2018-11-05 WIF Broken Glass AwardsAgency Report of:
Ceremonial Role Events and TicketlPass Distributions A Public Document
1. Agency Name 2019 VfIF vat to • '
City of Palm Springs
Division, Department, or Region (if applicable) _ _. . . !... For official use Only
Designated Agency Contact (Name, Title)
Christina Craftier, Executive Assistant to Mayor and Council EjAmendment (Must PovideExplanation inPart 3.)
760-322-8366 I christina.chartier@palmspringsca.gov I Date of Original Filing:
(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 100.00
9 Y p Y� Yes ® No ❑
Event Description: WIF Broken Glass Awards Date(s) 1 05 / 18 1 1
Provide Title/Explanation
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(s)I
Describe the public purpose made pursuant to the agency's policy
Passes
Number
Name of Individual
N
B"
of Ticket(s)/
Identify one of the following:
(Last, First)
Passes
Moon, Robert
Ceremonial Role ❑ Other Q Income ❑
1
Ir rhecking'Cemmonial Role" or'Olher describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Ceremonial Role ❑ Other U Income ❑
It checkng'Ceremonial Role" or'Olher'describe below:
Name of Outside Organization
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.
Comment:
18944.1 and 18942. 1 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: 866/ASK-FPPC (8661275-3772)