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2019-11-19 PS Art Museum the Art of PrideAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document --------------------------..,.,-Hi~-F-ii-+-----1. Agency Name Cit y of Pa lm Springs Div ision, Department, or Re gion (if applicable) Designated Age ncy Contact (Name, Title) Shari Wrona, Executive Services Administra t or A re a Code/Phone Number 760-322-8632 E-ma il shari .wrona@palmsprin gsca.gov California 802 Form Fo r Official Use On ly 0 Ame ndment (Must Provide Explanation in Part 3.) Da t e o f O rigi na l F i ling: _1_1...,.I 1_B_l.,,.1_9.,...----,-- (month, day. year) 2 . Function or Event Information Does the a gency have a t icket p olicy? Yes [81 No • Face Value of Each TickeUPass $ _1_5_0_.o_o _____ _ E vent Descript ion: PS Art M useum the Art of Pride Provide Title/ Explanation ___J___J __ Ticket(s)/Pass(es) provided by agency? Yes ~ No O If no: _________________ _ Name of Source Was ticket distribution made at the behest Yes • No ~ If yes: ------c:-:::--:---::--~---,,--,---=.---,--------- O,,;cia/'s Name (Last. First) of agency official? 3 . Recipients • Use Section A lo ident ify t he age ncy's d epart m ent o r u nit. • Use Section B lo identify an individual. • Use Section C to id e n tify an o u t side organization. Number A . Name o f A gen c y, D ep artment or Unit of Ti cket (s)t Descr i be the pub lic p urpose made pursuant to t he agen cy's policy Pas ses Number B . Name of Individual of Ticket (s)/ Identify on e o f the following: (Last. First) Passes Ceremonial Role 0 Othe r it(! Income 0 Moo n , R obert 1 II checking ·ceremonial Role" or "Other" descnbe below· Public Purpose as desc ri bed by PS Resolu tion No. 22454, Section 1 (d )(vi)(viii)(xi) Ceremonial Role 0 Other ~ Income 0 R oberts, J .R. l If ch9cking "Ceremonial Role .. or "Other" describe below· Public Pu rpose as described by PS Resolution No. 22454, Section 1 (d )(vi)(vi ii )(xi) Name of Outside Organization Number C. of Ticket(s)I De scribe the public purpose made pursuant to the agency's policy (Include a ddre ss and de scription) Pas ses 4. Verification I have read and understand FPPC Regulations 18944 .1 and 1894 2. I have verified that the distribution set forth above, is in accordance with the requirements. D avid R ea d y Print Name C ity Manager n ue ll·\q.19 (month, day, year) FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/27 5-3772)