2018-10-06 PS Mod. Com. Presrevation AwardsAgency Report of:
Ceremonial Role Events and TickeVPass Distributions A Public Document
1. Agency Name `F �Jte`stamp
City of Palm Springs '
Division, Department, or Region (if applicable) 2019 n, '-iR 20 For Official use Only
Christina Chartier, Executive Assistant to Mayor and Council
❑ Amendment (Must Provide Explanation in Pert 3.)
Area Code/Phone Number E-mail
760-322-8366 chdstina.chartier alms rin sca. ov Date of Original Filing:
@p P 9 g (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes IN No ❑ Face Value of Each Ticket/Pass $ 100.00
Event Description: PS Mod.Com.Preservation Awards Date(s) 10 l 06 l 188
Provide Ttle/Explanatfon
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Official's Name (Last, Firs
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'ncket(s)I
Passes
Identify one of the following:
Roberts, J.R.
1
Ceremonial Role ❑ Other ❑X Income ❑
1l checking'Celemonial Role"or'Olher' describe below.
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Middleton, Lisa
1
Ceremonial Role ❑ Other ❑X Income ❑
Il chockng'Cemmontal Rde"or'OtheCde be below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)i
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
/ have read and understand FP Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance
with the requirements. /) '
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275.3772)