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2010 Sinatra Starkey Hearing Foundation Golf TournamentTickets Provided by Agency Report 1. Agency Name City of La Quinta Division, Department, or Region (if applicable) jtreet Aaaress 78-495 Calle Tampico lrea Code/Phone Number A Public Document 760-777-7100 1 tgenoves@la-quinta.org 4gency Contact (name and title) Date Stamp TICKETS PROVIDED BY AGENCY REPORT For Official Use Only ❑ Amendment (Must explain in Part 5.) Date of Original Filing: (month, day, year) Thomas P. Genovese, City Manager 2. Event For Which Tickets Were Distributed Date(s) of Event: 02 f 19 1 10 Description of Event: Sinatra Starkey Hearing Foundation Golf Tournament 02 t 20 1 10 Face Value of Ticket: $ 10.00 Agency Event ❑ Yes 0 No (Identify source of tickets below.) Name of Outside Source of Ticket(s) Provided to Agency: Sinatra Starkey Hearing Foundation Golf Tournament Number of Tickets Received: 28 Ticket(s) Provided to Agency: ❑x Gratuitously ❑ Pursuant to Contract 3. Agency Officials) Receiving Ticket(s) (use a continuation sheet for additional names) Name of Official Number State Whether the Distribution is Income to the Official or (Last, First) I of Tickets I Describe the Public Purpose for the Distribution Lopez, Michelle 1 8 Maysels, Susan 1 4 No income. Promotion of charitable organization No income. Promotion of charitable organization 4. Individual or Organization Receiving Ticket(s) (Provided atthe behest of an agency official.) Name of Behesting Agency Official: Name of Individual or Organization: Description of Organization: Thomas P. Genovese, City Manager Sinatra Starkey Hearing Foundation Tourney supports the Barbara Sinatra Children's Center Address of Organization: 39000 Bob Hope Drive Number and Street Rancho Mirage City Purpose for Distribution: (Describe the public purpose for the distribution to the organization.) Promotion of community program and charitable organization Number of Tickets: 28 CA 92270 State Zip Code 5. Verification ve do e r in t the distribution of tickets set forth above is in accordance with the provisions of FPPC Regulation 98944.1. Thomas P. Genovese City Manager 02-18-10 r11,221 gnature of Agency Head or Designee Print Name Title (month, day, year) Comment: (Use this space or an attachment for any additional information including amendment explanation.) FPPC Form 802 (Feb/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)