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2018-04-28 NASF Scholarship Fund BallAgency Report of: Ceremonial Role Events and TicketlPass Distributions A Public Document 1. Agency Name M81AW - 802 City of Palm Springs 4 P A F; ,; , ' ForOfficial Use Only Division, Department, or Region (if applicable) JUL 19 AN 8: 0 Designated gency Contact (Name,Tttle) O G " THE CITY Cljw Christina Chartier, Executive Assistant to Mayor and Council ❑ Amendment (Must ProWde Explanation m Part 3.) Area ode/Phone Number E-mail 760-322-8366 chdstina.chartier alms do scaDate of Orlglnal Filing: @P P 9 . 9ov (month, day, year) 2. Function or Event Information Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 65.00 9 Y P Y Yes ® No ❑ Event Description: NASF Scholarship Fund Ball Date(s) 04 1 28 1. 18 fir._ Provide TiderExplanadon Tickets)/Pass(es) provided by agency? Yes ® No ❑ If no: Name of Source Was ticket distribution made at the behest Yes ❑ No ® If yes: Ofliciat's Name (Last, First) of agency official? 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section & to identify an individual. • Use Section t to identify an outside organization. Number A. Name of Agency, department or Unit ofTickettsy Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual of roket(sg Identify one of the following: (Last First Passes Robert Moorr Ceremonial Role ❑ Other ® Income ❑ 1 NChKkng Teremonle) Rafe" or'Other• desmbe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ Other X❑ Income ❑ Lisa Middleton HdwhV'C&emonratRob'ar otherdesaibaberow Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Name of Outside Organization Number of Tk kat(sN Describe the public purpose made pursuant to the agency's policy C. (include address and description) Passes 4. Verification l have read and understand FRPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with the requirements. 411 Comment: David Ready City Manager Print Name Title (month, day, year) FPPC Form 602 (212016) FPPC Toll -Free Helplins: 8661ASK-FPPC (8661275-3772)