2017-04-20 Hospitality Association LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name R PAL tt� c; '
City of Palm Springs OJT Y Q •
Division, Department, or Region (if applicable) v +2 30 For Official Use Only
Designated Agency Contact (Name, Title) \ , r 1
g g y \ F10E F iF1w �ITy
Cindy Cairns, Executive Services Administrator
❑ Amendment (Must Provide Explanation in Part 3.)
Area CodelPhone Number E-mail
l Filing:
i i f Original ng:
760-322-8362 cindy.cairns@palmspringsca.gov Date o(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy. Yes ® No ❑
Face Value of Each Ticket/Pass $ 30.00
Event Description: PS Hospitality Assoc Member Lunch Date(s) 41 20 1 17 _ -1_ 1
Provide Tide/ Explanation
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
Official's Name (Last First)
3. Recipients
• Use Section A to identify the amencv'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
B. Name of Individual
(Last First)
Moon, Robert
C. Name of Outside Organization
(include address and description{
4. Verification
I have read and understand
with the requirements.
of Agency Head or
Comment:
I-
Number
of Tlckegay Describe the public purpose made pursuant to the agency's policy
Passes
Number
of Ticket(sy Identify one of the following:
Passes
Ceremonial Role ❑ Other ® Income ❑
1 ff checking 'Ceremonial Role" or Othel' describe below:
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other X❑ Income ❑
If checking "Ceremonial Role "or `Other" describe below
Number
of Tickeksjl Describe the public purpose made pursuant to the agency's policy
Passes
Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in
David Ready City Manager J�
Print Name Trtle (month, cray, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)