2016-10-15 Community Foundation GalaAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name R E EI W iUk stamp
City of Palm Springs OF
Division, Department, or Region (if applicable)
2011 MAY FM
Designated Agency Contact (Name, Title)
Cindy Cairns, Executive Services Administrator
760-322-8362 I cindy.cairns@paimspringsca.gov
2. Function or Event information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: The Community Foundation Gala
Provide Trt<e/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑
A Public Document
Use Only
of HCE OF-1 HE Cl i Y' CLE`r;t'; X
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 125.00
Date(s) 10 1 15 1 16 ___J__J
If no:
Was ticket distribution made at the behest Yes ❑ No ® If yes:
of agency official?
Name of Source
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.
Number
A. Name of Agency, Department or Unit of Tlckegs►1 Describe the public purpose made pursuant to the agency's policy
Passes
B.
Foat, Ginny
Name of Individual
(Last First)
of Ticket( I Identify one of the following:
Passes
Ceremonial Role ❑ Other ® Income ❑
1 lrcheoung "Ceremonial Rae"or "0thar'rlescnbe below,,,
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑ Income ❑
Irohecking "cemmonial Rote" or "Other' describe below:
Name of Outside Organization Number
C. of Tlcket(sy Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4. Verification
I have read and
with the reouirel
Signature of
Comment:
Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager 5 D I Z i -1
Print Name Title (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866IASK-FPPC (8661275.3772)