2018-10-05 PS Speaks - Offerman-MullalyAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public
1. Aaencv Name Date stamp r
City of Palm
or
Designated Agency Contact (Name, Title)
Christina Chartier, Executive Assistant
!r'. " 1 i : 1 For Offidal Use Only
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8366 I christina.chartier@palmspringsca.gov I Date of Original Filing: (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 60.00
9 Y P Y� Yes® No
Event Description: PS Speaks - Offerman/Mullaly Date(s) 10 ) 05 1 18
Pmvide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Palm Springs Speaks
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.
A. Name of Agency, Department or Unit
Number
of Ticket(s)l
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Timberckegs)f
Passes
Identify one of the following:
Ceremonial Role ❑ Other ❑x Income ❑
Holstege, Christy
2
I/ec ong Temnlonial Role-or'Ofber describe below:
ch
Public Purpose as defined by PS Resolution No. 22454,
Sect. 1 d vii
Ceremonial Role ❑ Other ❑x Income ❑
I�OfS, Geoff
lfcheck'na"Ceremmial Role-or'Otherdescnbe below:
Public Purpose as defined by PS Resolution No. 22454,
Sect. 1 d vii
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)f
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand
with the requirements.
Comment:
18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: , caiaornia 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 Tickegs)1
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Tickegs)l
Passes
Identify one of the following:
Brown, Arron
2
Ceremonial Role ❑ Other El Income ❑
1t checking "Ceremonial Rote" or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Sect. 1(d)(x)
Valdivia, Nancy
1
Ceremonial Role ❑ Other ® Income ❑
If checking Ceremonial Role" or "Other'describe below:
Public Purpose as defined by PS Resolution No. 22454,
Sect. 1 d x
Schaefer, Stacl
2
Ceremonial Role ❑ Other ® Income ❑
11 checking 'Ceremonial Role" or "Other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Sect. 1 d x
Ceremonial Role ❑ Other ❑ Income ❑
It checking 'Ceremonial Role" or'Other" describe below:
Name of Outside Organization
C. g
(Include address and description)
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)