2017-03-25 Art Musuem GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency (dame
City of Palm Springs
Division, Department, or Region (ifapplicable) `
ossignated Agency corimci (ivame, irate) ur r
Cindy Cairns, Executive Services Administrator
Area CodelPhone (Number I E-mail
760-322-8362 1 cindy.cairns@paimspdngsca.gov
A Public Document
OF PIA, LM 5r RI
For Official Use Only
17 APR 24 PM 5: Idq
ICE (r I HE cil `I` Ci-
❑ 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 $ 150.00
Event Description: Palm Springs Art Museum Gala Date(s) 31 25 1 17 11
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: PS Art 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 Tickegey Describe the public purpose made pursuant to the agency's policy
Passes
B.
Moon, Robert
Foat, Ginny
Name of Individual
(Last Fist)
of Th kegsu I Identify one of the following:
Passes
Ceremonial Role ❑ other ® Income ❑
2 If checla'ng "Ceremanial Role"w'Other'descnhe below_
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ other K❑ Income ❑
2 !t checking "Ceremonlot Rote" or "Othe'damnbe below:
Public Purpose as defined by PS Resolution No. 22454
C.Name of Outside organization I Tlckagsu I Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4. Verification
1 have read and understand
with the requirements_
re at Agency mean or
Comment:
18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager + ]Q7 ! 1-1
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
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 Tiekegsu
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of TickegsN
passes
Identify one of the following:
Kors, Geoff
2
Ceremonial Role ❑ Other El Income ❑
If checking "Ceremonial Role" or "0fher' describe below
Public Purpose as defined by PS Resolution No. 22454
Roberts, J.R.
1
Ceremonial Role ❑ Other ® Income ❑
Ifchecking°Ceremonial Role"or"Ofher'descnbe below:
Public Purpose as defined by PS Resolution No. 22454
Brenner, Melanie
1
Ceremonial Role ❑ Other ® Income ❑
If checking°Ceremonial Rate" or"Other"descnbebelow:
Public Purpose as defined by PS Resolution No. 22454
Murray, Alfonso
1
Ceremonial Role ❑ other ® Income ❑
ffchacking"Ceremonial Role"or "Other' describebeiow:
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization
C•of
(include address and description)
Number
Ticket(sy
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 666IASK-FPPC (8661275-3772)
Form 802 —Additional Tickets for Palm Springs Art Museum Gala 3 25 17
Yanni, Thomas —1, Public Purpose as described by PS Resolution No. 22454