2016-02-12 Air Museum GalaAgency Report of:
RECEIVED
Ceremonial Role Events and Ticket/Pass Distributio MYOF PALH SPR INA Public Document
1. Agency Name
Stamp �
City of Palm Springs
?Dl
FEB 23 •
iQ� 4 �FmOfficial
Use Only
SUtM
Division, Department, or Region (if Applicable)
�
C �Y C�ER
Designated Agency Contact Name Title
9 9 Y ( )
Jennifer Nelson, Executive Asst. to Mayor/Council
❑ Amendment (Must provide explanation in Part 3.)
Area Code/Phone Number
E-mail
760-323-8200
jennifer.nelson@palmspdngsra.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 TicketlPass $ 395.00
Event Description PS Air Museum Gala
Date(s) 21 12 1 16
Provide rtte/Explanadon
Ticket(s)IPass(es) provided by agency? Yes ❑ No ®
If no: Wintec Energy LTD
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 unit. a Use Section B to Identify an Individual. • Use section C to identify an outside organization.
A. Name of Agency, Department or Unit
Number of
Ticket(s)l
Describe the public purpose made pursuant to the agency's policy
Passles)
lv
B. Name of Individual
Number of
Tiekags)!
Identify one of the following:
Passes)
Ceremonial Role ❑ ther ® Income ❑
Moon, Rob
it checking Teremeniai Role-ar Other•downbe be)aw-
2
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ® '�iG7rrG ❑
Mills, Chris
2
ltcheckingTemmonlalRole'ar'Other'dascribebelow,
Public
Purpose as defined by PS Resolution No. 22454
C.Name of Outside Organization
(include address and description)
Number of
Ticket(s)t
Describe the public purpose made pursuant to the agency's policy
Passlas)
4. Verification
f have read artd unders�end t i'PC Regulations 18944.1 end 18942. r have verified that the disldbuLbn set forth above, is in accordance with the requirements
David H. Ready
City Manager
Slgneturo otApa cX Nr Print Name
llMM (Month, Day, Year)
Comment:
FPPC Form 80214112)
FPPC Toll -Free Helpline: S661ASK-FPPC (8661276-77721
Agency Report of:
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 B to Identify an individual. • Use Section C to Identify an outside organization -
Number of
A. Name of Agency, Department or unit TicketlsN Describe the public purpose made pursuant to the agency's polloy
Paulo$)
B. Name of Individual
("" f1raq
�ketts)l
Identify one of the following,
Pass{es)
Ceremonial Role ❑ Other ® Income ❑
Foat, Ginny
1
Itchocking Teremonial Role- a •Otherdescribe bebw
Public Purpose as defined by PS Resolution No- 22454
Ceremonial Role ❑ Other ® Income ❑
Ready, David
,)
If checking Tervmm+alRole or Otherdescribebelow
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑ Income ❑
If checking Teremmial Rob or Other' describe below
Ceremonial Role ❑ Other ❑ Income ❑
lrchecking'CeremonalRole or Other' descnbebelow
C. Name of Outside Organization
(include address and description)
Number of
Tickags)t
Describe the public purpose made pursuant to the agency's policy
Passes)
FPPC Form 802 (4112)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-7772)