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041418 MSJC Foundation 10th Annual Gala Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp . . ' City of Temecula For Official • Division,Department,or Region (if applicable) Use Only City Clerk's Office Designated Agency Contact(Name,Title) Randi Johl, City Clerk ❑ Area Code/Phone Number E-mail Amendment (Must Provide Explanation in Part 3.) 951-694-6421 randi.johl@temeculaca.gov Date of Original Filing: (month,day,year) 2. Function or Event Information Does the agency have a ticket policy? Yes® No❑ Face Value of Each Ticket/Pass$ 150 Event Description: MSJC Foundation 10th Annual Gala Date(s) 04 / 14 / 18 Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes❑ No® If no: MSJC Foundation Name of Source Was ticket distribution made at the behest Yes❑ No® If yes: Official's Name(Last,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 A. Name of Agency,Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes City Manager's Office 2 Advertise and Promote City of Temecula Number B. Name of Individual of Ticket(s)/ Identify one of the following: (Last,First) Passes Matt Rahn Ceremonial Role ❑ Other ® Income ❑ 2 It checking'Ceremonial Role"or"Other'describe below Advertise and Promote City of Temecula Mike Naggar Ceremonial Role ❑ Other X❑ Income ❑ 2 It checking'Ceremonial Role"or"Other'describe below Advertise and Promote City of Temecula Name of Outside Organization Number C. (include address and description) of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes 4. Verification l have read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance with ;Ze�quirement,. Randi Johl City Clerk 04/16/18 Agency Head or Designee Print Name Title (month,day,year) Comment: FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)