2017-02-17 Air Museum GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
Division, Department, or Region (if applicable)
Designated Agency Contact (Name, Title)
Cindy Cairns, Executive Services Administrator
Area Code/Phone Number E-mail
760-322-8362 1 cindy.caims@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: Palm Springs Air Museum Gala 2017
Provide Titie/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ED
A Public Document
I i 'f 0 F Pt4LN SP •
1111 APR 24 PH
For Official Use Only
VICE OF THLE W 543 LLERIt
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 350.00
Date(s) 02 / 17 1 17
If no: PS Air Museum
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 Tickagay Describe the public purpose matte pursuant to the agency's policy
Passes
A
Moon, Robert
Mills, Chris
Name of Individual
(Last, First)
of Tickag Y I Iderift one of the following:
Passes
Ceremonial Role ❑ Other ® Income ❑
2 Ifcheckng'Ceremonial Role"or'Other describe below:
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other El Income ❑
2 If checking Taremonla! Role' or-0ther' describe below:
Public Purpose as defined by PS Resolution No. 22454
C. Name of Outside Organization I Tlcket(s)J I Describe the public purpose made pursuant to the agency's policy
of
(include address and description) Passes
4. Verification
I have read and understand
with the requirements.
nature
Comment:
Regulations 18944.1 and 18942. ! have verified that the distribution set forth above, is in accordance
David Ready City Manager 'fib 1 I`?
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: -
Ceremonial Role Events and Ticket/Pass Distributions W`
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 R to identify an individual. • Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit
of Tlckegajl
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of T11069MY
Pam"
Identify one of the following:
Kors, Geoff
2
Ceremonial Role ❑ Other El Income ❑
it checking"Cammonia!Role" or"Other"descnbeberow
Public Purpose as defined by PS Resolution No. 22454
Roberts, J.R.
1
Ceremonial Role ❑ Other ® Income ❑
lfchacking°Ceremonial Role"or"Othe�'descnbe below
Public Purpose as defined by PS Resolution No. 22454
Ready, David
1
Ceremonial Role ❑ Other ® Income ❑
lrchecking"CeremonialRoie"or'Other'descnbebelow.
Public Purpose as defined by PS Resolution No. 22454
Reyes, Bryan
2
Ceremonial Role ❑ Other ® Income ❑
trchecking "Ceremonial Role'or'Othee describe beiow
Public Purpose as defined by PS Resolution No. 22454
Organization
CName of Outside 0. r9
(include address and description)
Number
of 71ckt#(sy
passes
Describe the public purpose made pursuant W the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)