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2017-07-27 Hospitality AssociationAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs ' t Division, Department, or Region (if applicable)11� Designated Agency Contact (Name,Title) Christina Chartier, Executive Assistant to Mayor and Council rea r 760-322-8366 1 christina.chartier@palmspringsca.gov 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Event Description: Palm Springs Hospitality Assoc. Provide Title/ Explanation Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ Jkublic Document IBM a • ff ` y C A . 32 1=or Official Use Onty ❑ Amendment (Must Provide Explena8ort in Part 3.) Bate of Original Filing: (month, day, year) Face Value of Each Ticket/Pass $ 35.00 Date(s)i 07 1 27 1 17 _1 f. If no: Name of Source Was ticket distribution made at the behest Yes ❑ No ® If yes: Olfiaal'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 organisation. Number A. Name of Agency, Department or Unit of Tlcketls)l Describe the public purpose made pursuant to the agency's policy Passes Name of Individual Number B. of Tlckat(sy Identify one of the following: (Last, First) pp Moon, Robert Ceremonial Role ❑ Other © Income ❑ tf checking "Ceremonial Role" or °Other' describe below. Public Purpose as defined by PS Resolution No. 22454 Kors, Geoff Ceremonial Role ❑ Other ® Income ❑ +� It checking 'Cefemonial Role- or 'Other' doWibe below Public Purpose as defined by PS Resolution No. 22454 Name of Outside Organization Number C. (include address and description) of Tlckegsy Describe the public purpose made pursuant to the agony's policy Passes 4. Verification I have read and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance with the requirements. L David Ready City Manager �� t7— Signature of Agency Head or D Print Name Title (month, day, year) Comment: FPPC Form 802 1212016) FPPC Toll-Frse Helpline: 8661ASK-FPPC (8661276-3772)