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080618 United Way Golf Tournament 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) For Official Use Only City Clerk Designated Agency Contact(Name,Title) Randi Johl, Director of Legislative Affairs/City Clerk ❑ Amendment (Must Provide Explanation in Part 3.) Area Code/Phone Number E-mail 951-694-6421 temeculaca. ov randi.johl Date of Original Filing: randi.johI@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$ 200 Event Description: United Way Golf Tournament Date(s) 08 / 06 / 18 Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes❑ No® If no:Abbott Vascular 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(su Describe the public purpose made pursuant to the agency's policy Passes City Manager'Office 1 Advertise and Promote the City Public Works 1 Advertise and Promote the City Number B. Name of Individual of Tickegs)/ Identify one of the following: (Last,First) Passes Jeff Comerchero Ceremonial Role ❑ Other ❑ Income ❑ 1 If checking"Ceremonial Role"or"Other'describe below: Advertise and Promote the City Ceremonial Role ❑ Other❑ Income ❑ If checking"Ceremonial Role"or"Other'describe below: Name of Outside Organization Number of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy C. (include address and description) Passes 4. Verification l have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance with uirements. Director of Legislative Affairs/ Randi Johl City Clerk 08/10/18 Signat ncy Head or Designee Print Name Tile (month,day,year) Comment: FPPC Form 802(2/2016) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) Agency Report of: California 1 Ceremonial Role Events and Ticket/Pass Distributions Form 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 organization. Number A. Name of Agency,Department or Unit of Ticket(s)f Describe the public purpose made pursuant to the agency's policy Passes Community Development 1 Advertise and Promote the City Name of Individual Number B. of Tlcket(su Identify one of the following: (Last,First) Passes Ceremonial Role ❑ Other❑ Income ❑ If checking"Ceremonial Role"or"Other"describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking"Ceremonial Role"or"Other"describe below Ceremonial Role ❑ Other❑ Income ❑ If checking"Ceremonial Role"or"Other'describe below: Ceremonial Role ❑ Other❑ Income ❑ If checking"Ceremonial Role"or"Other'describe below: 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 FPPC Form 802(212016) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772)