2017-10-21 Desert AIDS WalkAgency Report of:
Ceremonial Role Events and TicketlPass Distributions
1. Agency Name
City of Palm Springs AT
T Y
or
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 1 chdstina.chartier@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 25.00
Event Description: Desert AIDS Walk 2017 Date(s) 10 1 21 1 17 1
Provide 'Rtiat Explanation
Ticket(s)IPass(es) provided by agency? Yes ® No ❑ If no:
A Public Document
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For OtCcial Use ONy
2�1� AN 3 l AH 8� 50
!EPIC OF Tht Cl T Y CLE
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing: (month, day, year)
Name at Source
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Official's Name (Last. Frrst)
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 Tickagey Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual I of Mcksgsu I Identify one of the following:
aAA First) Passes
Ceremonial Role ❑ Other ® Income ❑
Roberts, J.R. 1 lfchecldng'CeremonlaiRde-or•ofWdescrfbebftw
Public Purpose as define by PS Resolution No.22454
Section 1 d vii
Ceremonial Role ❑ Other ❑ Income ❑
IF eMciang -Ceremonial Roie- or'Othee descnbe below
C. Name of Outside Organization I ofTick—eisu I Describe the public purpose made pursuant to the agency's policy
nclude address and description) (iPasses
4. Verification
1 have read and understand ref C Regulations 16944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements. 7
s ; + David Ready City Manager �r W_
Signature otAgerufy HVP 115p0esignee Print Name Title (month, day, year)
Comment:.
FPPC Form 802 (212016)
FPPC Toll -Free Helpiine: 8661ASK-FPPC (8661275-3772)