2018-10-20 Desert AIDS WalkAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name Date stamp. . 1
City of Palm Springs L a
Division, Department, or Region (if applicable) r; , t� 2O pg' I I : 12 For Official use only
2U19 fiF � L Ft1'
Designated Agency Contact (Name,Tit/e) -
Christina Chartier, Executive Assistant to Mayor and Council
❑ Amendment (Must Provide&planeh'oo in Part 3.)
Area Code/Phone Number E-mail
760-322-8366 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 $ 25.00
9 Y P Y� Yes ® No ❑
Event Description: Desert AIDS Walk Date(s) 10 ) 20 ) 18
Provide rifle/Explanation
Ttcket(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, 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 Tlckat(s)/
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Tfcket(s)/
Passes
Identify one of the following:
Moon, Robert
1
Ceremonial Role ❑ Other Q Income ❑
Iichecking'Ceremonial Rde' or'Ofhel describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Roberts, J.R.
Ceremonial Role ❑ Other Q Income ❑
1
1/checking'Ceremonial Role-of-OMef desonbe 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)/
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and under
with the requirements.
Comment:
Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Till (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866IASK-FPPC (866/275.3772)
Agency Report of: California 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 71cket(s)i
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Ttcket(s)I
Passes
Identify one of the following:
Middleton, Lisa
1
Ceremonial Role ❑ Other El Income ❑
If checking 'Ceremonial Role" or-Other"descnbebelow:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(vii)
Ceremonial Role ❑ Other ❑ Income ❑
If checking 'Ceremonial Role" or 'Other' describe below:
Ceremonial Role ❑ Other ❑ Income ❑
If checking 'Ceremonial Role" or *other describe below.
Ceremonial Role ❑ Other ❑ Income ❑
If 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 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772)