❑ Other ❑ - Income.❑
h checking -Ceremonial Role'or-Other' describe below:
r
Ceremonial Role ❑ Other ❑ Income
Itchecking -Ceremonial Rote'or'01her' describe below:
❑
Ceremonial Role ❑ Other ❑ Income
I/ checking 'Cemmonla/Role'or'O1her'descdbe below:
❑
C.
I
Name of Outside Organization
include address and description)
( P )
Number
of PasTicket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
1
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275.3772)