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2016-09-22 LGBTQ Film FestivalAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions RECEIVED A Public Document 1. Agency Name 7,11 . bt t • City of Palm Springs 9017 APR26 AN 10: 45 For Official Use Only Division, Department, or Region (tfApphrable) „',., iJ FICE r ! iI- �t i `c ; Designated Agency Contact (Name, Title) 1 1101.1,/ Joanne Bruggemans, Executive Asst. to Mayor/Council ❑ Amendment (Must provide explanation in Part 3.) Area CodelPhone Number E-mail 760-323-8200 joanne.bruggemans@palmspringsca.gov Date of Original Filing: (Month, Day,, Year) 2. Function or Event Information Does the agency have a ticket polio Face Value of Each Ticket/Pass $ 169'00 9 Y Y? Yes ® No ❑ Event Description Palm Springs LGBTQ Film Festival Date(s) �� t � 9 22 16 9 26 16 — Provide Titte/Exptanation Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: Palm Springs Palm Springs Cultural Center Name of Source Was ticket distribution made at the behest No ® Yes ❑ If yes: of agency official? Officiars Name (Last, First) 3. Recipients e Use Section A to identify the agency's department or unit. • Use Section S to identify an individual. • Use Section C to identify an outside organization. A. Name of Agency, Department or Unit Number of Ticka ey Describe the public purpose made pursuant to the agency's policy Pass(es) n B. Name oof Individual Numberof TlckeysU Identify one of the following: tti Passes) Ceremonial Role ❑ Other ® Income ❑ Moon, Robert It checking'Ceremonial Role" of 'Other" describe below.' 2 Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income ❑ Foat, Ginny it checking "CefemoniarRole"or"Other"describe beiow: 2 Public Purpose as defined by PS Resolution No. 22454 C. Name of Outside Organization Number of Tickagay Describe the public purpose made pursuant to the agency's policy (include address and description) Pass(**) 4. Verification 1 have read and understand FPntins 16944.1 and 18942, i have verified that the distribution set forth above, is in accordance with the requirements. David H. Ready City Manager Signature ofAgency Head i06"Ia Print Name Tibe (Month, Day, Year) Comment: FPPC Form 802 (4112) FPPC Toll -Free Helpline: 0661ASK-FPPC (8661275-7772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions California rm 802 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. • Use Section B to identify an individual. • Use Section C to identify an outside organization. Number of A. Name of Agency, Department or Unit nokelI Describe the public purpose made pursuant to the agency's policy Pass(ea) iil B. Name of Individual Number of Tlcket(s)! Identity one Of the following: {e w. Find) pass(es) Ceremonial Role ❑ Other ® Income ❑ Fuller, Marcus 2 Ifchecking"CemmonialRofe"or"Other'descnbebelow: Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income ❑ Oltean, Vickie 2 if checking"Cemmonlal Fide"ar"Other' descnbe below.' Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ❑ Income ❑ if checking 'Ceremonial Rde" or "Other" descnbe below.. Ceremonial Role ❑ Other ❑ Income ❑ if checking "Ceremonial Role" or "Other' descnbe below- C. Name of Outside organization Number of Ticketlep Describe the public purpose made pursuant to the agency's policy (include address and description} Pass(es) FPPC Form 802 (4/12) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-7772)