2017-11-10 Spirit of Home USOAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name �iT p P L_1 rFFor
City of Palm SpringsDivision, Department, or Region (if applicable) 24}a JN 31 �H 8' 5Zcial u70nly
Designated Agency Contact (Name,71de) ; ; r t r
CLEP
Christina Chartler, Executive Assistant to Mayor and Council
❑ Amendment (Must Provide Explanation In Part 3.)
Area GodelPhone Number �-mail
760-322-8366 chdstlna.chartier@paimspdngsca.gov 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 $ 125.00
Event Description: Spirit of Hope USO Event Date(s) 11 / 10 ' 17
Provide Tde/Explanabon
Ticket(s)IPass(es) provided by agency? Yes ® No ❑ If no:
Name at Scum&
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 $ to identify an individual. -Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit of Tickegs)l Describe the public purpose made pursuant to the agency's policy
Passes
B.
Name of Individual
(Last, First)
of Ticket{&)!
Passes
Identify one of the following:
Ceremonial Role ❑ Other ® Income ❑
Moon, Robert itch
ecklni;TeremonialRole or'OtWdescdDebeiow
Public Purpose as define by PS Resolution No.22454
Section 7 d vii
Ceremonial Role ❑ Other ❑ noome ❑
fi dw ng'Censmonial Role w0theP de
Name of Outside Organization I Number I
C. (include address and description) of Ticket(&)! Describe the public purpose made pursuant to the agency's policy
Passes
4. Verification
1 have read and understand
with the requirements.
Comment:
18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager r 1— 15 ( 7
Print Name Title {month day, year)
FPPC Form 802 (2(2016)
FPPC Tall -Free Helpline: 8661ASK-FPPC (86W275-3772)