2019-11-19 Darkside in RiversideAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document ~-=----=-=-----------------------rT"'C"'1r'""='T'!t''IPF~--1. Agency Name 'i'i"'r-ff'1'1 'fN Gs California 802
City of Palm Spri ngs Form
Division, Departm en t , or Region (if applicable) AM \I: 11 For Official Use Only
=D-es"""i-gn-a--:-t-ed-:-A-=--ge_n_c_y-::C:-o-n.,...ta_c.,...t .,..(N-am-e,.,.,.Ti-1/e..,..) -------------,o=-=F,,._,~-+, F TH E CIT y CLE Ri.
Shari Wrona, Exec utive Services Administrato r
Area Code/Phone Number
760-322-8632
E-mail
s hari .wrona@ palmspringsca.gov
0 Amendment (Must Pro vide Explana tion in Part 3.)
Date of Original Filing :--;---,,--,----.--
(mon th, day, year)
2 . Function or Event Information
Does the agency have a t icket policy? Yes 181 No • Face Value of Each T icket/Pass $ _4_5_.o_o _____ _
E vent Description : Darks ide in Riverside
Provide Tille/ Explanation
Ticket(s)/Pa ss(es) provided by agency? Yes • N o ~ If no: _C_o_m_ic_C __ on_P_S ____________ _
Name o f Source
Was ticket distribution made at the behest Yes • No ~ If yes: ----.,.,...,-,---------------
officiars Name (L ast. First)
of agency official?
3 . Recipients
• Use Section A lo identify the agency's departme nt or un it. • Use Section 8 t o identify a.n individual. • Use Sectio n C to id e ntify a n o uts id e organization.
Number
A . Name of Agency, Department or Unit of Tlcket(s)/ Describe the public purpose made pursuant to the agency's policy
Pas ses
Number
B. Name of Individual of Tlcket(s)I Identify one of the following:
(Last, First) Pa sses
Ceremonial Role D Other [8] Income D
Brown , Arron 2 If checking "'Ceremornal Role· or "Ot her" describe below:
P ublic Purp ose as described by P S Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role D Other [8] Income 0
Goedhart, Veronica 2 If checking "'Ceremornal Role"' or "'Other" describe below:
Public Purpose as described by PS Reso lutio n No. 22454,
Section 1 ( d )(x)
Name of Outside Organization Number
C . of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4. Verification
ions 18944.1 and 18942. I have verified that the distrib ution set forth ab ove, is in accordance
ll -t9 ,I~
(month, day, year)
Comment: __ ___,,,_ ______________________________________ _
FPPC Form 802 (2/201 6)
FPPC Toll-Free He l pline: 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. Name of Agency, Department or Unit of Ticket(s)f
I Passes
' Number B. Name of Individual of Tlcket(s)I
! (Last, First) Passes
Fattaruso, Robert 2
Samonte, Elisa 2
Bates, Rylee 2
Washington, Sachel 2
I Name of Outside Organization Number
C. of Ticket(s)I
I (include address and description) Passes
Describe the public purpose made pursuant to the agency's policy
Identify one of the following: I
Ceremonlal Role D Other~ Income D
If checking "Ceremonial Role" or "Other" describe be/ow:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role D Other@ Income D
If checking "Ceremonial Role" or"Olher"describe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 ldllx)
Ceremonial Role D Other @ Income D
If checking •ceremonial Role" or"Other" descn·be below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Ceremonial Role D Other·@ Income D
If checking "Ceremonial Role-or '"Other" descnbe below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(x)
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
I
"· ' ..
Form 802 -Additional Tickets for Darkside in Riverside 10.18.19 to 10.20.19
Cook, Joe-2, Public Purpose as described by PS Resolution No. 22454, Section l{d)(xi)
Ballard, Jonathon -2, Public Purpose as described by PS Resolution No. 22454, Section l(d)(xi)