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080916 Abbott United Way Golf Tournament Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp City of Temecula • Division, Department, or Region (if applicable) For Official Use only City Clerk's Office Designated Agency Contact(Name,Title) Randi Johl, City Clerk ❑ Amendment (Must Provide Explanation in Part 3.) Area CodelPhone Number E-mail 951-694-6421 randi.johl@cityoftemecula.org Date of Original Filing: 08/09/16 (month, day,year) 2. Function or Event Information Does the agency have a ticket policy? Yes® No❑ Face Value of Each Ticket/Pass $ 200.00 Event Description: Abbott United Way Golf Tournament Date(s) 08 ) 08 1 16 1 1 Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes❑ No® If no: Abbott Vascular Name of Source Was ticket distribution made at the behest Yes❑ No® If yes: Officials 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)1 Describe the public purpose made pursuant to the agency's policy Passes City Manager 2 Advertise and Promote the City of Temecula/Enhance Employee Morale Number B. Name of Individual of Ticket(s)f Identify one of the following: (Last,First) Passes Comerchero, Jeff Ceremonial Role ❑ Other Z Income ❑ 1 if checking-Ceremonial Role"or'Other'describe below. Advertise &Promote the City of Temecula Rahn, Matt Ceremonial Stole ❑ Other Q income L] 1 If checking'Ceremonial Role"or"Other"describe below: Advertise & Promote the City of Temecula Number Name of Outside Organization C. (include address and description) of Ticket(s)l Describe the public purpose made pursuant to the agency's policy Passes 4. Verification !have r d and understand FPPC Regulations 16944.1 and 18942. i have verified that the distribution set forth above, is in accordance with t e equirements. Randi Johl City Clerk 08/09/2016 Signituire-brAgency Head or Designee Print Name Tale (month,day,year) Comment: FPPC Form 802(2/2016) FPPC Toll-Free Helpline:8661A$K-FPPC(8661275-3772)