2018-02-03 Black History Awards GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name I R EW$IY O
C' fP 1 S ?C' Y OF CALM SPR11z •
Ity o a m prings
Division, Department, or Region (if applicable)
Designated Agency Contact (Name. Title) 5FEI
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 christina.chartier@palmspdngsca.gov
e JUN 20 AM 9: 5Far Official Use Only
CE DE THE CI T Y CLEIRr-I
❑ Amendment (Must Provide Explanation In Part 3.)
Date of Original Filing: (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes IN No ❑
Face Value of Each Ticket/Pass $ 70.00
Event Description: 9th Annual Black History Awards Gala Date(s) 02 r 03 r 18 1
Provide T11WExplanabon
Ticket(s)IPass(es) provided by agency? Yes ❑ No ® If no: Palm Springs Black History Committee
Name of 5oume
Was ticket distribution made at the behest Yes ❑ No ® 1f yes:
of agency official?
Offiral's Name (Last. First)
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 o(Agency, Department or unit
of Ticket(ol l Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual of Tlcksga}1 identify one of the fallowing:
(Last. Flirt) Pass"
Robert Moon Ceremonial Rale ❑ Other EN Income ❑
2 if checlar j'Ceremonial Rafe or Other' *scribe below
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Lisa Middleton Ceremonial Role ❑ Other ❑X Income ❑
2 ff checkng -CeremoNat Rote or Other describe below
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Name of Outside Organization Number
C. (Include address and description) of'rMegail Describe the public purpose made pursuant to the agency's policy
Pe""
4. Verification
l have read and
with the reauirel
Comment:
Regulations 18944.1 and 18942. l have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toil -Free Helpline: 8661ASK-FPPC (8661275-3712)
Agency Report of: California e
02
Ceremonial Role Events and Ticket/Pass Distributions '
Continuation Sheet 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.
Numhor
A. Name of Agency, Department or Unit
of 7ickegsp
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last Fk&)
Number
of Tickeasy
Passes
Identify one of the following:
David Ready
1
Ceremonial Role ❑ Other ® In=me ❑
0ctwkfn C&emorre1Ro1e•or•01nerdescribeWow
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)
Ceremonial Role ❑ Other ❑ Iruartle ❑
IrcheckM 'Ceremomar Role•or'Other describe below
Ceremonial Role ❑ Other ❑ Income ❑
if checlang Teremorrlal Roie' or 01har desc9be bebw
Ceremonial Role ❑ Other ❑ Income ❑
rr checkkV 'Cemmordal Roe" or'Other descibe below
Name of outside Organization
C. (include address and description)
Humber
of Ticket{sy
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Fonn 802 (212016)
FPPC Toll -Free Helptine: 8661ASK-FPPC 18661275-3772)