2019-11-19 Agua Caliente Dinner in the Canyons· Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributi s A Public Document _________________________ ,._;;..i..~ ... ~-----
1. Agency Name CITY OF P California 802
City of Pa lm Springs
Division, Department, or Region (if applicable)
Form
For Official Use Only AM 11: 18
Designated Age nc y Conta ct (Name, Title)
Shari Wrona, Executive Services Administrator D Amendment (Must Provide Explanation in Part 3.)
Area Code/Phone Number E-mail
760-322-8632 shari .wrona@palmspringsca .gov Date of Original Filing:-----,--,----
(month, day, year)
2. Function or Event Information
Does the agen cy have a ticket policy? Yes 181 No • Face Val ue of Each TickeUPa ss $ _8_33_·_33 _____ _
Event Descrip tion : Agua Cali ente Dinner in the Ca nyons
Provide Tille/ Explanation
Date ( s) ~____g_;~ ___J___j __
Ticket(s)/Pass(es) provided by agency? Yes~ No D If no : ________________ _
Name of Source
Was ticket distribution made at the behest Yes • No~ If yes :-----------------Official'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 i dentify an outside organization.
Number
A. Name of Agency, Departme nt or Unit of Tlcket(s)/ Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of Tlcket(s)I Identi fy one of the follow ing:
(Lasi, First) Passes
Ceremonial Role D Other ~ Income D
Kors , Geoff 2 If checking ·co~monial Role" or ·other' describe below:
Public Purpo se as described by PS Reso lution No . 22454,
Section 1 (d)(vi)(vi ii )(xi)
Ceremon ial Role D Othe r ! Income D
Middleton , Lisa 2 If checking ·ce~monial Role" or "Other' des 'be below:
Publ ic Purpose as described by PS Resolution No. 22454,
Section 1 (d )(vi)(vi ii)(xi)
Name of Outside Organizat ion Number
C. of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
(Include address and description ) Passes
4. Verification
Da vid Ready City Manager ll-/9./9
Print Name Trtle (month, day, year)
Comment:-----------------------------------------
FPPC Form 802 (2/2016)
FPPC To ll-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 ~ection B to identify an individual. • Use Section C to identify an outside organization.
Number
A .. Name of Agency, Department or Unit of Ticket(s}I
I Passes
s. Number
Name of Individual ofTlcke~s)/
I (Last, First;' Passes
Ready, David 1
..
Wrona, Shari 1
I Name of Outside Organization Number
C. of Ticket(S)I
I (include address ai1d description) Passes
Describe the public purpose made pursuant to ttle agency's policy
'
Identify one of the following: I
Ceremonial Role D Other@ Income D
If checking "Ceremonial Rola" or "Other" describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 id)(vi)(x)
Ceremonial Role D Other@ Income D
If checking ·ceremonial Role" or "Other" describe beloW:
Public Purpose as described by PS Resolution No. 22454,
Section 1 ld)(vil
Ceremonial Role D Other D Income D
If checking 'Ceremonial Role" or "Other" describe below:
Ceremonial Role D Other D Income D
If checking "Ceremonial Role" or "Other' describe below:
Describe the public purpose made pursuant to the agency's Polley
FPPC Form 802 (212016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
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