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2017-03-11 LGBT Community Center Red Dress PartyAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs , Department, or Region (if applicable) Cindy Cairns, Executive Services Administrator 760-322-8362 1 cindy.cairns@palmspringsca.gov A Public Document *£*10Y E D I California: 1 T'Y OF PALH Sp, Far Official Use Only 2017 APR 24 PM 5 43 "FICE OF IHE CITY ❑ 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 $ 75.00 Event Description: Red Dress Dress Red Dance Party Date(s) 31 11 ! 17 Provide Title/ Explanation Ticket(s)/Pass(es) provided by agency? Yes ❑ No El If no: LGBT Community Center of the Desert 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 Ticksgsp Describe the public purpose trade pursuant to the agency's policy Passes B. Moon, Robert Name of Individual (Last, First) of Ticke4sy I identify one of the following: Passes Ceremonial Role ❑ Other © Income ❑ 2 If checking 'Ceremonial Role" or"' r 'tither' describe below: Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ® Other ❑ Income ❑ If checking'Ceremonial Role" or "other' describe below. Name of Outside Organization Number Describe the public u made pursuant to the a nc 's poll C. (include address and description) of Tickegiii P P P ge y policy Passes 4. Verification I have read and understand FP Regulations Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance with the requirements. ,% � �U�� David Ready Print Name Comment: City Manager 00 t FL Title (month, day, year) FPPC Form 8021212016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)