2016-11-11 Spirit of Home USOAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name P n L R U I M
City of Palm springs i I 0
Division, Department, or Region (if applicable) 2011 M Y _2 PM 5: 30"Foroffificialse Only
Designated Agency Contact (Name,Title)
Cindy Cairns, Executive Services Administrator
Area Code/Phone Number I E-mail
i:yti'i,.
I�FF r F THE C►1� CL
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8362 cindy.cairns@paimspringsca.gov Date of Original Filing:
y. @palms rin sca. p g gov (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass 125.00
Event Description: Spirit of Hope for the LISO Dates) 11 f 11 i 16 _� r
Provide Titte/Expianabon
Tickets)/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.
Number
A. Name of Agency, Department or Unit of TlcksNsu Describe the public purpose made pursuant to the agency's policy
Passes
s.
Moon, Robert
Name of Individual
(Last, First)
of Tlckegsu I Identify one of the following:
s Pas
Ceremonial Role ❑ Other i9 Income ❑
1 tr remoRoFe"Or 'Other describe below:
Public PurposeCheCking"Ceas denialfined by PS Resolution No. 22454
Ceremonial Role ❑ Other ❑ Income ❑
If checking "Ceremonisi Rae' or "other describe below
C. Name of Outside Organization of Ticket(s)► I Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4. Verification
I have read and understan C Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements. ^4f
Comment:
David Ready City ManagerrJ Oj
Print Name Tide (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)