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2016-02-27 Opera Arts When I RiseRECEIVED Agency Report of: CITY OF PALM SpRING'v Ceremonial Role Events and Ticket/Pass Distr r km 9; 08 me City of Palm Springs or Jennifer Nelson, Executive Asst. to Mayor/Council Date Stamp DAMES TFi ERK 760-323-8200 1 jennifer.nelson@paimspdngsca.gov 2. Function or Event Information Does the agency have a ticket policy? Yes No ❑ Mizell Stars Among Us Gala 2 27 16 -1 N Event Description Date(s) I I Provide Tirle/Explanation,, a• •�= Ticket(s)IPass(es) provided by agency? Yes ❑ No ® Mizell Senior Center If no' Name of Source y- ; Was ticket distribution made at the behest No ® Yes ❑ If yes- of agency official? ofratiat's Name (Last, Firsfl- . S9 3. Recipients co *Use Secdon A to identify the agency's department or unit a Use section O to Identify an Individual. *Use section C to identify an oudwe organization. Number of A. Name of Agency, Department or Unit Tlc"su Describe the public purpose made pursuant to the ageacy's Macy Pasa;es) A Public Document For OfWal Use Only ❑ Amendment {Must provide explanation In Part 3. Date of Original Filing: (Month, Day Year) Face Value of Each Ticket/Pass $ B. Name of Individual Number of Lw rni Tickettsy Identify one of the following: Passtesl Mills, Chris Ready, David 285.00 Ceremonial Role ❑ Other ® Income ❑ lrchftkr,g'Ceremonlal Rofe' or %Nher describe below Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income N checking 'Commonlei Rore' or'OtheP describe below Public Purpose as defined by PS Resolution No. 22454 CName of Outside Organization Number of (include address and description) Tickegsp Describe the public purpose made pursuant to the agency's policy Passtes} t have read and understand F Regrrtahons 18944 1 and 18942 1 have verified that the distribuh'on set forth above is in accordance Mth the regWrements. r David H. Ready City Manager Signature afAgeA HWPF Designee Pdnt Name TIM (Month. Day, Year) Comment: FPPC Form 802 (4112) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-TT72) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions Ron 0 =1 Continuation Sheet A Public Document Agency Name City of Palm Springs 3. Recipients . Use Section A to Identify the agency's department or unit. a Use Section S to identify an individual- a Use Section C to identify an outside organization. A. Name of Agency, Department or Unit Number of Tiekegs)I Describe the public purpose made pursuant to the agency's policy Passes) B. Noma of individual Number of Tlcket(s)l Identify one of the fW orwing: �••c ra,a) Passes) Ceremonial Role ❑ Olher ® income ❑ Roberts, J.R. 2 if chacfa}p"CeremonrefRofe or Other' describe below Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income ❑ Lyons, Ken 2 NchmkirV ceremwia,R&o'or*ohereesc beberow Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income ❑ Holland, Doug 2 11chec"'CommoMalfte"or -Yrherdescrrbebelow Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ❑ Income ❑ ftchacfdng "Ceremonial Role"or'Other'descrrbe below Name of Outside Organization C. (Include address and description) Number of Ticke#sy Describe the public purpose made pursuant to the agency's policy Pass{es) FPPC Form 802 (4112) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-7772)