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2019-11-19 18th Modernism Show-Sale PreviewAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name City of Palm Springs Divis ion, Department, or Region (if applicable) California 802 Form For Official Use Only =D-e....,si,....g-n-at_e__,,d,....A,....g_e_n_c_y....,C,....o_n_t-ac_t_(_N_am_e_,_Ti-t/e_J ________ ....,., ...... ....,... ___ E CITY CLE Rt' Shari Wrona, Executive Services Administrator Area Code/Phone Number 760-322-8632 E-mail shari .wrona@palm springs ca.gov 0 Ame ndment (Must Provide Explanation In P art 3 .) Da te of Original Filing: 11 118119 --i,-m-on-th-.-d-a}:-. -ye-a-,)- 2. Function or Event I nformation Does the agen cy have a t icket policy? Yes 181 No • Face Va lue of Ea ch TickeUPass $ _5_5 ._o_o _____ _ Event Descript ion : 18th Modernism Show/Sale Preview Provide Title/ Explanation ___}___} __ Ticke t(s)/Pa ss(es) provided by agency? Yes~ No D If no: _________________ _ Name of Source Was ticket distribu tion made at the behest Yes • No ~ If yes:------------------ Official's Name (Last. First) of agency official? 3. Recipients • Use Sectio n A t o identify the agency's d epartme nt o r unit. • Use Sectio n B t o identify an individual. • Use Sect ion C to id entify an o uts ide o rga nization. Number A. Name of Agency, Department or Unit of Ticket(s)I Desc ribe the public purpo se mad e pursuant to the agency's policy Passes Number B . Name of Individual of Tl cket(s)/ Identify one of the following : (Last, First) Pa sses Ceremonial Role D Other D Income D Roberts, J .R . 2 If checking "'Ceremonial Role " or .. Other" dsscribe below; Publ ic Pu rp ose as described by PS Resolution No. 22454 , Sect ion 1 (d)(vi)(viii)(xi) Cere monial Role D Other D Income 0 Kors , Geoff 2 If checking ·ceremonial Role" or "Other· describe below Public Purpose as described by PS Resolution No. 22454 , Section 1 ( d)(vi)(viii)(xi) Name of Outside Organizati on Number C. of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Pa sses 4 . Verification I have read and understand FPPC Regulat ions 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance with the requirements. Dav id Read y City Manager 11 -/9 ./9 Print Name TiUe (month. day, year) Comment:------------------------------------------- FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK·FPPC (866/275-3772) .. -.. Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions Continuation Sheet California 802 Form 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. ,N<;1me of Agency, Department or Unit .of-Ticket(s)/ I Passes s. ·Number Name of Individual of Ticket(s)/ I (last, First) ~asses Pauley, Nancy 2 ! Name of Outside Organ1z·at1on :Number C. of Tickel{s)/ I (include addl'ess·and description) Passes ' Describe t~e public purpose made pursuant to the agency's policy Identify one of the following: I Ceremonial Role D Other~ Income D If cher:king •ceremonial Role" or "Other" describe below: Public Purpose as described by PS Resolution No. 22454, Section 1 (d)(vi)(viii)(xi) Ceremonial Role D Other D Income D If checking "Ceremonial Role" or"Olher"descnDe below: Ceremonial Role D Other D Income D If checking "Ceremonial Ro/e"or"Olher"describe below: Ceremonial Role D Other D Income D If checking "Ceremonial Rofe"or "Other" describe below: Describe the publl~ ptirpose made pursuant to the agency's policy FPPC Form 802 (2/2016) FPPC To!!-Free He!p!ine: 866/ASK-FPPC (866/275-3772) I