2016-01-29 Women Leaders Forum Scholarship LuncheonAgency Report of: RECEIVED
Ceremonial Role Events and TicketlPass DistrMUOMPALM SPRIhIc;� j�APublic Document
1. Agency Name 2618 FEB — AM I Date
Stamp
p � � California � 1
City of Palm Springs
Iv s on, Diiiiartment, or Region (If Applicable) CITY CLERK
omp s tFor Otfidal Use Only
f
1
Designated Agency Contact (Name. title)
Jennifer Nelson, Executive Asst. to Mayor/Council
_ ❑Amendment (Must provide explanation In Part 3.)
760-323-8200
1 jennifer.nelson@palmspringsca.gov
I Date of original Filing:
1 (Month, Day, Year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each TicketlPass $ 65.00
Event Description Women Who Rule Scholarship lunch Date(s)11 29 f 16
Provide riftExplanation
Ticket(s)IPass(es) provided by agency? Yes ❑ No ® If no: Women Leaders Forum
Name of Source
Was ticket distribution made at the behest No ® Yes ❑ If yes.
of agency official? official's Name (Last, First)
3. Recipients
*Use Section A to identify the agency's department or unll. *Use Section 8 to identify an Individual. . Use Section C to Identify an outside organization.
A. Name of Agency, Department or unitNumber
ofTicket(su
Describe the public purpose made pursuant to the agency's policy
Passes)
Name of d
Individual B. of
Number of
Ticket(sy
Identify one of the following:
ri
Passes)
Ceremonial Role ❑ Other ® Incnme ❑
Moon, Rob
rrchwkrng CeremmiarRe6le'cr'Otherdeschbobe44ow
1
Public Purpose as defined by PS Resolution No. 22454
`:eremonial Role ❑ Other ® income ❑
Blaisdell, Amy
lrcheckdV CeremonlarRore'cr-OMerdesarbabelaw
1
Public Purpose as defined by PS Resolution No. 22454
C'Name of Outside Organization
' (include address and description)Tk:ket(s)l
Number of
Describe the public purpose made pursuant to the agency's policy
Passes)
4. Verification
e ►cad and undens'Ond FPPC Fie 1 'ans f 6944. r and t8942 1 have verified that the distribution set forth above is in accordance with the requirements
David H. Ready City Manager
Sipnarunf otApency '0.. Print Name TWO (M-M, Day, Year)
Comment:
FPPC Form 802 (4112)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276-7772)