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Home My WebLink About2023-05 Form 802 - State of the City (2)Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp "For . ' CITY OF PALM DESERT Division, Department, or Region (if applicable) Use Only Designated Agency contact (Name, Title) ANTHONYJ. MEJIA ❑ Amendment (Must Provide Explanation in Part3.) Area Code/Phone Number E-mail 760-346-0611 AMEJIA@PALMDESERT.GOV Date of Original Filing: (month, day, year) 2. Function or Event Information Does the agency have a ticket policy? Yes 0 No ❑ Face Value of Each Ticket/Pass $ _ Event Description. STATE OF THE CITY -PALM DESERT Date(s) 5/ 12 / 2023 Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes 0 No ❑ If no: Name of Source Was ticket distribution made at the behest If yes: L. TODD HILEMAN Yes Q NO ❑ Official's Name (Last, First) of agency official? 40.00 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)/ Describe the public purpose made pursuant to the agency's policy Passes City Manager's Office 5 PD Resolution No. 2019-70, Section 6-C-17 Finance PD Resolution No. 2019-70, Section 6-C-17 2 Number B. Name of Individual of Ticket(s)/ Identify one of the following: (Last, First) Passes Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other' describe below.' Name of Outside Organization Number C. (include address and description) of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes 4. Verification l have read and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance with the requirements. A,,tl, ",yM�"' "zoz311zePDT) ANTHONY J. MEJIA CITY CLERK 6/14/23 Signature of Agency Head or Designee Comment: Print Name Title (month, day, year) FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions This form is for use by all state and local government agendas. The bon identifies persons that receive admisalan tickets and tracer and machines Me public purpose for the distribution. Thlsformwespreparedby Me Fair Pohlical Practice Commission (FPPC) and a available at www.fppaca.gov. General Information FPPC Regulation 18944.1 sets out to circumstances under which an agencys Separation Mtidrets to entertainment events, sparing events, and like occasions would not resuk in a gift t individuals Mat allend the function. In Persia, Me agency mart adopt a policy which identifea the public purpose served in distributing the grievers, The Farm 802 serves t detail each event and Me public impose off each idea distribution. FPPC Regulation 189421iaN exceptions to referees gins, Inducing ceremonial events, when listed on tis form. When the regulation procedures are folbxed, persons, organizations, or agencies who receive admissions are Ilshd on a Form 802 Agency officials do nM report Me admissions on Me packets Statement of Economic Interests. Form 700, and the value of Me acmissian is not subject to the gad limit. The Form 802 also informs to public as to whether the armisslms were made at the behest of an agency Ntidal and whether the behested tickets were treaded to an arganhatsm or t specific individuate. Exception FPPC This form is not required or admission provided to a school or university district official, coach, all character, or employee to Mend an amateur evert performed by students MMat cahoot or universiy. Reporting and Public Posting Ticket Distribution Policies: An agency must we its ticket policy on its "Image whin 30 days off adoption ar amendment and e-mail a link of the webslte location to FPPC at caring thfppc.ca.gov. Form SO: The use of Me ticket or pass under Me policy must be reported on Form SO and treated an the agency's website within 45 days a distribution. Alink to Me websim location of the evil must be e-mailed to FPPC at form802@11hippc eli gov. The FPPC will post on its website Me link to each agency policy and completed tams. It is not necessary to bond an III each time a new Form W2 is prefer. It Is only necessary to submit the link if the Fargo location changes. This foil must be maintained as a public document. Privacy Information Notice Information requested by the FPPC Is used to administer and enforce Me Political Reform Act. Failurebprovids information may be a vendor subject t administrative. criminal, or civil penalties. All reports am public dicoMs enable for inspection and mpmduction. Direct quarters to FPPC's General Counsel. Instructions Part 1. Agency ldeMMp Uon: List the agency a name. Provide a tlesignated agency contact never, their phone number, and a -mail address. Mai the amendment box If changing any Information on a previously form and include the data of Me original filing. Part 2. Function or Event Information: Cori that your agency has a policy for ticket distribution. Unless the ceremonial rote or Income box In Pad 3, Section B, is marked, this form is only applicable b your agency has a policy. Complete all of the other required fields Mat identify Me ticket value, description Never, goal and whether the nickel was provided by the agency or an agenda source. If an agency official behests Me tickets, the official's name is lso required. Use Me comment field or an attachment o explain M full. Pad 3. Ticket Redpients: This part giantlike; who uses Me fears. The idenbficatlm requirements vary depending upon who received Me tickets and are eregor'aetl into tree sections. Each section must isube number M needs received. uaetM comment fiek or an attscbment to explain in MI. Section A. Ral tickets Mail co ad b agency smff other then an elected official or governing boa of member, pursuantloteagencysprllry It is nut neressaryto list each employee's name, but identify Me unitUdeparnment for which Me employee works. The agency must desvibe the public purpose associated with the ficket distribution. A reference to this policy Is permissible. Section B. Report: l) any agency official who performs mortal role; 2) any agency official who reports the value as income; or 3) tickets used by elected officials and governing boar members (including those distributed pursuant to Me agency's policy). Sorption C. Repod tickets provided to an organization. The organlzabon's name, an address (agents of is immussiblal, and a brief description of the public purpose are required. 802 ca l FPVc TolHneaeignoSaVA +MC(U5 5 P2) 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 of Agency, Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes Economic Development PD Resolution No. 2019-70, Section 6-C-17 7 Development Services PD Resolution No. 2019-70, Section 6-C-17 2 Capital Projects PD Resolution No. 2019-70, Section 6-C-17 1 Public Works PD Resolution No. 2019-70, Section 6-C-17 2 Number B. Name of Individual of Ticket(s)l Identify one of the following: (Last, First) Passes Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other' describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: Name of Outside Organization C. Number of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Passes City Attorney / BBK PD Resolution No. 2019-70, Section 6-C-17 2 FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Form 802 - State of the City Final Audit Report 2023-06-14 Created: 2023-06-14 By: Marie de Vera (mdevera@palmdesert.gov) Status: Signed Transaction ID: CBJCHBCAABAA28MGN70zwG8alaYFK9MgPH431SVaVQOB "Form 802 - State of the City" History Document created by Marie de Vera (mdevera@palmdesert.gov) 2023-06-14 - 6:06:52 PM GMT Document emailed to Anthony Mejia (amejia@palmdesert.gov) for signature 2023-06-14 - 6:07:25 PM GMT Email viewed by Anthony Mejia (amejia@palmdesert.gov) 2023-06-14 - 6:16:32 PM GMT pro Document e-signed by Anthony Mejia (amejia@palmdesert.gov) Signature Date: 2023-06-14 - 6:28:52 PM GMT - Time Source: server O Agreement completed. 2023-06-14 - 6:28:52 PM GMT 0 Adobe Acrobat Sign