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031617 Steam Cirque at Circus Vargas Agency Report of: Ceremonial Role Events and TickeUPass Distributions A Public Document 1. Agency Name Date Stamp . . . ' City of Temecula ' � Divbion, Departrnent,or Region/i�app�icab�e) For ONual Use O�ly City Clerk's Office Deafgnated Agency Contact/Name,rne) Randi Johl, City Clerk Area CodelPbone Number E-mail ❑ Amendment (Musf Pmvrtle Exdenetion m Part 3.) (951)694-6421 randi.johl@temeculaca.gov Dab of ONglnal Flling: 03/22/17 (�m.tley yeeh 2. Function or Event Information Does the agency have a ticket policy? Yes� No❑ Face Value of Each TickeUPass$ 2�.00 Event Description: Steam Cirque at Circus Vargas Date(s)JJ �� �_�_ P�oaee raeiE.d�a� Ticket(s)lPass(es) provided by agency? Yes❑ No� If no: Circus Vargas NemeolSou2r Was ticket distribution made at the behest Yes❑ No� If yes: of agency official? D�+N's Nrrie(Latf.Firsq 3. Recipients •Use Section A[o identify lhe agency's department or unil. •Cse Sec[ion B to identifi�an individval. •Uu Section C la identih an outside organiration. NumMr A. Name o(Agen�y,Department or Untt of Tkk�y�y Deacribe Me public purpoae maAe purawirt to Ma agency's polky Puaes City Manager Z Enhance Employee Morale Finance Z Enhance Employee Morale NaTa ot InA7vltluel NumEw B. of Twkaqsy �dentlty one of Ne fdlowing: (Lsa(FiaQ Pnws Naggar, Mike Grartwnid Rde ❑ ana�� i��� ❑ ,2 II cnecWip-Ceremonm/Itde'or"Ofner'CexnEe Oelow. Advertise and Promote the City of Temecula Comerchero, Jeff ca�r aws ❑ an� 0 moome � 2 ncnxkrp'CerenwixslRde'or'OrneY'asscnDeDelow AdveRise and Promote the City of Temecula Name of OWIAe Oryanizrtlon NumMr C• p�cmae aaa'.ss a�a aescr��ion� ot Mk�qtV DBs�NDe Me pudk purpose ma0a punuaMto Ne agency's policy Paafas 4. Veriflcation I have�ead and understand FPPC Regulations 18944.1 and 18942. I have venfied that tha disMbu[ion set lorth above. is in accordance ��e requirements. Randi Johl CityClerk 03l22/17 alure of Agency Head or Deaipnae Pnnt Name TiNe (rtronfh,day yea� Comment: FPPC Form 802(2f2078) FPPC Toll-Frae Helpl{ne:86&ASK•FPPC(86812753772) 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[o identify the agen<y's departmen[or unit •Ose SeRion B to iden[ify an individual. •Use Sec[ion C ta idenlify an ou[side organiza[ion. Number A, Name of Agency,Department or Unit of Tickat�s�l Describe the public purpose made pursuant to the agency's policy Passes Human Resources 2 Enhance Employee Morale Information Systems z Enhance Employee Morale Public Works 8 Enhance Employee Morale Community Services 9 Enhance Employee Morale Name of Intlivitlual Number B. o(Tickeqs�l Identify one of the(ollowing: (LasL Firs!) Passes Ceremanial Rde ❑ Other ❑ Income ❑ Ilcheckin9'Ceremomal Role'or'Ofnel'aescrrbe below Ceremonial Role ❑ Ot�er ❑ Income ❑ II c�eckng'Ce�emonial RWe"or'Of�e/'Oescnbe Eelow Ceremonial RWe ❑ Othet ❑ Income ❑ Ilc�eckrng'Ceremonial Role"or'Ot�e/'descnbe Oeiow Ceremonial Rde ❑ Ot�er ❑ Inwme ❑ Ilchecbnq"Cerpmomal Role'or"Other'tlescn0e Oelow Name of Outnide Organization Number C" (Inclutle atltlress anU tlesc�iptlon) o�7lckat�s�l DescNbe Ne public purpose made pursuarrt to the agancy's policy Passes FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866IASK-FPPC(866/275•3772)