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10032021 Sweet 16 Celebration - Old Town Temecula Community TheaterAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Temecula Division, Department, or Region (if applicable) City Clerk Designated Agency Contact (Name, Title) Randi Johl, Legislative Affairs Director/City Clerk Area Code/Phone Number E-mail 951-694-6421 1 randi.johl@temeculaca.gov 2. Function or Event Information Does the agency have a ticket policy? Event Description: Sweet 16 Celebration Date Stamp A Public Document For Official Use Only ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) Yes ■ No ❑ Face Value of Each Ticket/Pass $ Date(s) 10/ 03 / 21 Provide Tiffe/Explanation Ticket(s)/Pass(es) provided by agency? Yes ■ No ❑ If no: Was ticket distribution made at the behest Yes ❑ No ■ If yes: of agency official? Name of Source Official's Name (Last, First) 55 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 B. Name of Individual Number of Ticket(s)/ Identify one of the following: (Last. First) Passes Ceremonial Role ❑ Other Income ❑ Rahn, Matt 2 If checking "Ceremonial Role" or "Other' describe below: Advertise/Promote the City. Monitor quality of event and venue. Ceremonial Role ❑ Other ❑ Income ❑ If checking 'Ceremonial Role" or "Other' describe below: Name of Outside Organization C. (include address and description) Number of Ticket(s)/ Passes Describe the public purpose made pursuant to the agency's policy 4. Verification 1 have d and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance wit e e ents. Legislative Affairs Director/ Randi Johl CitVClerk 10/19/2021 Si ure of Agency 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)