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062217 WRCOG General Assembly & Leadership Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Da�e Stamp . ' City of Temecula � Division, Department,or Region (i/applicable) For oHiciai use onty City Clerk's Office Designated Agency Contact(Namo,Title) . Randi Johl, City Clerk ❑ Amendment (Must P�ovide Explanalion in Part 3.) Area Code/Phone Number E-mail Date of Original Filing: �7/�5/�� (951) 694-6421 randi.johl@temeculaca.gov (monfh,day,year) 2. Function or Event Information Does the agency have a ticket policy? Yes� No❑ Face Value of Each TickeUPass$ 150 Event Description: WRCOG Gen Assembly & Leadership Date(s)�� » ��_ Provide Title/Explanafion Ticket(s)/Pass(es) provided by agency? Yes❑ No� If no:Western Riverside Council of Governments Nameo/Soume Was ticket distribution made at the behest Yes❑ No� �f yes: of agency official? �KGa/'s Name(Last,FirstJ 3. Recipients •Use Section A m identify lhe agency's Jepartmenl or uniL •Use Section B to idenlify an individual. •Ose Seclion C to idenlify an oulside organiaalion. Number �� �� ,s A Name ot Agency,Department or Unit of 7icket�s)/ Describe the public purpose matle pursuant to tha agancy's policy� C Passes City Manager's Office Advertise & Promote the City of Temecula 2 Community Development Advertise & Promote the City of Temecula 2 Number B, Name ot Individual of 7icket�s)/ Identify one of the following: . (Las(,FirsfJ passes Edwards, Maryann Ceremonial Role ❑ ome� ❑O Income ❑ ,� Ilchacking'CaiemonialRole'or'OfheYdesciibebalow: Advertise & Promote the City of Temecula Rahn, Matt Ceremonial Role ❑ Other ❑x Income ❑ 2 1/checkinA'Ceremonial Role'or'Ofher"descnbe below: Advertise & Promote the City of Temecula Name of Outsitle O�ganization Number � � C'' (include atltlress and description) of 7ickeqs)I Describe the public purpose made pursuant to the agency's poliry Pa55e5 4. Verification 1 have read and understand FPPC Regulations 18944J and 18942. I have verified that the distribution set forth above, is in accordance wit requirements. Randi Johl City Clerk 07/05/17 ignatu of Agency Head or Ucsigncc Print Name Ttle /monfh,day,year) Comment: FPPC Form 802(2I2016) FPPC Toll-Free Helpline:8661ASK•FPPC(866/2753772)