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2018-06-02 PSFD Fish FryAgency Report of: Ceremonial Role Events and TicketlPass Distributions A Public Document 1. Agency Name K t U t V C. -WP tamp ' City of Palm Springs I T Y OF PAI M 5 f' R'-% Division, Department, or Region (if applicable) 2010 JUN 2 0AM T 51 For Official Use Only Designated Agency Contact (Name, Title) Itt UI' I e-IL GIB 's Christina Chartier, Executive Assistant to Mayor and Council ❑ Amendment (Must Provide Explanation in Part 3 ) 760-322-8366 I christina.chartier@palmspdngsca.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 $ 10.00 Event Description: PSFD Assoc. Fish Fry Date(s) 06 1 02 1 18 1 1 Provide Tit1e/Explanishon Ticket(s)IPass(es) provided by agency? Yes ❑ No ® If no: Palm Springs Firemen's Association Name of Source Was ticket distribution made at the behest Yes ❑ No ® If yes: Official's Name (Last. First) of agency official? 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 Tlckogsy Describe the public purpose made pursuant to the agency's policy Passes Number B. Name of Individual of Tickettay Identify one of the following: (Last RP7 Passes Robert Moon Ceremonlal Role ❑ Other ® inwR'e ❑ 2 "cheating Teremonfal Rote' or •Other describe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii J.R. Roberts Ceremonial Role ❑ Other X❑ ncema ❑ 2 frchecl ing Teremontal Role'br'Other describe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Name of Outside Organization Number tr' (include address and description} of TicketleY Describe the public purpose made pursuant to the agency's policy Passes 4. Verification 1 have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above. is in accordance with the requirements David Ready City Manager Signature of Agency HVsjorpi4nee Print Name Tilt `month day. year; Comment: FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Agency Report of: California 802 Ceremonial Role Events and Ticket/Pass Distributions Form 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(syl Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual (Last, First) Number ofTicket(s)f Passes Identify one of the following: Ceremonial Role ❑ Other El Income ❑ Christy Holstege 2 Itcheckng-_-sTmomarRoite or Otherdewnbehelow Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(vii) Ceremonial Bole ❑ Other ® Income ❑ Geoff Kors 2 trdacldng raWor-Other describe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ Other ® Income ❑ Lisa Middleton 2 Ifehe,-*rgTeremomarRde or*&Wdescnbebelow Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ Other ❑ Income ❑ Marcus Fuller 2 Irched wV'Ceremonlel Role or Othe alesmbe below Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Name of Outside Organization C.of (include address and description) Number Tiekegsy! Pam Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)