2016-03-25 Coyote Stateworks Art PerformanceAgency Report of: RECEIVED
Ceremonial Role Events and Ticket/Pass DistdMidWSP A LM SPRING Public Document
1. Agency Name 2016 MAR 2 AM
City of Palm Springs
Division, Department, or Region (If Applicable) JAMES lHOMPSUN For OKciiai use only
CITY LERK
Designated Agency contact (Name, Title)
Jennifer Nelson, Executive Asst. to Mayor/Council
Area ode/Phone Number E-mail ❑Amendment (Must provide explanation in Part 3.)
760-323-8200 1 jennifer.nelson@palmspdngsoa.gov Date of Original Filing: nirnnth name VAAA
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description Coyote Stageworks Art performance
Provide' iftExplanadon
Tickets)/Pass(es) provided by agency? Yes ❑ No
Face Value of Each TicketilPass $ 60.00
Date(s) 3 25 6
If no: PS Cultural Museum
Name of Source
Was ticket distribution made at the behest No ® Yes ❑ If yes:
of agency official? Offldal's Name (Last. First)
3. Recipients
• Use Section A to identify the agency's department or unit • Use Section S to identtly an individual. • Use Section C to Identify an outside organization.
A. Name of Agency, Department or unit Humber of Describe the public purpose made
� �� � Tlcketls}! P P rp pursuant t0 the agency's policy
Passes)
Name of Number of
B. f Individual di Ticket(s}! Identify one of the following:
Pass(es)
Ceremonial Role ❑ Other ® tr G�mC ❑
Lyon, Ken if dwidng -Ceremon el R 'r r therlde=ba bekw
2 Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ® incarne ❑
Collela, Jake 't-aecAfvTenrmmielRote' orrotWdescrlbebekw
2 Public Purpose as defined by PS Resolution No. 22454
C. Name of Outside Organization Number of
(include address and deacriptlon} Tic"ay Describe the public purpose made pursuant to the agency's policy
Pass(es)
4. Verification
1 have read and understand FPPC
Comment:
lions 18944.1 and 18942. ! have verified that the d+stribution Sol forth above. is in accordance with the requirements.
David H. Ready City Manager
PWnf Name Me (Monts, Day, Year)
FPPC Form 802 (4112)
FPPC Toll -Free Helpline: 8661ASK-FPPC 18661275-7772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions e
jin
Continuation Sheet e
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 ldentily an Individual. • Use Section C to Identify an outside organization.
A. Name of Agency, Department or Unit
Number of
Tkkst(su
Describe the public purpose made pursuant to the agency's policy
Pesetas)
B. Name of Individual
Number of
Ticket(s}f
Ida" one of the following:
(LEA w+
Pass(es)
Ceremonial Rde ❑ Other ® Income ❑
Muniz, Adana
2
!lcheckng'Cerem iarRare or Cthet dessrfbebWow
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ® Income ❑
Hart, Kathie
2
If checking TemmaniWRofe'or'OrherdesaibebeMw-
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Rde ❑ Other ® Income ❑
Van Hom, Cathy
2
If chocking TaivimanialRale•or'otberdescribeberow,
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ® Income ❑
Zerebny, Lesley
2
t/ checking TeremwWRde'or'OthePdesenbebobw-
Public Purpose as defined by PS Resolution No. 22454
C Name of Outside Organization
(include address and description)
Number of
Ticket(sp
Describe the public purpose made pursuant to the agency's policy
Pass(esl
FPPC Form 802 (4172)
FPPC Toll -Free Helpllne: 8661ASK-FPPC (8661275-7772)
Form 802 - Additional tickets for PS Coyote Stageworks - Art
Larry Stickles - 2 - Public Purpose as defined by PS Resolution No. 22454
Alberto Gradilla - 2 - Public Purpose as defined by PS Resolution No. 22454
Rick Minjares -2 - Public Purpose as defined by PS Resolution No. 22454
Jose Arellano -2- Public Purpose as defined by PS Resolution No. 22454