2019-11-19 PS Equality AwardsAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name
City of Palm Springs
Division, Departmen t , or Region (if applicable) AM II: 17
California 802
Form
Fo r Official Use Only
-::::D-e....,si:--g-n....,at,..e....,d--=A-g_e_n-cy---=c-on....,t,..a-ct:-(".'""N:-am-e,"'.'Cri:-t/e....,.J----------P,,;:.i,'+f',,i;...f,-+-~E CIT y CL ER r
Shari Wrona , Executive Se rvi ces Adm inistrato r
Area Code/Phone Number
760-32 2-8632
E-mail
shari.wrona@pa lmsp ring sca.gov
D Amendme nt (Musi Provide El<planat,on in Patt 3.)
Date of Orig ina l Fi ling: 1 1118119
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2. Function or Event Information
Does the age ncy have a ticket pol icy? Yes 181 No D Face Va lue of Each TickeUPass $ _3_o_o._o_o _____ _
Even t Description : PS Eq ua lity Award s Date( s) __2Q__j ~ ~ __J__j __
Provide Title/ Explanation
Ticket(s)/Pa ss(es) provided by agency? Ye s ~ No D If no: _________________ _
Name of Source
Was ticket distrib ution made at th e behest Yes • No ~ If yes: ------,,.,.,,...,....,....,...,.....--,--....,.....---------
officiars Name (Last. First)
of agency offici al?
3 . Recipients
• Use Secti on A t o id enti fy the agency's depa rtment o r uni l. • Use Sect ion B t o ident if y an indiv id ual. • Use Section C t o iden ti fy a n o utside or ga nizat ion.
Num ber
A. Name of Agency, Department or Unit of Ticket(s)I Describe the public purpose made pursuant to the agency's policy
Passes
Num ber B. Name of Individual of Tlcket(s)/ Identify one of the following:
(Last, First) Passes
Ce remonial Role D Other D Income D
Mej ia, Anthony 2 If checking "Ceremonial Role· or ·Othe~ descnbe below·
Public Purpose as described by PS Re sol ution No. 224 54,
Section 1 (d)(vi)
Ceremonial Role D Other D In come D
Schafe r, Staci 2. If checking ·ceremonial Role· or 'Olher" descnbe below·
Public Purpose as described by PS Resolution No . 224 54 ,
Sectio n 1 { d ){vi )
Name of Ou tside Organization Num ber
C. of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4 . Verification
I have read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
with the requirements.
Da vi d Read y City Manage r //./q.JC,
PnntName Tide (month, day, year)
Comment:-------------------------------------------
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
IA ' • II
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 lo identify lhe agency's department or unil. • Use Section B to identify an individual. • Use Section C to identify an outside organization.
A. Name of Agency, Department or Unit of Tlcket(s)/
·Number
I Passes
' Number B. Name of Individual of Tlcket(s}/
I (L_ast, First) Passes
Pauley, Nancy 1
Goedhart, Veronica 1
Stamback, John 2
Waits, Jasmine 2
I Name of .Outside Organization Number
C. of Tlcket(s)/
I (include address and description) Passes
Describe the public purpose made pursuant to the agency's policy
Identify one of the following: I
Ceremonial Role D Other~ Income D
If checking "Ceremonial Rote• or "Other" descn'be below:
Public Purpose as described by PS Resolution No. 22454,
Section 1 (d)(vi)
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 I dllvil
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 (dl(vil
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 (d)(vi)
,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