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092619 2019 Boys Scouts Distinguished Citizen of the Year Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp California Q O2 City of Temecula Form v For Official Use Only Division, Department,or Region(if applicable) City Clerk Designated Agency Contact(Name,Title) Randi Johl, Director of Legislative Affairs/City Clerk ❑ Amendment (Must Provide Explanation in Part 3.) Area Code/Phone Number E-mail 10/01/19 (951)694-6421 randi.johl@temeculaca.gov 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$ 150 2019 Boy Scouts Distinguished Event Description:fiti7Pn of the Year Date(s) 09 / 26 / 19 Provide Title/Explanation Tickets)/Pass(es) provided by agency? Yes❑ No ElIf no: Eastern Municipal Water District Name of Source Was ticket distribution made at the behest Yes❑ No® If 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(s)/ Describe the public purpose made pursuant to the agency's policy Passes Number B. Name of Individual of Ticket(s)/ Identify one of the following: (Last,First) Passes Ceremonial Role ❑ Other ® Income ❑ Mike S. Naggar 2 If checking"Ceremonial Role"or"Other"describe below: Advertise and Promote the City 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 /have read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance with t uirements. Director of Legislative Affairs/ Randi Johl City Clerk 10/01/19 Sign ency Head or Designee Print Name Title (month,day,year) Comment: FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)