2017-06-22 Film Festival Shortfest GayLaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
or Region (ifapplicable)
A Public Document
;JTY OF PALH SPR
Designated Agency Contact (Name,Trtle) q
Cindy Cairns, Special Assistant to City Manager
760-322-8362 1 cindy.caims@paimspringsca.gov
11 DEC 19 PM 8: 6 For Official Use Only
ICE of THE Chi Y LUL
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing: (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Face Value of Each Ticket/Pass $ 25.00
9 Y p Y Yes ® No ❑
Event Description: PS international ShortFest Gay!La Date(s) 06 1 22 1 17 061 22 1 17
Fovids Wile/Fxplanabon
Ttcket(s)IPass(es) provided by agency? Yes ❑ No E) If no: Palm Springs International Film Festival
Name of source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Officials 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 Tlck"ay Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of Individual of TickegsY Identify one of the following:
(Last, Fist) I Passes
Ceremonial Role ❑ Other ® Inc.ma ❑
Moon, Robert 2 rrcneckfap "eremowaffe orUhefdesafbebelow
Public Purpose as defined by PS Resolution No_ 22454,
Section 1 d vill .
Ceremonial Role ❑ Other ❑ Inccrie ❑
llchaerdng ;,9nw=WRo1e'or,0tMrdescib&below
Name of Outside Organizadon Number
C. (include address and description) of Tfeket(s)f Describe the public purpose made pursuant to the agency's policy
Passes
4. Verification
! have read and understand
with the requirements. ,,,
of
Comment:
Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager la' j ohl
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276-3772)