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031617 Temecula Valley Xenia Hospitality Awards Agency Report of: Ceremonial Role Events and TickeUPass Distributions A Public Document 1. Agency Name Date Stamp . � � , City of Temecula • � Division,Dapar6nent,or Region j�app�icab�e) F�����uu o�iY City Clerk's Office Designatad Agency onhct(n/ame.rme) Randi Johl, City Clerk ❑ AMl11f1MB11I (Must P/ontlB Explenefion in PeR 3) Area Coda! hone Number E�nail Dab of Orl inal Fllin 03l22l17 (951)694-6421 randi.johl@temeculaca.gov 9 9' (monm.dey year) 2. Function or Event Information Does the a n have a ticket olic 7 Face Value of Each TickeVPass$ �0.00 9e �Y P Y Yes� No❑ Event Description: N Xenia Hospitality Awards Date(s)���� �_J_ Piovide rneiExplanafion Ticket(s)/Pass(es) provided by agency? Yes❑ No� If no: Visit Temecula Valley Neme oI Sou�te Was ticket distribution made at the behest Yes❑ No� If yes: of agency olRcial? �Y's Nems(Latl.First) 3. Retipienta •Uu Section A to idenlify the agency's depariment or unit •Use Seclion B lo ideNify an indiaidual. •Use Seclion C lo idenlify an outside organiza[ion, NumEw A. N�m�dAgMcy,Mpartm�nt or unK of 7kk�qaN Uescrlbs Na Walc purpo�a maG punuarrt to N�ap�ncy's polky Passas wm.a i�dwa�.i NumMr B. of TkkWsV WanUty one ol Na folbwing: Il.b(FYOtJ PMsas Edwards, Maryann ���R� ❑ an„ � i��� ❑ 1 ncpecbrg'Cemmoma�Ade�o�-Orl�el�0escreete�ow Advertise and Promote the City of Temecula cna,wl.r Rae ❑ ane,❑ i�mme ❑ u crwcwrg'eeremonur aoir oi'Omer oe:mee x�ow IYiM Of Out610�OtganUaLon Number C, (����e�������o�� oT 7ickut�sy Des�rlDe Ne public purpoae ma0e punuaM to the agancy's policy Passea 4. Verificatlon f have read and undsrstand FPPC RegulaGons 18944.1 aM 18942. I haHe verified lhat the disM6ution se!lorth above, is in accordance with quirements. Randi Johl City Clerk 03/22/17 spnrwa a nqsncy Hsaa or oeaqnae Pnnt Name rme l,ro�m.day.yee� Comment: FPPC Form 802(Y12016) FPPC Toll-Frea Halpllne:866lASK�FPPC(8661t75-3772)