2018-10-13 PS Equality AwardsAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name baleslamp _ ims
City of Palm Springs
Division, Department, or Region (if applicable) tp A I 20 Ali (I : [, Far Official Use Only
9R19 rif;i
Designated Agency Contact (Name,Ttt/e)
Christina Chartier, Executive Assistant to Mayor and Council
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8366 1 christina.chartier alms rin sca. ov Date of Original Filing:
@P P 9 9 (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 275.00
9 Y P Y Yes ® No ❑
Event Description: PS Equality Awards Date(s) 10 ) 13 / 18
Provide ntle/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Equality California
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)/
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
ofp Passes
Identity one of the following:
Roberts, J.R.
1
Ceremonial Role ❑ Other ❑X Income ❑
Ifcheddng'Cemmonlal Rale" or'Other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii
Ready, David
1
Ceremonial Role ❑ Other ❑X Income ❑
Ifcheckng'Cemmonial Role" or -Other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and
with the reauirel
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 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: : California
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 Ticket(s)l
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(s)l
Identify one of the following:
(Last, First)
Passes
Baron, Harriet
Ceremonial Role ❑ Other ® Income ❑
2
if checking "Ceremonial Role" or `Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Mejia, Anthony
Ceremonial Role ❑ Other ® Income ❑
2
if checking "Ceremonial Role" or `Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Nalder, Kevin
Ceremonial Role ❑ Other ® Income ❑
1
!f checking "Ceremonial Role" or "Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Cook, Dale
Ceremonial Role ❑ Other ® Income ❑
!f checking "Ceremonial Role" or "Other" describe below:
2
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(x)
Name of Outside Organization
C. g
Number
of Ticket(s)l
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Form 802 —Additional Tickets for Palm Springs Equality Awards 10/13/18
Reyes, Bryan —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x)