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2018-11-08 CVEP Economic SummitAgency'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) rim Christina Chartier, Executive Assistant to Mayor and Council 760-322-8366 1 chdstina.chartier@palmspringsca.gov For Official Use Only ❑ Amendment (Must Provide Explanation in Pan 3.) Date of Original Filing: (month, day, year) 2. Function or Event Information Does the agency have a ticket olio Face Value of Each Ticket/Pass $ 95_00 9 Y policy? Yes® Non Event Description: CVEP Economic Summit Dates) 11 t 08 t 18 Provide 7ille/Explanaton Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: CVEP 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. A. Name of Agency, Department or Unit Number of ncket(s)/ Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Timbercket(s)l Identify one of the following: (Last, First) Passes Moon, Robert 1 Ceremonial Role ❑ Other ❑% Income ❑ IfchecWng'Ceremonial RoWor'OthePdescnbe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii viii Holstege, Christy 2II Ceremonial Role ❑ Other ❑7C Income ❑ chechng'Ceremonial Role' or'Other'descnbe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 d vii viii Name of Outside Organization C. (include address and description) Number of Ticket(s)l Passes Describe the public purpose made pursuant to the agency's policy 4. Verification I have read and understand with the requirements. Regulations 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 (212016) FPPC Toll -Free Helpline: 866IASK-FPPC (866/275-3772) Agency Report of: - 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 Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual (Last, First) Number of Ticket(sy Passes Identify one of the following: Roberts, J.R. Ceremonial Role ❑ Other El Income ❑ 1 if checking 'Ceremonial Role" or 'Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(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) Fagg, Flinn Ceremonial Role ❑ Other El Income ❑ 1 If checking 'Ceremonial Role" or 'Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Nolan, Tom Ceremonial Role ❑ Other ® Income ❑ 1 If checking 'Ceremonial Role" or 'Other' describe below: Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Name of Outside Organization C. (include address and description Number of Ticket(s)i Passes Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Form 802 — Additional Tickets for CVEP 14th Annual Greater Palm Springs Economic Summit 11 08 18 Pendleton, Marla —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(x) Virata, Jay —1, Public Purpose as defined by PS Resolution No. 22454, Section 1 (d)(x) Van Horn, Cathy —1, Public Purpose as defined by PS Resolution No. 22454, Section 1(d)(x)