2017-04-27 Architecture and Design Council SalonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name R E C `Im, MW
City of Palm Springs Yi 0 P `�LDivision, Department, or Region (if applicable) 5� 30 For Offic
�o�� AY -2 QM
Designated Agency Contact (Name, Title)
Cindy Cairns, Executive Services Administrator
OFFIC OF .� tiff
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8362
cindy.cairns@palmspringsca.gov
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 $ 100.00
Event Description: Architecture & Design Council Salon Date(s) 41 27 / 17
Provide Title/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:
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 Tickakay
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Ticketlsu
Identify one of the following:
(Last First)
Passes
Ceremonial Role ❑ Other ❑X Income ❑
Roberts, J.R.
1
If checking `Cammoniai Role" or "Other' describe below:
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑X Income ❑
If checking "Ceremonial Role"or "Other' descnbe below.
Name of Outside Organization
C.
Number
ofPassesaN
Describe the public u made pursuant to the agency's policy
P purpose Pu
(include address and description)
Passes
4. Verification
1 have read and understan egulations
18944.1 and 18942. 1
have verified that the distribution set forth above, is in accordance
with the requirements.
David Ready
City Manager 5/0/1-1
Signature of Agency Hel or i n
Print Name
Title (month, day, year)
7
Comment:
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276-3772)