2019-11-19 CVEP 15th Annual PS SummitAgency Report of:
Ceremonial Role Events and Ticket/Pass Distri
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable)
Shari Wrona, Executive Services Administrator
A Public Document
I5 r
�Ml`
N15 PM 6: 2i THE CITY CLER&'
❑ Amendment (Must Provide Explanason in Part 3.)
760-322-8632 I shad.wrona@palmspringsca.gov I Date of Original Filing: (month, day, year)
rmmmm
2. Function or Event Information
Does the agency have a ticket policy. Yes ® No ❑
Face Value of Each Ticket/Pass $ 110.00
Event Description: CVEP - 15th Annual PS Summit Date(s) 11 1 19 l 19 _1 19 ( 19
Provide Tide/Explanation
Tickets)/Pass(es) provided by agency? Yes® No ❑ If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ NON If yes:
Official's Fiat)
Name (Last. Flrs
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 Tlcket(s)I
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last F,rsl)
Number
of7lckerys)I
Poem
Identity one of the following:
Ceremonial Role ❑ Other Income ❑
Moon, Robert
1
if n Mrg-CemmanWRae'or'Other'eescnbaberow
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii viii xi
Ceremonial Role ❑ Other ® Income ❑
Virata, Jay
I
nchecxlg-Cmemonlal Role- or -Other deschbe Wow
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii x
Name of Outside Organization
C. (include address and description)
Number
of Ticketlsp
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand FPPC Regulations 16944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements.
David Ready City Manager
Signature otAgency Head tiffbasigi Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
Continuation Sheet A Public Document
Agency Name
of Palm Springs
3. Recipients
• Use Section A to identify the agency's department or unit. • Use Sections to identify an individual. • Use Section C to identity an outside organization.
Number
A. Name of Agency, Department or Unit
of Ticket(s)i
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First) -
Number
of Tlcket(s)l
'Passes
Identify one of the following:
Ceremonial Role ❑ Other El Income ❑
Shay, Diana
1
pecking'CemmoniatRole•or'Otherdescnbe below
Public Purpose as described by PS Resolution No. 22454,
Section 1(d)(vii)(x) '
Ceremonial Role ❑ Other El Income ❑
Pauley, Nancy
1
ItchecMngTeremonlal Role•or•Other describe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii x
Ceremonial Role ❑ Other El Income ❑
Reid, Celeste
1
Itcheckini Ia'Ceremonlal Role•or•Otherdescnbe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1 d vii x
Ceremonial Role ❑ Other ® Income ❑
Tallarico, Patrick
1
hchecking•Ceremonial Role- or'Otherdescribe below.
Public Purpose as described by PS Resolution No. 22454,
Section 1(d)(vii)(x)
C. Name of Outside Organization
(Include address and description)
Number
of T cket(s)l
',Passes
Describe the public purpose madepursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)