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2016-10-15 EQCA Equality AwardsAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs 2111 Division, Department, or Region (if Applicable) cy Contact (Name, Title) Joanne Bruggemans, Executive Asst. to Mayor/Council RECEIVED 26 AM IQ: 45 JF FICE O HE Ci l Y CLERi I 760-323-8200 I joanne.bruggemans@palmspringsca.gov 2. Function or Event Information A Public Document For Official Use Only ❑ Amendment (Must provide explanation in Part3.) Date of Original Filing: Does the agency have a ticket policy? Yes © No ❑ Face Value of Each Ticket/Pass $ Event Description EQCA Equality Awards Palm Springs Date(s) 10 1. 15 / 16 Provide Titte/Explanation $250.00 Ticket(s)/Pass(es) provided by agency? Yes ❑ No IS If no: Equality California Name of Source 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 8 to identify an individual. • Use Section C to identify an outside organization. A. Name of Agency, Department or Unit Number of Ticket(sy Describe the public purpose made pursuant to the agency's policy Passes) B. Name Of Individual Numberof Tcket(sy Identify one of the following: (Cast, Passes) Ceremonial Role ❑ Other ® Income ❑ Moon, Robert if checking "CeremonialRoie" or`Othe,"descnbebelow 2 Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ® Income ❑ Foat, Ginny if checking "Ceremonial Role"or"Other'descnbehelwv 2 Public Purpose as defined by PS Resolution No. 22454 Name of Outside organization C. Number of n cket(sy Describe the public purpose made pursuant to the agency's policy (include address and description) Poss(es) 4. Verification I have read and understand C ul tions 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with the requirements. David H. Ready City Manager Signature ofAgency 4dorovs nee PnntName rifle (Month, Day, Year) Comment: FPPc Form 802 (4112) FPPC Toll -Free Helpline: 8661A5K-FPPC (8661275-7712) Agency Report of: California Ceremonial Role Events and TickeVPass Distributions 802 Continuation Sheet e rm 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. A. Name of Agency, Department or Unit Number of Tlcket(sy Pass(es) Describe the public purpose made pursuant to the agency's policy B. Name of Individual (Last, First) Numberof Ticket(sy Pas(es) Identify one the following: Roberts, J.R. 1 Ceremonial Role ❑ Other ® Income ❑ if checking 'Cemmonia! Role" or "Other' describe below Public Purpose as defined by PS Resolution No. 22454 Ready, David Ceremonial Role ❑ Other ® Income ❑ If checking 'Ceremonial Role- or"Ofher'doscnbeberow Public Purpose as defined by PS Resolution No. 22454 Bogard, Bob 1 Ceremonial Role ❑ Other ® Income ❑ If checking `CeremanialRcie"or'Other'descnbe below: Public Purpose as defined by PS Resolution No. 22454 Severi n, Suzanne ,( Ceremonial Role ❑ Other ® Income ❑ II checking "Ceremonial Rote"or "Other" describe below: Public Purpose as defined by PS Resolution No. 22454 Name of Outside Organization C. (include address and description)Tickege►1 Number of Passles) Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (4112) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-7772) Form 802 —Additional tickets for Equality Awards Palm Springs, October 15, 2016 Mr. Michael Von Wittenau - 1 Public Purpose as described by PS Resolution No. 22454