2018-10-31 Halloween Palm SpringsAgency Report of
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name Date Stamp . '
City of Palm Springs r s o
Division, Department, or Region (if applicable) 204 Fill 2: I' For Official Use Only
Designated Agency Contact (Name,Trtle)
Christina Chartier, Executive Assistant to Mayor and Council ❑ amendment (Must Provide Explanation In Pad s.)
760-322-8366 I chhstina.chartier alms rin sca. ov I 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 $ 75.00
9 Y P Y Yes ® No ❑
Event Description: Halloween Palm Springs Date(s) 10 ) 31 / 18 t
Pmwde Tt/e/Fxplanatlon
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Halloween Palm Springs
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(s)/
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticket(s)I
Identify one of the following:
(Last, First)
Passes
Roberts, J.R.
3
Ceremonial Role ❑ Other ❑% Income ❑
Itchecking'Ceremonial Role` or'Other oescnbs below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d iii vii viii
Moon, Robert
Ceremonial Role ❑ Other ❑X Income ❑
2
Iichwkng'Cemmonial Role' or'Other Mscdbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d iii vii viii
Name of Outside Organization
C. (include address and description)
Number
of7lcket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and under PPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the reouiremen
David Ready City Manager
Print Name The (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (86612763772)
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.
milmhwr
A. Name of Agency, Department or Unit
of 71cket(s)l
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Tlcket(s)/
Passes
Identify one of the following:
Holstege, Christy
Ceremonial Role ❑ Other El Income ❑
2
if checking 'Ceremonial Role" or 'Other' describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 (d)(iii)(vii)(viii)
Middleton, Lisa
2
Ceremonial Role ❑ Other ® Income ❑
if checking 'Ceremonial Role' or'Other" describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d iii)vii viii
Ready, David
1
Ceremonial Role ❑ Other ® Income ❑
if checking 'Ceremonial Role" or'Other describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d x
Ceremonial Role ❑ Other ❑ Income ❑
If checking 'Ceremonial Role" or 'Other' describe below:
C. Name of Outside Organization
(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 (8661275-3772)