2017-04-18 Chamber Police and Fire Appreciation LuncheonAgency Report of:
Ceremonial Role Events and TicketlPass Distributions A Public Document
1. Agency Name i t ��'
City of Palm Springs OF PALM .,�'
Division, Department, or Region (if applicable) _l%2011 APR
2 4 DM 5, r "Foral Use Only
Designated Agency Contact (Name, Title)
i Ji` 1 rrL 4-, i 11 _L. .,
Cindy Cairns, Executive Services Administrator
❑ Amendment (Must Provide Explanation in Part3.)
Area Code/Phone Number E-mail
760-322-8362 1 cindy.cairns@paimspringsca.gov Date of Original Filing:
y. @palmsprin sca. 9 gov (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: Police & Fire Appreciation Luncheon
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No 91
Face Value of Each Ticket/Pass $ 60.00
Date(s) 04 1 18 1 17
If no: PS Chamber of Commerce
Name of Source
Was ticket distribution made at the behest Yes ❑ No ICJ 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 Ticket(s)l Describe the public purpose made pursuant to the agency's policy
Paaaaa
B. Name of Individual
(Last, first)
of Ticket(sy I Identify one of the following:
Passes
Ceremonial Role ❑ Other I] Income ❑
Moon, Robert 2 If checking 'CeremonielR0le"or'Ofher'MxnbeMOM
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other Q Income ❑
Roberts, J.R. 1 Ilchecking'CeremonialRae"or"Other'descnbebelow
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization Number
C. of Tkket(su 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
Comment:
18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Tile (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of:
Ceremonial Role Events and TickeVPass Distributions 0*9EL112
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 Tickagay
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Tickegs)i
Passes
Identify one of the following:
Ready, David
1
Ceremonial Role ❑ Other El Income ❑
if checking "Ceremonial Role" or "Other' downbe below
Public Purpose as defined by PS Resolution No. 22454
Reyes, Bryan
1
Ceremonial Role ❑ Other ® Income ❑
It checking "Ceremoniai Rote" or "Other' descnbe below:
Public Purpose as defined by PS Resolution No. 22454
Nalder, Kevin
1
Ceremonial Role ❑ Other El Income ❑
If checking 'Ceremonial Rote"o("Other"describebetow:
Public Purpose as defined by PS Resolution No. 22454
Blaisdell, Amy
Ceremonial Role ❑ Other ® Income ❑
If checking 'Ceremonial Role'or"Other"describabehw:
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organisation
G' (include address and description)
Number
of PasBese)/
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (66ril275-3772)
Form 802 — Additional Tickets for Police & Fire Appreciation Luncheon, 4/18 17
Fuller, Marcus —1, Public Purpose as described by PS Resolution No. 22454
Severin, Suzanne --1, Public Purpose as described by PS Resolution No. 22454
Stark, Boris —1, Public Purpose as described by PS Resolution No. 22454
Hart, Kathie —1, Public Purpose as described by PS Resolution No. 22454
Sawyer, Angela —1, Public Purpose as described by PS Resolution No. 22454
Goolsby, Denise —1, Public Purpose as described by PS Resolution No. 22454
Gileno, Leigh —1, Public Purpose as described by PS Resolution No. 22454
Pope, Luz —1, Public Purpose as described by PS Resolution No. 22454
Craig, Sid —1, Public Purpose as described by PS Resolution No. 22454
Berardi, Cindy —1, Public Purpose as described by PS.Resolution No. 22454
Brown, Arron —1, Public Purpose as described by PS Resolution No. 22454