HomeMy WebLinkAbout100717 Our Kids Rock Fundraiser Agency Report of:
Ceremonial Role Events and TickeUPass Distributions A Public Document
1. Agency Name Dale Slamp . � . '
City of Temecula ' �
Divislon,Department,or Regfon/ifapp�icabk) ForpfGcial Use Only
City Clerk's Office
Designated Ageacy ConUct(Name,7rtb)
Randi Johl, City Clerk
❑ Amendment (Musf ProNda Explanetian in Pert 3.)
Area CodelPhone Number E-mall
951-694-6421 randi.'ohl temeculaca. ov DateofOrlglnalFlling: �0/19/17
1 @ 9 rmo�m.aey.Yea.�
2. Function or Event Information
Does the agency have a ticket policy? Yes� No❑ Face Value of Each TickeVPass$ �25
Event Description: Our Kids Rock Fundraiser Date(s)���� ��_
Provida Tfle�Explanation
Ticket(s)/Pass(es) provided by agency? Yes O No� If no: Boys and Girls Club
Name a/Saurce
Was ticket distribution made at the behest Yes O No� If yes:
of agency official? Olficial's Neme(Lasf,FirsfJ
3. Recipients
•Uc<Se<�lon A lo identify lhe egmcy4 deparlment or unit. •Use Section B to idenli(y an individual. •Use Section C lo identify en outside argani�ation.
Numlwr
(+, Neme o(Agen�y,Dapartment or Unit of 7lckat(.)I Des�riEe tha publl�purpose made punuant to[he agency's pollcy
Pas�as
Number
B. Nama of IndNidual of Tick�q�y Identify one of tha following:
(Last.Firsf) Paasn
Maryann Edwards Ceremonim Rda � Omer ❑ inmme ❑
,2 tlNreckrp'CeremomalRde"oi'ONei OesrnceOe�ow
Advertise and Promote lhe City
Ceremonial Rde ❑ ONar ❑ Income ❑
P Mxking'Ceremoniai Rde"oi'ONe�'0.^trnDe De�ow.
Nama ol Outslda Organization Number
C' (Inclutle atlEress antl deacription) °�T�k°u'u Des�riba the public purpose made punuant to the agency's policy
Pesaas
4. VeriTication
I have d and understand FPPC Regulations 18944.1 and 18942. 1 have venfied that the distribution set/orth above, is in accordance
with e quiremenls.
Randi Johl City Clerk 10/19/17
Si nq HaaO or Despnee Pnnt Name Titla (monM,dag year)
Comment:
FPPC Form 802(212016)
FPPC Totl-Free Helpllne:E681ASN•FPPC(8661275-3772)