HomeMy WebLinkAbout081015 Abbott United Way GolfAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Temecula
Division, Department, or Region (If Applicable)
City Council/City Manager
Designated Agency Contact (Name, Title)
Sue Steffen, Executive Assistant
Date Stamp
A Public Document
California Q A f>t
Form Q V JIL
For Official Use Only
Area Code/Phone Number
951-506-5100
E-mail
sue.steffen@cityoftemecula.org
❑ 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 El No 11
Face Value of Each Ticket/Pass $ 200.00
Event Description Abbott United Way Golf Tournament Date(s) 08 / 10 f 15
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency?
Was ticket distribution made at the behest
of agency official?
Yes ❑ No El
If no: Abbott Vascular
Name of Source
No x❑ Yes ❑ If yes:
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.
A.
Name of Agency, Department or Unit
Number of
Ticket(s)/
Pass(es)
Describe the public purpose made pursuant to the agency's policy
City Manager
2
Advertise/Promote City. Employee morale.
Community Development
1
Advertise/Promote City. Employee morale.
B.
Name of Individual
(Lest, First)
Number of
Ticket(s)/
Pass(es)
Identify one of the following:
Ceremonial Role ❑ Other ❑
If checking "Ceremonial Role" or "Other' describe below:
Income ❑
Ceremonial Role ❑ Other ❑
If checking "Ceremonial Role" or "Other' describe below:
Income ❑
C.
Name of Outside Organization
(include address and description)
Number of
Ticket(s)/
Pass(es)
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with the requirements.
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Signature of Agency
Comment:
e or Designee
Sue Steffen
Print Name
Executive Assistant
Title
8/18/15
(Month, Day, Year)
FPPC Form 802 (4/12)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-7772)
Agency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
Continuation Sheet
California 802
Form
A Public Document
Agency Name
City of Temecula
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 of
A. Name of Agency, Department or Unit Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
Pass(es)
Public Works 1 Advertise/Promote City. Employee Morale.
B.
Name of Individual
(Last, First)
Number of
Ticket(s)/
Pass(es)
Identify one of the following:
Ceremonial Role ❑ Other ❑
If checking "Ceremonial Role" or "Other" describe below:
Income ❑
Ceremonial Role ❑ Other ❑
If checking "Ceremonial Role" or "Other deschbe below:
Income ❑
Ceremonial Role ❑ Other 0
If checking "Ceremonial Role" or "Other" descnbe below:
Income ❑
Ceremonial Role ❑ Other ❑
If checking "Ceremonial Role" or "Other" describe below:
Income ❑
C.
Name of Outside Organization
(include address and description)
Number of
Ticket(s)/
Pass(es)
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (4/12)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-7772)