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030818-031918 Annual Autism Event at Circus Vargas Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp . 1 City of Temecula Division,Department,or Region (if applicable) For Official Use Only City Clerk Designated Agency Contact(Name,Title) Randi Johl, City Clerk ❑ Amendment (Must ProvideExplanation inFad3J Area Code/Phone Number E-mail 951-694-6421 ov randi.'ohl temeculaca. Date of original Filing: 03/19/2018 9 (month,day,year) 2. Function or Event Information Does the agency have a ticket policy? Yes® No❑ Face Value of Each Ticket/Pass$ 37 Event Description: Annual Autism Event at Circus Vargas Date(s)1__8_J 18 1 19 / 18 Provide Ttle/Explanabon Ticket(s)/Pass(es) provided by agency? Yes❑ No El If no: Circus Vargas Name or Source Was ticket distribution made at the behest Yes❑ No® If yes: Official's Name(Lest,First) of agency official? 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. Number, /� Name of Agency Department or Umb ;of Tckeyey Descnbe the public purpose made pursuant to the agency s policy o- t'. L $`. _Pasaea r �, Number r r q B Name of Individual j Y t r : -of Tickerye)I + `Idenhiy one of the follovnng �. #' Leaf Nrst d rZ _ ( .Pasaea Mike Naggar Ceremonial Role ❑ Other ® Income ❑ Z Irchecklnp'Ceremonial Role'or'Other describe below: Advertise and Promote the City of Temecula James Stewart Ceremonial Role ❑ Other ❑X Income ❑ 2 1/ch ecb'ng'Ceremonial Role"or"OtheYcaScnbe below: Advertise and Promote the City of Temecula IName OfOUtside Organization -Number C of rickeds)I c prpose', Oeseribe the publiumade pursuant to the agency s policy I . :' (Include address and descrlphon) r= ,F . 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 tl uirements. Randi Johl City Clerk 3/19/18 Signa ency Head or Designee Print Name This (month,day,year) Comment: FPPC Form 802(2J201 6) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275.3772) 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 to identify the agency's department or unit. •Use Section B to identify an individual. •Use Section C to identify an outside organimlion. Number A ..Name of Agency Department or Unit ,, 'of Tckeys)I Describe the public purpose made pursuant to the agency s policy I pC: to }JAN R umber B - Name of Indlvtdual r `of Ti keye)/ Y' z 1 Identify one of the foll vnng i I = r;; Passes Maryann Edwards Ceremonial Role ❑ Other ® Income ❑ ,2 If chacking'Ceremonial Rdow: e'or'Olher oescribe bel Advertise and Promote the City of Temecula Ceremonial Role ❑ Other ❑ Income ❑ Irchecking'Cemmonial Rde'or'Olher mwnbe below: Ceremonial Role ❑ Other ❑ Income ❑ If chocking'Cemrrcnial Rde-or'Ofhee descnbe below: Ceremonial Role ❑ Other❑ Income ❑ It checking°Ceremonial Rale-or'Other oescnbe below f Organization Number ` Name,of�Cutld ._ f Tl kets)/ Describe the publto purpose made pursuant to the agency s policy _. (Include address and descriPtlon) t- paesea FPPC Form 802(212016) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772)