2016-12-02 Sanctuary PS BenefitAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Palm Springs
or Region (if applicable)
Designated Agency Contact (Name,Titte) -
Cindy Cairns, Executive Services Administrator rL
760-322-8362 1 cindy.cairns@palmspringsca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Event Description: Sanctuary PS Benefit
Provide Title/ Explanation
Ticket(s)/Pass(es) provided by agency? Yes ® No ❑
A Public Document
Y OF PALM Spr, Form •
02
For Official Use Only
1017 APR 24 Pik 5= 44
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 75-00
Date(s) 12 t 02 / 16
If no:
Flame 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 ofTickegaY Describe the public purpose made pursuant to the agency's policy
Passes
B.
Foat, Ginny
Name of Individual
(Last, First)
of Tlck&esN Y I Identify one of the following:
Pass
Ceremonial Role ❑ Other ❑X Income ❑
if checking -Ceremonial Role" or "Other' descnbe below.
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other I] Income ❑
if checking "Ceremonial Role- or °Other" describe below:
C. Name of Outside Organization I o'rcklsu I Describe the public purpose made pursuant to the agency's policy
(include address and description) Passes
4. Verification
i have read and under
with the requirements.
Comment:
Regulations 18944,1 and 18542. t have verified that the distribution set forth above, is in accordance
II David Ready City Manager 11-7-
or V411nee Print Name Title (month, dayyear)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)