2018-09-25 Habitat for Humanity Fall EventAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
A Public Document
1. Agency Name
City of Palm Springs
or
Designated Agency contact (Name,Trtte)
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 chdstina.chartier@palmspringsca.gov
2. Function or Event Information
Date Stamp
R 20
AM I I:' II For Official Use Only
Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day year)
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 15.00
9 Y p Y� Yes ® No ❑
Event Description: Habitat for Humanity Fall Event Date(s) 09/ 25 / 188 _
Provide ritle/Explanab'on
Tickets)/Pass(es) provided by agency? Yes ® No ❑ If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
O ficial'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 Ticket's)/
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(sy
Identify one of the following:
(Last, First)
Passes
Moon, Robert
Ceremonial Role ❑ Other ❑x Income ❑
1
( ecking'Ceremonial Ro'e'or'Other'descnbebelow:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Ceremonial Role ❑ Other ❑ Income ❑
It chetl ng'Ceremoaial Role or'Other cesonbe below:
Name of Outside Organization
C.
Number
of Ticket(s)I
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
/ have read and understand FPPg Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements.
4e, David Ready City Manager
Signature of Agen Il5r signee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
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