2017-12-01 Chamber Athena AwardsAgency Report of:
Ceremonial Role Events and TicketlPass Distributions A Public Document
1. Agency Name l Y p F PALM 5 R ll"�
City of Palm Springs
division, Department, or Region (if applicable) UL 19 AM 8: 04 FF.rOffidal Use Only
Christina Chartier, Executive Assistant to Mayor and Council
760-322-8366 J chr stina.chartier@palmspdngsca.gov
r,
2. Function or Event Information
Does the agency have a ticket policy?
Event Description: Athena Awards
Provide Trtfe/Prrplanattan
Ttcket(s)/Pass(es) provided by agency? Yes ❑ No El
Yes ® No ❑
Was ticket distribution made at the behest Yes ❑ No
of agency official?
OF THE CITY CLEF I ✓
Amendment (Must Provide ExplanaSon In Pan 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 85'00
Date(s) 12 / 01 r 17
If no: Palm Springs Chamber of Commerce
Name of Sousse
If yes:
Offidal'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 organisation.
A. Name of Agency, Department or Unit
of Ticket{sy I Describe the public purpose made pursuant to the agency's policy
es Pass
B. Name of Individual
of TlckagaY
Identify one of the following:
(Lai. FkAi
Passes
Moon, Robert
Ceremonial Role ❑ Other IN Income ❑
2
HcheckkV7afemordalRole'or'OfftrdesWbobobw
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
J.R. Roberts
Ceremonial Role ❑ Other El :nwme ❑
1
N checking 'C&wwnW RokY or'Other des0be below
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Name of Outside Organization
C'
Number
of Ticketlsy
Describe the public purpose made pursuant to the agency's policy
(include address and description)
Passes
4. Verification
i have read and understand
with the requirements. e
Comment:
Regulations 18944 1 and 18942 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Tile (month, day, year)
FPPC Form $02 (212016)
FPPC Toll -Free Helpllne: 666IASK-FPPC (8661275-3772)
Agency Report of: California
02
Ceremonial Role Events and Ticket/Pass Distributions '
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 $ to identify an individual. -Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit
of Ticket(sy
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
{Last, Fk4
Number
of Tickoqsyr
Passes
identify one of the following;
Ginny Foat
1
Ceremonial Role ❑ Other ® n om ❑
itcneckV'Ca,emoMaraae-or'otnardescdbeceiow
Public Purpose as defined by PS Resolution No. 22454,
Section 1(d)(vll)
Geoff Kors
1
Ceremonial Role ❑ other ® ,ta,,e ❑
ifdw nq'C bftw
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Lisa Middleton
Ceremonial Role ❑ Other ® Income ❑
+rchecft'CeremorarRde-or'Otftrdesobebebw
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Christy Holstege
Ceremonlal Role ❑ other ® Income ❑
#cWknc cenm=ziotRob'or*Othw'descdbabotow
Public Purpose as defined by PS Resolution No. 22454,
Section 1(d)(vii)
Name of Outside Organisation
C. include address and description)
pU )
Number
of Tlck"ey
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Form 802 — Additional Tickets for Athena Awards 12.1.17
Ready, David —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(vii)
Blaisdell, Amy —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(vii)
Severin, Suzanne —1, Public Purpose as described by PS Resolution No. 22454, Section 1(d)(vii)