2017-02-16 Hospitality Association LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable)
Cindy Cairns, Executive Services Administrator
Area CodelPhone Number E-mail
760-322-8362 1 cindy.cairns@palmspringsca.gov
` t t UsW:i1i M S
2917 APR 2 4 PM
ublic Document
1_ For Official Use Only
FFICE 01" i 1lrr CiT'i Irs� E3;
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing: (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy. Yes ® No ❑
Face Value of Each Ticket/Pass $ 30.00
Event Description: PS Hospitality Association Luncheon Date(s) 02 1 16 j 17
Provide Titte/Expianabon
Tickets)/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 Tickegsy Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of Tickeljay Identify one of the follovuing:
(Last, First) I paw
Moon, Robert
Foat, Ginny
Ceremonial Role ❑ Other 17 Income ❑
1 If checking 'Ceremonial Role" or "Other' descnbe below_
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other I] Income ❑
.� !I checking °Ceremonies! Rde" or "Other' describe bebw:
Public Purpose as defined by PS Resolution No. 22454
C. Name of Outside Organiration I of
Tkkeysll I 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.
of Agency Head
Comment:
Regulations 18944.1 and 18942. I 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: 8661ASK-FPPC (8661275-3772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
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 S to identify an individual. -Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit
of'nckegsu
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Ticket(s)t
passes
Identify one of the following:
Kors, Geoff
)
Ceremonial Role ❑ Other El Income ❑
lfcheckng CeremalalRole"or"Othe descrbebelow:
Public Purpose as defined by PS Resolution No. 22454
Roberts, J.R.
1
Ceremonial Role ❑ Other ® Income ❑
It checking "Ceremonial Role" or'Other' describe below:
Public Purpose as defined by PS Resolution No. 22454
Ready, David
Ceremonial Role ❑ Other ® Income ❑
If checking 'Ceremonial Role' or "Ofher describe below.
Public Purpose as defined by PS Resolution No. 22454
Blaisdell, Amy
Ceremonial Role ❑ Other ® Income ❑
ncti eking°Ceremonial Role"or'Other"describebelow:
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization
C.
(include address and description)
Number
of Ttcket(sy
pain
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 1212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Form 802 —Additional Tickets for PS Hospitality Association Luncheon 02 16 17
Reyes, Bryan —1, Public Purpose as described by PS Resolution No. 22454
Peeters, Hank —1, Public Purpose as described by PS Resolution No. 22454
Goolsby, Denise —1, Public Purpose as described by PS Resolution No. 22454
Middleton, Lisa —1, Public Purpose as described by PS Resolution No. 22454