2018-10-22 CVRep 10th Annual CelebrationAgency Report of
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name Date Stamp
City of Palm Springs
Division, Department, or Region (if applicable) n ,� For Official Use Only
L'JIJ 2� 11
Designated Agency Contact (Name, Title)
Christina Chartier, Executive Assistant to Mayor and Council ❑Amendment (Must Provide Explanation 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? Yes ® No ❑ Face Value of Each Ticket/Pass $ 150.00
Event Description: CVRep 10th Annual Celebration Date(s) 10 y 22 / 188
Provide TifferExp/anation
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. 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 Ticket(sy
Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual
of rckerys)I
Identity one of the following:
(Last, First)
Passes
Moon, Robert
Ceremonial Role ❑ Other ❑ Income ❑
1
If checking'Ceremonial Role' or'Othee describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Ceremonial Role ❑ Other ❑ Income ❑
Ifche krng-Cemmonial Rde'or'Otherdescribe below:
Name of Outside Organ'vation
C.
Number
of Ticket(s)/
Describe the public purpose made pursuant to the agency's policy
(Include address and description)
Passes
4. Verification
I have read and understand
with the requirements. Y
Comment:
18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name The (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)