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2018-06-19 Film Festival Shortfest SponsorAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs Division, Department, or Region (if applicable) fill Christina Chartier, Executive Assistant to Mayor and Council A Public Document F PALM SPR}lv:a For Official Use Only 19 AM 8: 06 F THE CI rY CLEP L } ❑ Amendment (Must Provide Explanation in Part 3.) 760-322-8366 1 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 $ 200.00 Sponsor Event Description: PSIFF ShortFest Date(s) 06 1 19 1 18 06 ) 24 ) 18 Provide Tidel Expfanabon Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: PSIFF 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 $ to identify an individual. • Use Section C to identify an outside organization. Number A. dame of Agency, Department or Unit of Tkket(sy Describe the public purpose made pursuant to the agency's policy Passes Number B. Name of Individual ofP oqsyt Identify one of the following: (Last FW) Robert Moon Ceremonial Role ❑ Other © Income ❑ 2 lr dmckng -CemmorxW Role or'Other desalbe below Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ Other Q Income ❑ J.R. Roberts 2 Hchedd�g CefsmonialRoAe' or-otherdesctbe betmv Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Name of Outside Organization Number °f Tkkei(syf Describe the public purpose made pursuant to the agency's policy C. (include address and description) Passes 4. Verification 1 have read and understan with the requirements f Comment: Regulations 18944 1 and 18942 1 have verified that the distribution set forth above, is in accordance David Ready City Manager Print Name Title (month. day year) FPPC Form 8021212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) 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. Nkhmhor A. Name of Agency, Department or Unit of Tlcket(ay Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual (Lest, First) Number of Tkkegs}! passes Identify one of the following: Ceremonial Role ❑ Other ® Irxme ❑ Lisa Middleton 2 frchwkng CersmoNelRare-ar•O(Wdownbebeiow Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(vii) Ceremonial Role ❑ Other ® 'ni*ne ❑ Christy Holstege 2 nsaeoxng CemmonlarRde'or'Otnerdes=iwbarow Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ other ® Income ❑ David Ready 2 +s•,ng'CommanlsrRode•or•OtherdeWbebabw Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii Ceremonial Role ❑ Other ® Income ❑ Edward Kotkin itdwkngC&emrtialRore'or'OtWdescdbebobw Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(vil) Name of Outside Organisation C. include address and description ( p ) Number of Tieket(sj1 Passes Describe fire public purpose made pursuant to the agency's policy FPPC Form Bat (2120/6) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Form 802 —Additional Tickets for PSIFF ShortFest 06.19 to 06.24.18 Barron, Harriett —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x) Mejia, Anthony - 2, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x) Goolsby, Denise — 2, Public Purpose as defined by PS Resolution No. 22454, Section 1(d)(x) Madison, Perry — 2, Public Purpose as defined by PS Resolution No. 22454, Section 1(d)(x)