2018-10-25 These Doors Stay Open FundraiserAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
A Public Document
City of Palm Springs
Division, Department, or Region (if applicable)
Christina Chartier, Executive Assistant to Mayor and Council
Date Stamp
(� r 1 �. I I For Official Use Only
. [ iJ I I
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8366 I alms rin sca. ov christina.chartier I 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 $ 100.00
Event Description: These Doors Stay Open Fundraiser Date(s) 10 f 25 / 18
Provide 7itte/Explanafion
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Planned Parenthood
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
Official's Name (Last, First)
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
of Ticket(s)I
Passes
Identify one of the following:
Holstege, Christy
1
Ceremonial Role ❑% Other ❑ Income ❑
if checking'Ceremonial Rde"or"Olhef descnbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d viii
Moon, Robert
Ceremonial Role I] Other ❑ Income ❑
1
11 checking "Ceremonial Role"or "Other describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d viii
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 understand FPPC
with the requirements. lei
Comment:
18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Tide (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772)