2016-12-31 ACBCI New Years EveAgency Report of:
Ceremonial Role Events and TicketlPass Distributions
1. Agency Name
City of Palm Springs
, Department, or Region (if applicable)
Cindy Cairns, Executive Services Administrator
760-322-8362 1 cindy.cairns@palmspringsca.gov
A Public Document
Date Stamp X L (
CI r Y OF P
For Official Use Only
2017 APR 2 PM 5: 4 4
C� FICE or- f E CI1- f CL Eiu%
❑ Amendment (Must Provide Explanation in Part 3)
Date of Original Filing:
(month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑ Face Value of Each Ticket/Pass $ 75.00
Event Description: Spa Resort Casino NYE Block Party Date(s) 12 1 31 t 16 1 1
Provide 7-Itle/Explana8on
Ticket(s)/Pass(es) provided by agency? Yes ❑ No El If no: Spa Resort Casino
Name of Source
Was ticket distribution made at the behest Yes ❑ No ® it 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 Ticket(sy Describe the public purpose made pursuant to the agency's policy
Passes
B.
Moon, Robert
Foat, Ginny
Name of Individual
(Last, First)
of t-,ckell(ay I Identify one of the following:
Passes
Ceremonial Role ❑ Other 0 Income ❑
2 !f checking -
ceremonial Role" or "Other' describe below
Public Purpose as defined by PS Resolution No. 22454
Ceremonial Role ❑ Other X❑ Income ❑
2 kt checking 'Ceremonial Role^ or 'Ofher' describe below:
Public Purpose as defined by PS Resolution No. 22454
C. Name of Outside Organization I of Tickagay I Describe the public purpose made pursuant to the agency's policy
(include address and description) Pass"
4. Verification
I have read and understand
with the requirements.
Signature of Agency
Comment:
Regulations 18944,1 and 18942. 1 have verified that the distribution set forth above, is in accordance
David Ready City Manager :)v ( r
Print Name Title (month, day, year)
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpllne: 866/ASK-FPPC (8661275-3772)
Agency Report of: camornia
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 li to identify an individual. • Use Section C to identify an outside organization.
Number
A. Name of Agency, Department or Unit
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, Rrst)
Number
of Tickei(au
Rases
Identify one of the following:
Mills, Chris
2
Ceremonial Role ❑ Other ® Income ❑
If checking 'Ceremonial Roie"or"01her'describebelow-
Public Purpose as defined by PS Resolution No. 22454
Kors, Geoff
2
Ceremonial Role ❑ Other ® Income ❑
lfchecking 'Ceremonial Role"or'Other"descnbebelow:
Public Purpose as defined by PS Resolution No. 22454
Roberts, J.R.
2
Ceremonial Role ❑ Other ® Income ❑
It checking 'Ceremonial Role" or"Other"descnbebelow:
Public Purpose as defined by PS Resolution No. 22454
Ready, David
2
Ceremonial Role ❑ Other ® Income ❑
llcheclling"CeremonialRole" or"Other'descnbebelow
Public Purpose as defined by PS Resolution No. 22454
Organization
Name of Outside O
C. r9
(include address and description)
Number
Of Ticggt(su
Passes
Describe the public purpose made pursuant to the agency's policy
FP PC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)