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2016-11-04 Pride Kick Off EventAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Palm Springs Division, Department, or Region (if applicable)�� Designated Agency Contact (Name,Titie) ur r lu Cindy Cairns, Executive Services Administrator 760-322-8362 1 cindy.cairns@palmspringsca.gov 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Event Description: PRIDE Kick -Off Event at DRMC Provide TiNe/Explanation Ticket(s)/Pass(es) provided by agency? Yes ❑ No El Was ticket distribution made at the behest Yes ❑ No of agency official? A Public Document FOP t', �'PPi 41 i, ` i • 02 NY QM 5*. 31 For Official Use Only ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) Face Value of Each Ticket/Pass $ 100.00 Date(s) 11 1 04 i 16 If no: Greater Palm Springs Pride Name of Source If yes: Oifticial'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. Number A. Name of Agency, Department or Unit of Ticket(sy Describe the public purpose made pursuantto the agency's policy Passes Number B. Name of Individual of Ticket(sy Identify one of the following: (Last First) Passes Ceremonial Role ❑ Other © Income ❑ Moon, Robert If Macking'Cefemonlal RoIs "or 'Other" describe below: Public Purpose as defined by PS Resolution No. 22454 Ceremonial Role ❑ Other ❑X Income ❑ Foat, Ginny 1 If checking 'Cemmonia!Role" WOthWWscnbebeiow- Public Purpose as defined by PS Resolution No. 22454 C. Name of Outside Organization I of Ticket(sy I Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 4. Verification 1 have read and understand with the requirements. Signature of Agency gnee Comment: Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance David Ready City Manager -5 b Print Name Title (month, day, year) FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC 48661276-3772) Agency Report of: logo •Ceremonial Role Events and Ticket/Pass Distributions Continuation Sheet 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 A. Name of Agency, Department or Unit of Ticket(s)f Passes Describe the public purpose made pursuant to the agency's policy B. Name of Individual (Last First) Number of Tlckvgsll Passes identify one of the following: Mills, Chris 1 Ceremonial Role ❑ Other El Income ❑ l/ checking "Ceremonial Rae" or"Other"describe below, Public Purpose as defined by PS Resolution No. 22454 Kors, Geoff ,I Ceremonial Role ❑ Other ® Income ❑ if checking "Ceremonial Role" or `Other describe below Public Purpose as defined by PS Resolution No. 22454 Roberts, J.R. 1 Ceremonial Role ❑ Other El Income ❑ Nchecking 'Ceremonial Role"or'Other'describebelow Public Purpose as defined by PS Resolution No. 22454 Ceremonial Rode ❑ Other ❑ Income ❑ If checking "Ceremonial Rote" or "Other describe below: Name of Outside Organization C. � on (include address and description) Number of Ticket(su Pages$ Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)