HomeMy WebLinkAbout2022-10 Form 802 - PDACC - Installation Dinner & Business Meeting (2) Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions err y -LK 'E('ic Document
1. Agency Name D fat is .DEscaiiforciia 802
CITY OF PALM DESERT Form
Division,Department,or Region(if applicable)- 2022 OCT '5 bH .69r icial Use Only
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Designated Agency Contact(Name,Title)
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ANTHONY J. MEJIA
Area Code/Phone Number E-mail ElAmendment (Must Provide Explanation in Part 3.)
(760).346-0611 amejia@cityofpalmdesert.org Date of Original Filing:
(month,day,year)
2. Function or Event Information
Does thew agency have a ticket policy? Face Value of Each Ticket/Pass$ 350
9 Y Yesp No
Event Description: PDACC- Installation Dinner&Busine�J_ Date(s), 09 22 / 202d
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes❑ No 0 If no:
Name of Source
Was ticket distribution made at the behest Yes p No p 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 B to identify an individual. Use Section C to identify an outside organization.
Name of Agency,Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
Passes
CITY MANAGER DEPARTMENT 4 CITY OF PALM DESERT TICKET POLICY
RESOLUTION NO. (2019-70)
Name.of Individual Numb( i
of Ticket s) : t Identify one.of the following:
..,. Last,First
Ceremonial Role❑ Other❑ Income ❑
HARN I K,JAN 2 If checking'Ceremonial Role"or"Other"describe below:
CITY OF PALM DESERT TICKET POLICY RESOLUTI4
Ceremonial Role ❑ Other❑ Income ❑
Q U I NTAN I LLA, KART NA 2 If checking"Ceremonial Role"or"Other"describe below:
CITY OF PALM DESERT TICKET POLICY RESOLUTIsi
Numb
Name of Outside Organization
t ;
, of Ticket s)/`° Describe the public purpose.made pursuant to the agency's policy
r (include address and description) Passes
4. Verification
I hay read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
with e requirements.
ANTHONY J. MEJIA CITY CLERK 10/5/22
Si ature of Agency or Design e Print Name Title (month,day,year)
Comment:
Print Clear FPPC Form 802(2/2016)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)
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Agency Report of: California 802
Ceremonial Role Events and Ticket/Pass Distributions Form
Continuation Sheet A Public Document
Agency Name
CITY OF PALM DESERT
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 ofAgency,Department or Unit• of Ticket(s)I : Describe the public purpose made pursuant to the agency's policy
. ' Passes
.• — — — — - Number — v
Name of Individual
B: of Ticket(s)i . Identify one of the following;
(Last,First) - Passes•. . •
Ceremonial Role ❑ Other❑ Income ❑
If checking."Ceremonial Role"or"Other"describe below:
:Kelly, Kathleen 2 CITY OF PALM DESERT TICKET POLICY.RESOLUTIii
Ceremonial Role ❑ Other❑ Income ❑
If checking"Ceremonial Role"or"Other"describe below:
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Ceremonial Role ❑ Other❑ Income ❑
If checking"Ceremonial Role"or"Other"describe below:
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Ceremonial Role ❑ Other❑ Income ❑
If checking"Ceremonial Role"or'Other"describe below:
I Number
' Name of Outside Organization of Ticke s/ Describe thepublic purpose madepursuant to the agency's. olic
C - �O P P P Y
(include address and description) Passes - ,
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Print Clear
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FPPC Form 802.(2/2016)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)