2018-10-18 PSHA LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
A Public Document
of Palm
or
Designated Agency Contact (Name, Title)
Christina Chartier, Executive Assistant to Mayor and Council
Date Stamp
'' i l ' 2 For Official Use Only
HIS
❑ Amendment (Must Provide Explanation in Part 3.)
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? Face Value of Each Ticket/Pass $ 30.00
9 Y P Y Yes ® No ❑
Event Description: PSHA Luncheon Date(s) 10 t 18 t 18
Provide Me/Explanation
Ticket(s)/Pass(es) provided by agency? Yes El No ❑ If no:
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 Tlcket(s)I
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(s)/
Identify one of the following:
(Lest, First)
Passes
Moon, Robert
Ceremonial Role ❑ Other 0 Income ❑
If checkng'Ceremonial Ro'e-or'Other descroi below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii ix
Kors, Geoff
1
Ceremonial Role ❑ Other x❑ Income ❑
Ilche kfg'Cemmonial Rde'or'Other' describe bebw:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii ix
Name of Outside Organization
C. (include address and description)
Number
of Tlcket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
1 have read and under
with the requirements.
Comment:
Regulations 18944.1 and 18942. / 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)