2017-12-12 St Teresa School LuncheonAgency Report of:
Ceremonial Role Events and TicketlPass Distributions A Public Document
1. Agency Name R E t El V P* stamp
City of Palm Springs IT Y OF If A L H S P R t - •
or Region (ltapplicable) I For official use only
�Oi9 JUL 119 �M l2� 03
Designated Agency contact (Name,Title) "i . CITY GLU
Christina Chartier, Executive Assistant to Mayor and Council
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8366 1 chdstlna.chartier aims fin sca. OV Date of original Filing:
@P P 9 9 {month, day, Year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event DescriDtion: St. Teresa School Luncheon
Face Value of Each Ticket/Pass $ 85.00
Date(s) 12 f 12 r 17 1 1
Provide ride/Explanation
Ticket(s)IPass(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 (Lost. 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.
Number
A. Name of Agency, Department or Unit of Ticket(sy Describe the public purpose made pursuant to the agency's policy
Passes
Number
B. Name of
ual su Identify one of the following:
(Lost
Moon, Robert Ceremonial Role ❑ Other ❑ Income ❑
Ncheckng 'Ceremonial RoAr or'Other desalbe below
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii
Ceremonial mole ❑ Other R Income ❑
Middleton, Lisa It checking'emmonlalRde'or'Other descdbebelow
Public Purpose as defined by PS Resolution No. 22454,
C. Name of Outside Organization I of Ticket(ey! I 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.
Comment:
Regulations 18944,1 and 18942. / have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
Agency Report of: California
'i
Ceremonial Role Events and TicketlPass 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 B to identify an Individual. • Use Section C to identify an outside organization.
Number
A.
Name of Agency, Department or Unit
of Tic"sjt
Passes
Describe the public purpose made pursuant to the agency's policy
B.
Name of Individual
(Last, First)
Number
of Tkket(syf
Passes
Identify one of file following-,
Holstege, Christy
Ceremonial Role ❑ Other ® Incorna
It ClWCMnp'CeremorWROW Or'OtherdesalsenoMnw
Public Purpose as defined by PS Resolution No. 22454,
Section 1(d)(rrii)
❑
Ceremonial Role ❑ other ❑ Irwrne
it checking 'Caremonlal Role' or'Olher downx cte 3m
❑
Ceremonial Role ❑ Other ❑ Income
Irc1mcking'Ceremonial Role-or'Other describe
❑
Ceremonial Role ❑ Other ❑ wr*ie
lrchotklnp'Ceremorirel RO*'Or'OtWdespfbe `r m
❑
C.
Name of Outside Organisation
prelude addrosa and description)
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)