2019-11-21 PSHA Member LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributio
1. Agency Name CITY
City of Palm Springs
Division, Department, or Region (if applicable) 2620
Shari Wrona. Executive Services Administrator
A Public Document
' L.4 P'PpNbS . a
5 PM 6: 21 For official Use Onh
HE CITY CLERr
❑ Amendment (Must PmWde Expfanae'on in Part 3.)
760-322-8632 I shari.wrona@palmspringsca.gov I Date of Original Filing: month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 30.00
Event Description: PSHA Member Luncheon Date(s) 19 _1
Provide Trtle/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no:
Name of source
Ms ticket distribution made at the behest Yes ❑ No N If Yes:
Of
of agency official? fida's Name (Last. Fir"
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 Tickeysy
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last. First)
Number
of Timber I
Passes
Identify one of the following:
Ceremonial Role ❑ other Income ❑
Moon, Robert
klq'Cemasmoma Ro e'o 'OtlmYeescrleeeelow
Public
Public Purpdescribed by PS Resolution No. 22454,
Section 1 d vi viii xi
Ceremonial Role ❑ Other ❑ Income ❑
llchecklrg'CemmonlRoleor'Orheroe aeeebw
Name of Outside Organization
C. (include address and description)
Number
of Ttcket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand
with the requirements.
Comment:
Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager
Pnnt Name Title (month, day year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)