2017-10-27 LGBT Center GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name K
OF
City of Palm Springs
or Region (if
Christina Chartier, Executive Assistant to Mayor and Council
764-322-8366 1 chdstina.chartier@palmspdngsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes IN No ❑
Event Description: LGBT Center Stage Gala
Provide Trtle/Explanation
Tickets)/Pass(es) provided by agency? Yes ® No ❑
A Public Documen
LH 5
AM 8' 51 1 For OtficialUse Only
❑ Amendment (Must Provde Explanation in Part a)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 195.00
Date(s) 10 ,. _27 1 17
If no:
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
Name of Source
Official's Name (Last, First)
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 Tlckst(sy Describe the public purpose made pursuant to the agency's policy
Passes
Name of Individual Number
B. of Ticket(sj! Identify one of the following:
(Last. FJW) I Passes
Ceremonial Role ❑ Other IN r=me ❑
Moon, Robert +/rnec►ono'ceaemwnfarRors-or'OtWdewdbeMaw
Public Purpose as define by PS Resolution No.22454
Section 1 d vil
Ceremonial Role ❑ Other ❑ Income ❑
it check ng Temmonief Rafe- or'OfW desmbe below
Name of Outside Organization
of Tkkstls}! Describe the public purpose made pursuant to the agency's policy
C. {Include address and description)
Passes
4. Verification
! have read and understand
with the requirements
Comment:
Regulations 18944 1 and 18942. t have verttred that the distribution set forth above, is in accordance
David Ready City Manager I r r __� , r
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)