2017-03-31 PS Cultural Center Documentary FestivalAgency 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.cairns@palmspringsca.gov
A Public Document
ITY OF PALM SP
For Official Use Only
Z�1T APR 24 PM 5 43
FICE 0IFFHE Ci i (ILER-P,
❑ 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 $ 225.00
Event Description: 6th Annual American Documentary FF Date(s) 3/ 1 31 1 17 41 05 1 17
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Palm Springs Cultural Center
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.
A. Name of Agency, Department or Unit
Number
of Tickot(syl
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Tlckat(s)l
Identify one of the following:
(Last, First)
Passes
Ceremonial Role ❑ Other ® Income❑
Moon, Robert
2
if checking Ceremonial Role" or "Other' describe below:
Public Purpose as defined by PS Resolution No. 22454
Foat, Ginny
Ceremonial Role ❑ Other X❑ Income ❑
2
it checking "Ceremonial ROIe" or "Other" descrlbe below.
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization
C.
Number
ofTk
Describe scriba the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
I have read and understa P Regulations 18944,1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements.
David Ready City Manager -7
Signature of Agency ead Desi ee Print Name Title (month, day, year)
Comment:
FPPC Form 802 (2120161
FPPC Toll -Free Helpllne: 866)ASK-FPPC (8661275-3772)
802
Agency Report of: Calitornia
Ceremonial Role Events and Ticket/Pass DistributionsForm
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 8 to identify an individual. • Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit
ofTickegsy
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Tickagay
Passee
Identify one of the following:
Mills, Chris
2
Ceremonial Role ❑ Other ® Income ❑
If checking 'Ceremonial Role" or "Other' describe below
Public Purpose as defined by PS Resolution No. 22454
Kors, Geoff
2
Ceremonial Role ❑ Other El Income ❑
!t checking 'Ceremonial Role" or "Other' describe below:
Public Purpose as defined by PS Resolution No. 22454
Roberts, J.R.
2
Ceremonial Role ❑ Other ® Income ❑
itchecking°Ceremonial Role"or'Other'describebefow:
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑ Income ❑
W checking 'Ceremonial Role" or "Otha' describe below:
Name of Outside Organization
(include address and description)
Number
ofTlcket(sy
Pam
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)