2017-05-06 White Party Main EventAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions JjbMlic Document
1. Agency Name j; C E l "Ymp
City of Palm Springs ;iT'Y F PALM SPRiN6
Division, Department, or Region (if applicable) 70fricialM
F017 Y I $ PH 6� 4Q
Designated Agency Contact (Name, Title)
t1F ICE I' W-E C1l t CI E
Cindy Cairns, Executive Services Administrator
❑ Amendment (Must Provide Explanation in Part 3.)
Area Code/Phone Number E-mail
760-322-8362 1 cindy.cairns@palmspringsca.gov i Date of Original Filing:
{month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: White Party Main Event
Provide Tiffe/Explanation
Tickets)/Pass(es) provided by agency? Yes ❑ No 91
Face Value of Each Ticket/Pass $ 150.00
Date(s) 05 1 06 i 17 J i
If no: White Party Entertainment, Inc.
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 S to identify an individual. • Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit of Tickagay Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of rtckket(sy Identify one of the following:
(Last, First) I Passes
Roberts, J.R.
Ceremonial Role ❑ Other I] Income ❑
2 If checking `Ceremonial Role"Or'tiOthei- descnbe below.
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑ Income ❑
If checking -Ceremonial Role" or "Other describe below.
Name of Outside Organization Number
C' {iDescribe the public purpose made pursuant to the agency's policy
include address and description) of Ticket(sK
Passes
4. Verification
I have read and under
with the requirements.
Comment:
Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
David Ready City Manager i
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)