2017-06-13 Chamber Installation LuncheonAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions( E.v.,, , : F V,,t ,',,- ubile Document
1. Agency Name ;i � `r ' - Date stamp 802
City of Palm Springs �' 3� '
Division, Department, or Region (it applicable) ' cJ For Official use Only
Designated Agency Contact (Name, Title)
Christina Chartier, Executive Assistant to Mayor and Council ❑Amendment (Must Provide Explanation in Part 3.)
one Numoer I t:-ma
760-322-8366 1 Christina.chartier@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. PS Chamber Installation Luncheon
Provide Title/Explanation
Tickets)/Pass(es) provided by agency? Yes ❑ No 91
Face Value of Each Ticket/Pass $ 70.00
Date(s) Q6 t 13 t 17 1
If no: PS Chamber of Commerce
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
o
of agency official?Official'sNameGast Fiat)
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 Tickegsp Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Number
B. of Tlcket(s)I Identify one of the following:
(Last, First) I passes
Moon, Robert
Roberts, J.R.
Ceremonial Role ❑ other ® Income ❑
2 N checking 'Ceremonial Role" or -Other' descrkbe below.
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ® Income ❑
1 !f checking "Ceremonial Rohe" or "Other' denenbe below:
Public Purpose as defined by PS Resolution No. 22454
C. Name of Outside Organization I 17cketts}I I Describe this public purpose made pursuant tothe agency's policy
(include address and description) passes
4. Verification
t have read and understand FPPC Regulations 18944,1 and 18942. t have verified that the distribution set forth above, is in accordance
with the requirements.
David Ready City Manager
Signature of Age or designee Prink Name Tdle (month, day, year)
Comment:
FPPC Form 802 1212016)
FPPC Toll -Free Helpline: B661A8K-FPPC (8661276-3772)
Agency Report of: Calitornia 802
Ceremonial Role Events and Ticket/Pass Distributions Form
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 B to identify an individual. • Use Section C to identify an outside organization.
Mumber
A. Name of Agency, Department or Unit
of'nckegs)l
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of 7ickettsj!
Passes
Identify one of the following:
Foat, Ginny
i
1
Ceremonial Role ❑ Other ® Income ❑
lrchecking Ceremonw Role"or'Orher" describe below
Public Purpose as defined by PS Resolution No. 22454
Kors, Geoff
Ceremonial Role ❑ Other ® Income ❑
l/checking"Ceremonial Role'or"Other'describe below:
Public Purpose as defined by PS Resolution No. 22454
Blaisdell, Amy
i
Ceremonial Role ❑ other ® Income ❑
lrchecking'CommonialRola"or'Ofher'describebelow.
Public Purpose as defined by PS Resolution No. 22454
Goolsby, Denise
1
Ceremonial Role ❑ Other ® Income ❑
lrchecking'CeremonialRole"or`Ofher'describebelow,
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization
C. (Include address and description)
Number
of itckegs►I
Passes
Describe tits public purpose matte pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Felplins: 8661ASK-FPPC 18661275-3772)
Form 802 —Additional Tickets for Palm Springs Chamber Installation Luncheon Pa$_.2
Dunn, Charles —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
Kays, Jeannie —1, Public Purpose as described by PS Resolution No. 22454
Gladders, Craig —1, Public Purpose as described by PS Resolution No. 22454
Berardi, Cindy —1, Public Purpose as described by PS Resolution No. 22454
George, Stephanie —1, Public Purpose as described by PS Resolution No. 22454