2016-04-08 Palm Springs Art MuseumAgency Report of: ECEIVED
Ceremonial Role Events and TicketlPass Distribylt-Tfq P A LM SPRING --,j,,i,4 Public Document
1. Agency Name e
City of Palm Springs 2016 MAY _9
Division, Department, or Region (if Applicable) J A HE T H 0 M P s O tl For Otfidal Use Only
cil Y CLERK
Designated Agency Contact (Name. Title)
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@paimspdngsca.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 TcketlPass $ 100.00
Event Description PSAM Meet the Art Museum
Date(s) _ 4 1. 8 1 16
Provide Ttle/Fxplanadan
Ttcket(s)IPass(es) provided by agency? Yes ❑ No ®
If no: Palm Springs Art Museum
Name of Sourm
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. • Use Section B to identify an individual. • Use Section C to identify an outside organization.
A. Name of Agency, Department or Unit
Number of
ket(s)1
Describe the public u
P purpose made pursuant to the agency's policy
Passies)
Name of Individual
B. 9mg AM)
Number of
Tlcket(s)l
Identify one of the following:
Pass(es)
Ceremonial Role ❑ Other ® 'come ❑
Moon, Rob
llchecltiriQ'CeromonialRde ar" Mer'describebftw
2
Public Purpose as defined by PS Resolution No. 22454
Ceremoniat Role ❑ Omer ❑ ,^come ❑
11chwidnp'Cemmcnla1Ra9e or'WM deserihebelow
C. Name of Outside Organization
(include address and description)
Number of
Tick"s)l
Describe the public purpose made pursuant to the agency's policy
Pas(es)
4. Verification
1 have read and understand FPPC Regulations 18W.1 and 19942. 1 have verified that the disMbulion set forth above. rS : n a=rdance with the raquiremenrs
�
David H. Ready
City Manager O S
SgnatumclA ncyHeadorAespnee
FWnrNeme
Tide M.,u- rear
Comment:
FPPC Form 80214112)
FPPC Toll -Free Helpiine: 8661ASK-FPPC (8661275-7772)
t
rI Chairman and Presenter
Mr. Harold Matzner
h1day, Apt 8,6AW9 P.W.
AS YOUR FAVORM OWIC HOK IIW
.� 00 TOUR
Tim Joc n, MD MATOLOGY Lee Erwin, Director
& c OSMFTIC SURGFr) (TNUR
Contour Yot, r b(c
PRESENTS
MC for the Evening - Palm Springs' Own Bella da Ball!