2016-09-08 Chamber CVB MixerAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name
i T Y OF
t i"
htp..rFor
e •
City of Palm Springs
2b AM 10.- 45
Official Use Only
Division, Department, or Region (if applicable)
2017 APR
Office of the City Manager
� �'� t;l � � �(
Designated Agency Contact (Name. Title)
OF
Cindy Cairns, Executive Services Administrator
❑ Amendment (Must Provide Explanafion in Para 3.)
Area Code/Phone Number
E-mail
760-322-8362
cind cairns alms rin sea. ov
y. @p p g g
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 Ticket/Pass $ 10.00
Event Description: PS Chamber of Commerce/CVB Mixer Date(s) 09 ) 08 t 16 _ J 1
Provide Tide/Explanafion
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑ If
no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® If
yes:
Official's Name (Last, First)
of agency official?
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 Ticket(sa
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
Number
of Tickeksy
Identify one of the following:
(Lest, First)
p�geg
Ceremonial Role ❑ Other ® Income ❑
Moon, Robert
1
if checking'Ceremonial Role"or"Otherdescnbe below:
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ® Other ❑ Income ❑
Roberts, J.R. 1 ifchecking°CeremoniefRole"or'pther"descdbe below.'
Public Purpose as defined by PS Resolution No. 22454
Name of Outside Organization Number Describe the public made pursuant to the agency's lic
C. of Tlckei�a)! P pt+t'Po�policy
(include address and description) paw
4. Verification
I have read and understand
with the requirements. OF
of Agency
Comment:
lulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager a S
Print Name Title (month, day, year)
FPPC Form 802 {212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)