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2018-05-10 Arthur Lyons Film NoirAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs 1,4'T Y ivision, Department, or Region (if applicable) Mo 1 vFFICE Christina Chartler, Executive Assistant to Mayor and Council 760-322-8366 1 chdstina.chartier@palmspdngsca.gov A Public Document 61 120 9. S7 For Official Use Only Tht. I.rl i i k+t_ ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (nronth, day, year) 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 129.00 Event Description: Arthur Lyons Film Noir Festival Date(s) 05 1 10 1 18 05 f 14 / 18 Provide TWExplanation Tickets)/Pass(es) provided by agency? Yes ❑ No El If no: Palm Springs Cultural Center Name of Source Was ticket distribution made at the behest Yes ❑ No ® If yes: OrriGal's Name (Last First) of agency official? 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section 8 to identify an individual. -Use Section C to identify an outside organisation. A. Name of Agency. Department or Unit of 7icket(a)I I Describe file public purpose mode pursuant to the agency's policy Passes Name of Individual Number B. of Ticket(s)1 Identify one of the following: (LOA First) passes Robert Moon Ceremonial Raie ❑ Other ® ncome ❑ 4 rr eheeidn9'Cmemonlat Rde- or'Ofherdesalbe tie« Public Purpose as defined by PS Resolution No. 22454, Section 1 d vil J.R. Roberts Ceremonial Rc;e ❑ Other ❑X income ❑ 2 It checklnp •ceremonial Rde or rather describe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Name of Outside O nWtion Number C. of TickegaY Describe the public purpose made pursuant to the agency's policy (include address and description) paw 4. Verification 1 have read and understand FPPC Regulations 18944.1 and 18942. t have verified that tale distribution set forth above, is in accordance with the requirements. ZT, David Ready City Manager Signature of Agkofy HqA 0 Designee Print Name Title ;month. day, year, FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) 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. Number A. Name of Agency, Department or Unit of Tickat(ap Passes Describe the public purpose made pursuant to the agency's policy B. Name of Individual (Last First) Number of Tkket(sjl Passes Identify one of the following: Lisa Middleton 2 Ceremonial Role ❑ Other ® lr=me ❑ uu,etking-Commonra+Rde-or•otWcfescnbebW w Public Purpose as defined by PS Resolution No. 22454r Section 1 (d)(vii) Denise Goolsby 2 Ceremonial Role ❑ Other ® Income ❑ IloVckh+?-CemmonlalRota'orrotheYdescrlbebelow Public Purpose as defined by PS Resolution No. 22454, Section 1 d x Shari Wrona 2 Ceremonial Role ❑ Other ® Income ❑ flchecking'CommoMalRale'or'OtWdescftbelow Public Purpose as defined by PS Resolution No. 22454, Section 1 d vx Ceremonial Role ❑ Other ❑ Income ❑ ll cheddng 'Comnwmal Role' or -OfW describe bftw Name of Outside Organization C. (include address and description) Number of Tickagsyf Passes Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Tall -Free Helpline: 8661ASK-FPPC (8661275-3772)