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022016 TV Chamber 50th Awards Gala Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp . . . : ' r City of Temecula ' I�IVIS1011, d8�i�l'�C►1�Ilk, or Regiorr(tf ap,�ficabfel For Official Use Only City Clerk's Office Resignated Agency Contac#(Name,Title) Randi Johl, City Clerk __ _ � Amendment (Must Provide Explanation in Part 3.) Area CcrdelPhane Nurra�aer �-mail 951-694-6421 randi.ohl ci oftemecula.or Date of Original Filing; Feb�Uefy 23, 2016 1 � �Y g (month,day,yearJ 2. Function or Event Information Does the a enc have a ticket olic ? Face Value of Each TickeUPass $ 125/$1350 Corp.Table 9 Y P Y• Yes� No❑ Event Description: 50th Awards Gala Date(s) 02 � 20 / 16 �� Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes❑ No� If no:Temecula Valley Chamber of Commerce Name of Source Was ticket distribution made at the behest Yes❑ No� If yes: O�cial's Name(Last,FirstJ 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)I Describe the public purpose made pursuant to the agency's policy Passes Ci�y 4111an�ger's Q��e Ad�ertise and pramate #he Giky of Temecula 5 Name of Individual Number B. of Tlcket(s)I Identify one of the following: (Last,First) Passes Maryann Edwards Ceremonial Role � Other ❑ Income ❑ 2 Present'�G`ify'�°ehi�ica�e°��izen`of�ie�ear and VYP & Lifetime Achievement Awards Matt Rahn Ceremonial Role ❑ Other Q Income ❑ 2 dvert�s�ani��promo�e��ie°E�`y o�`emecula Name of Outside Organization Number C' (include address and description) of Ticket(s)I Describe the public purpose made pursuant to the agency s policy Passes 4. Verification !have rea and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance wit�the r quirerrients. _- �- , Randi Johl City Clerk 02/23/16 �ig� ture of�� y Haacl or�3e5ignae Print Name Title (month,day,year) Comment: FPPC Form 802(2I2016) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Agency Report of: - • • • � Ceremonial Role Events and Ticket/Pass Distributions • � Continuation Sheet 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 A. Name of Agency,Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy _ Passes Name of Individual Number B. of Ticket(s)/ Identify one of the following: (Last,First) Passes Michael McCracken Ceremonial Role ❑ Other � Income ❑ ,� lf checking"Ceremonial Role"or"Ofher"describe below: duertise and promote the City of Temecula Ceremonial Role ❑ Other❑ Income ❑ If checking"Ceremonial Role"or'Ofher'describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking"Ceremonial Role"or"Ofher"describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking"Ceremonial Role"or"Olher"describe below: Name of Outside Organization Number C'' Include address and descri tlon af Ticket(s)/ Describe the public purpose made pursuant to the agency's policy � P � Passes FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)