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2012 Riverside County Fair & National Date FestivalAgency Report of: Ceremonial Role Events and Ticket/Admission Distributions 1. Agency Name City of La Quinta bivision, Department, or Region (ifapplicat Street Address 78-495 Calle Tampico, La Quinta, CA 92253 Designated Agency Contact (Name,Title) Mark Weiss, Interim City Manager Area Code/Phone Number E-mail 760-777-7100 1 mweiss@la-quinta.org 2. Function, Event, or Ceremonial Rale information Title 2012 Riverside County Fair Description A Public Document Date_Stap�r F-' ___� )!i For Official Use Only FEB 2 0 201211 1 rhY OF LP WISTA i, 6t1N,1 GFR'7 nlPa ❑ Amendment (Must provide explanation in Part 3.) Date of Original Filing: (month, day, year) Face Value of Each Admission $ 8.00 Date(s)02/2/ 17t 12 02 126t 12 Ticket(s)/Admission(s) provided by agency? Yes ❑ No E] If no: Riverside County EDA Name of Source Was the distribution to persons identified below made at the behest of an agency official? Yes [I No i] If yes: Official's Name (Last. First) and Title The identity of recipient(s) and the explanation: Name + Check the Income box If the agency official claims admission as (Last, First) Number of Agency taxable income. If the agency official performed a ceremonial role, or Admission(s)1 Official also provide a description. Organization Tickets) • If not Income, describe the public purpose, Including (Name, Address, Description) ceremonial roles, performed by an,agency official, individual, or organization. Yes ❑ Income see attached No ❑ ❑ Yes ❑ Income No ❑ Cl Yes ❑ Income No ❑ ❑ Yes ❑ Income No ❑ ❑ Yes ❑ Income No ❑ ❑ 3. Verification 1 have react and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution of admissions, set forth above, is in accordance with the provisions. Mark Weiss Interim City Manager 02/21/2012 Signature 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 (2111) FPPC Toll -Free Helpline: 866/ASK-FPPC (8861275-3772) California Form 802 — Attachment (2012 Riverside County Pair & National Date Festival) State below whether the Distribution is Income to the Official or Describe the Public Purpose for the distribution: No income. Public purpose for the distribution is for promotion of City -sponsored community program. 3. Agency Officials Receiving Tickets: (ticket value - $8.00150 received) Last Name First Name Title Number of Tickets Evans Linda Council Member 4 Osborne Lee Council Member 6 Jonasson Tim Public Works Director 2 Stoianovici Toma City Staff 1 Franco Yvonne City Staff 1 Fischer Kim City Staff 1 Ce'a Eric City Staff 1 Munoz George City Staff 1 Wise -Latta Wanda City Staff 1 Khatami Stephanie City Staff 1 Lopez Yolanda --City Staff 1 Titone Alma Cit Staff 1 Mendoza Missy City Staff 1 Villalpando Gilbert City Staff 1 Morris Michael City Staff 1 Gonzales Beto City Staff 1 Pecina Demetrio City Staff 1 Castaneda Ruben City Staff 1 Rodriguez Alberto City Staff 1 Hamilton Scott Cit Staff 1 Ortiz Anna City Staff 1 Santana Oscar City Staff 1 Arellano Augustin City Staff 1 Larson Tustin City Staff 1 Blondell Krystena City Staff 1 Mantilla Sandra City Staff 1 Wilson Jean City Staff 1 Sanchez Tommi City Staff 1 Sawyer David City Staff 1 Hensel Kay City Staff 1 Yu Amy City Staff 1 Martin Diane City Staff 1 Zarco Angelica city Staff 1 Misuraca Jackie City Staff 1 Casillas Maria City Staff 1 Frane Karen City Staff 1 Lopez Michelle City Staff 1 Ambriz Robert City Staff 1 Radeva Monika City Staff 1 Doran Caroline City Staff 1 Wyman Shelley City Staff 1