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022218 Freedom Riders Theater Concert Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp . ' City of Temecula Division,Department,or Region (if applicable) rForOfficial Only City Clerk Designated Agency Contact(Name,Title) Randi Johl, City Clerk ❑ Amendment (must arohd Provide Area Code/Phone Number E-mail Date of Original Filing: 03/19/2018 951-694-6421 randi.johl@temeculaca.gov (month,day,year) 2. Function or Event Information Does the agency have a ticket policy? Yes® No❑ Face Value of Each Ticket/Pass $ 15 Event Description: Freedom Riders Theater Concert Date(s)___2_J 22 ) 18 Provide Trtle/Explanabon Tickets)/Pass(es) provided by agency? YesED No❑ If no: City of Temecula-Community Services Nameof Soume Was ticket distribution made at the behest Yes❑ No® If yes: Firs Official's Name(Last First) 3. Recipients •Use Section A to identify the agency's department or unit. •Use Section B to identify an individual. •Use Section C to identify an outside organization. t Number the p A ,Name of Agency,'Department or Unit of Ticket(ap Describe ublic purpose made pursuant to the agency s policy I N:� �4� .]eir .".} ti Passes• jl, .nL i lV. I s. ' _..Number B• Name of Individual of Ticket's)/ Identify one of the follow g _ (Last Rrst)w. Passes' "r.�;.,,_ _z; + , I Matt Rahn Ceremonial Role ❑ Other ❑Q Income ❑ 2 if checkng'Ceremonial Role"or'Other descnbe below: Advertise and Promote the City of Temecula Ceremonial Role ❑ Other E Income ❑ It checkng'Ceremonial Role"or'Othee cascdbe below, I Name of;0utside Organaatlon NumberC. of Ticket(a)/ , Describe the public purpose Dude pursuant to the agency's policy , (Include address and description) *. Passes 4. Verification I have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with quirements. RandiJohl City Clerk 3/19/18 SWAsitucs-orAgency Head or Designee Print Name Title (month,day,year) Comment: FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772)