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082717 Boys & Girls Club Idol Competition Agency Report of: Ceremonial Role Events and TickeUPass Distributions A Public Document 1. Agency Name Date Stamp . . . ' City of Temecula ' � Division, �epartment,or Region (i/applicable) Fo�orr��ai use o�iy City Clerk's Office Designated Agency ConTact(Name.Trt�e1 Randi Johl, City Clerk � AmendmBnf (Must Pmvitle Explanation in Part 3.) Area CodelPhone Number E-mail 951-694-6421 randi.'ohl temeculaca. ov Data of Original Flling: 9����� 1 @ 9 (month.day,year) 2. Function or Event Information Dces the agency have a ticket policy? Yes� No❑ Face Value of Each TickeUPass $ �5 Event Description: Boys 8 Girls Club Idol Competition Date(s)���� ��_ Provide Titte/Explane0on Ticket(s)/Pass(es) provided by agency? Yes❑ No� If no: Boys& Girls Club Nameol5ou¢e Was ticket distribution made at the behest Yes❑ No� If yes: of agency official? Oflcial's Nama(Lest,First) 3. Recipients •Use Seclion A lo identi(y Ihe agency's departmeN or unit •Use Sectiun B to identify an indiviJaal. •Use Seclion C lo idenlify an outside organixalion. Numbar A. Name oi Agency,Deparlment or Unit of 7kkays�! Deacrlbe the public purpose made pursuant to the agency'e policy Pawn Public Works Department �� Enhance Employee Morale Finance Departmenl 4 Enhance Employee Morale Number B. Nama of IndlviAual o/7lckeqs)I Identiiy ona of the following: (LeSL Fi�St) Passef Edwards, Maryann Ceremonial Role ❑ Otner � Income ❑ ,L ilcneclunp'Ceremon�alRde'a'O��erOescnEeOelow Advertise and Promote the City Cercmonial Rde ❑ Other ❑ Income ❑ ncnecdng'Ceremon�a�Rde'o�'Omer'cescnce ae�ow Name of Oubide Organiution Number C'' (include addrees antl description) of Tlcket(s)I Describe the public purpose made pursuant to the agency'a policy Passet 4. Verification 1 have read and understand FPPC Regulations 18944J and 18942. I have venfied that the disMbution set lorth a6ove, is in accordance wifh requirements. Randi Johl City Clerk 9/7117 of Apency MeaC or Designee Print Name Title (monM.tlay,year) Comment: FPPC Form 802(YI2016) FPPC Toll-Free Helpline: 8667ASK-FPPC(8667275-3772) Agency Report of: • • • . � Ceremonial Role Events and TickeUPass Distributions • ' Continuation Sheet A Public Document Agency Name City of Temecula 3. Recipients •Uu Setlion A to identify the agency's Jeparlment or unit. •Use Sectiun B to idrnti(y an individuaL �Use Sec�ion f,lo idenlify an outside organi�alion. Number A. Nama of Agency,Dapartmant or Unit otTickeaau Dascriba tha publlt purpwe med�punuant ta the agency's policy Paasas City Clerk Office 2 Enhance Employee Morale Police Department 2 Enhance Employee Morale Number B, Name of Indlvldual otTlckaqsu Identiy one of the/ollowing: (Last,Firsf) Paasea Ceremonlal Role ❑ Omer ❑ Income ❑ II Gf1PLk1119'(�iBIPl110/IIAI RNB�O/rolll2/�5f1162 OBIOM' Ceremonlel Role ❑ OMer❑ Income ❑ II[heckinp"Caremonie!Rpb'a"Of�e/'tkscnbo pelow.' Ceremonial Rde ❑ OMer ❑ Income ❑ H c�eck�g'Ceremonlal Rde-o�'OIIreYWncnbe Uelow Ceremonial Rde ❑ OMer ❑ Income ❑ „cnp�h�ig'Caremonial Rde'or'O!M/tlescnpe celow. NameotOutalCeOrgani�tion NumWr (�', of Tkket(�N Deeeriba the puGlk purpoaa matla punuant to ttro agency's policy Qnclude aCdress and description) pu�es FPPC Fortn 802(TI2076) FPPC Toll-Free Melpllne:866fASK-FPPC(88W2753772)