2018-11-09 LGBT Center Stage DinnerAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable) 2019
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 chdstina.chartier@palmspdngsca.gov
Date Stamp
A Public Document
For Official Use Only
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month. tlay year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 195.00
Event Description: LGBT Center Stage Dinner Date(s) 11 y 09 1 188
Provide Tt/e/Exp/anaton
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:
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 riicket(s)I
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Ticket(s)/
Passes
Identify one of the following:
Moon, Robert
1
Ceremonial Role ❑ Other i] Income ❑
ll checking Temmoniel Rohe"or'Olhee' describe below.'
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Roberts, J.R.
Ceremonial Role ❑ Other Q Income ❑
1
ll checkbg'Ceremonial Rofe'or'Olher describe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
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
1 have read and understand
with the requirements. /
Comment:
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: 8661ASK-FPPC (866/275-3772)