2017-10-07 EQCA Equality Awards2Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name ri'
City of Palm Springs rnT Y OF
or Region (Happlicable) In J
M
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 christina.chartier@pa{mspdngsca.gov
jvlko� A Public Document
For Official Use Only
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? Yes ® No ❑
Face Value of Each Ticket/Pass $ 275.00
Event Description: Palm Springs Equality Awards Date(s) 10 1 07 1 17 1
Provide TiHe/Explanabon
Tcket(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 ofTlckeys)l Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Humber
B. of TkkN(su Identify one of the following:
(Last, First) Passes
Peeters, Henk Ceremonial Role ❑ Omer ® Income ❑
2 frchecking CeremonialRde or'O1Wd9sWbeb&bw
Public Purpose as define by PS Resolution No.22454
Section 1 d x
Fuller, Marcus Ceremonial Role ❑ Omer 0 Income ❑
2 Nchecidng Ceremonial Rde or'OtW describe below
Public Purpose as define by PS Resolution No.22454
Section 1 (d) (xl
Name of outside organization Number
of Tkket(ajl Describe the public purpose made pursuant to the agency's policy
C. (Include address and description)
Passes
4. Verification
1 have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements.
David Ready City Manager
Sign re of A Designee Print Name Tide (month, day, year)
Comment:
FPPC Form 802 (212016)
FPPC Toil -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: California
Ceremonial Role Events and Ticket/Pass DistributionsForm'
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.
Number
A. Name of Agency, Department or Unit
of Tteket(sy
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last First)
Number
of TickaS(sy!
Passes
Identify one of the following:
Schafer, Staci
2
Ceremonial Role ❑ Other ® Income ❑
NchecJft Ceremonla1Rde or'otherdescibebetow
Public Purpose as define by PS Resolution No.22454
Section 1 (d) (x)
Severin, Suzanne
2
Ceremonial Role ❑ Other ® Income ❑
lrchecking'CemmonialRole'ar'Otherdesalbet+eraw
Public Purpose as define by PS Resolution No.22454
Section 1 d x
Hays, Thomas
2
Ceremonial Role ❑ other ® Inrurn ❑
Ir chwJuV 'Ceremonler Role' or'Other descdbe bePow
Public Purpose as define by PS Resolution No.22454
Section i d x
Ceremonial Role ❑ Other ❑ 'nccme ❑
H dreckinQ'Ceremonfef Role' or'Other descrrhe helti.
Name of Outside Organization
C.
(Include address and description)
Number
of ricket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2i2016)
FPPC Toll -Free Helpline: 866tASK-FPPC (8661276-3772)