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080717 United Way Golf Tournament Agency Report of: Ceremonial Role Events and TickeUPass Distributions A Public Document 1. Agency Name Date Stamp . , City of Temecula � Division, �epartment,or Region�ifapplicable) For oro���i use o�iy Ciry Clerk's Office Designated Agency Conhct(Name,Tme) Randi Johl, City Clerk ❑ Amendment (Must P.ovide ExplanaM1on in Part 3.) Area CodelPhone Number E-mail 951-694-6421 randi.'ohl temeculaca. ov DateofOriglnalFlling: 08�22��� 1 @ 9 �mo�m,oay yea�� 2. Function or Event Information Does the agency have a ticket policy? Yes� No❑ Face Value of Each TickeVPass $ $200 Event Description: United Way Golf Tournament Date(s)���� ��_ PioNtle Ti11MExdanation Ticket(s)/Pass(es) provided by agency7 Yes❑ No� If no: Abbott Vascular NameolSaume Was ticket distribution made at the behest Yes❑ No� If yes: of agency official? Olfitial's Name(Las[FirstJ 3. Recipients •Use Sectian A lo identify lhe agency's departmenl or unit. •Use Sec[ion II to identify an Individual. •Use Section C to iJenlify en outside organization. Numbor (�. Name of Agenty,Department or Unil of 7lckaG�l� DesCribe Ihe public purpose meda pursuant to the agancy's Dolicy Paaw� Ciry Manager's Office � AdveRise and Promote the City of Temecula Name of Individual Numbar B. ol Tickaqsu �dentify one of the 101fowlnq: (Lesl,Firsf) Gassa� Maryann Edwards Ceremonial aale ❑ Ou+er � income ❑ ,� IIcnBClunq'CBrlmenialRde'or'OIneY'becnEeeelow Advertise and Promote the City of Temecula Ceremonial Rde ❑ ONer ❑ Income ❑ Ilc�ecking'Caremomal Rda'or"OMev descnDe pNow Nama of Outaide Organiration Numear C' (Inclutle addre�a anG tleacription) a T�ckrqsN Describa the public pu�poae made punuant to the agency's policy Puse� 4. Verification I have nd understand FPPC Regulations 18944.1 and 78942. I have verified that the distribution set lorth above, is in accordance wit e r irements. Randi Johl Ciry Clerk 8/22/17 Sig ency HeaG or Oesipnee Pnnt Name 7�tle (montn,tlay.yearJ Comment: FPPC Fortn 802(?I2016) FPPC Toll-Free Helpline: B661ASK-FPPC(86W275-3772) Agency Report of: • � • . � Ceremonial Role Events and TickeUPass Distributions • � Continuation Sheet A Public Document Agency Name City of Temecula 3. Recipients •Use Seclion A to idenli(y the agency's depanment or unit. •Use Section R tn identify an individual. •Ux Section C tu identi(y an oulside urganiration. Num6ar A, Nama of Agency,Dapartment or Unit of 7lckeqsl� Describe the public purpose made purauant to the agency'e policy PastN Community Development Department � Advertise and Promote the City of Temecula Public Works Department � Advertise and Promote the City of Temecula Nama of Individual Numbar B, of Tkkaq�y Identi(y ona of the following: (Last. Firsf) Pae�as Cercmonial Role ❑ OMer ❑ mrome ❑ u cnecking'Ceremon�a�ade'or'OtMr tlascnce oe�ow Ceremonial Rde ❑ Otl�er❑ income ❑ rc cneckmg'Cammorwl Rda'o�"OfM/tlasu�Ee bebw Ceremonial Rde ❑ OMer❑ Incame ❑ ncnecwig'Caemorrie�Ftle'or'Or,ml'descnee Dobw� Cercmonial Role ❑ 01her ❑ Inwma ❑ II phecbrrg"Ceremomal Rde o�'Of�ei desrnDe�elow Name oF Ou41da OrganWUon NumMr C• mc��ae aaa�sas.na aeac�� aoo� °�Tkk���� Detcriba the public purpow made punuant to tM agmcy's pollcy ( P Pauu FPPC Fortn 802(2/2016) FPPC Toll-Free Helpllne:B6WASK-FPPC(8661275•3772)