2023 Riverside County Scare & Pumpkin FestivalAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions A Public Document
1. Agency Name
City of La Quinta a
Division, Department, or Region (if applicewe) 0 C T 2. 42023 For Official Use Only
Designated Agency Contact (Name, Title) CITY OF LA QUINTA
;ffY CLERK DEPARTME
Jon McMillen, City Manager _ ❑ Amendment (Must Provide Explanation in Part 3.)
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 $
15.00
Event Description: Riverside County Scare and Pumpkin i Date(s) 101 27 i 23 10 i 31 / 23
Provide PW Explanadon
Ticket(syPass(es) provided by agency? Yes ■ No ❑ If no:
Name or Source
Was ticket distribution made at the behest Yes ❑ No 0 If yes: Offidel's Name (Last Fbst)
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 ldentlfy an outside organization.
OWNkber
A. Name of AOen % Department or unit OfTkmoy Destxibs the public pwpoaa made prasuant to the agency's poll"
Passes
Name eflndivedual Tkiamer
B. d'tklomt(mjf Identity am of the fall&ring:
R-eK FS) Paten!
Ceremonial Role ■ Other ❑ Income ❑
Jake Fuson 4 ach"ny-CarernonWRole'ar-0dW'descnbebebw:
LQ Resolution No. 2009-15 Section 4
Ceremonial Role 0 Other ❑ Income ❑
Brianna Rodriguez lrdbadna-cermraWF?m%-or^om•ed•srraebefar
LQ Resolution No. 2009-15 Section 4
!Vane of Outside Orgel i¢atlon Member
C. (include address mod description) d7lcket(s} Deserbe do public purpose made pursuant to the agency's polcy
Pass"
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
he requirements.
e
T "} Lr` Pn IG Lt 207
Signa[u l Agency Mead orDesignee Print !+Fame e (m M. day, arl
Comment:
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772)
Agency Report of: California
Ceremonial Role Events and TicketlPass Distributions Form 802
Continuation Sheet A Public Document
Agency Name
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 organi2adon.
Number
A. Name of Agency, Department or Unit
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(last First)
Number
of-ickelfay
Passes
Identify one of the fallowing:
Sandra Laureano
4
Ceremonial Role Other ❑ Income ❑
Kchecking "Ceremonial Rp7®' w "ether" describe betaw:
LQ Resolution No. 2009-15 Section 4
Celeste Villanueva
4
Ceremonial Role 0 me, ❑ Income ❑
irchecking "CeramonW RoW' or "Other" describe below:
LQ Resolution No. 2009-15 Section 4
Reyna Camarena
4
Ceremonial Role 0 other ❑ Income ❑
lFchecking "Ceremonial Rafe"or°other°describe below:
LQ Resolution No. 2009-15 Section 4
Lois Magallanes
4
Ceremonial Role Other ❑ Income ❑
lichwking 'Cemmonra+ Rare" w D1heY describe 6elaw.,
LQ Resolution No. 2009-15 Section 4
Name of Outside Organization
C. (include address and description}
Number
of Ticket(s)f
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275.3772)
Agency Report of: California 802
Ceremonial Role Events and Ticket/Pass Distributions Form
Continuation Sheet A Public Document
Agency Name `
_!; - fi:a
3. Red Tents
• 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)!
Passes
Describe the public purpose made pursuant to the agency's policy
B Name of Individual
(Last, First)
Number
of Ticket{sy
passes
Identify one of the following:
Jack Lima
L/
Ceremonial Role Other ❑ Income ❑
71 checking 'Ceremonial RoV or `Othor' dearnbe below:
LQ Resolution No. 2009-15 Section 4
Derrick Armendariz
Ceremonial Rolo Other ❑ Income ❑
N checking -Ceremonial Role"or `6lher" describe below:
LQ Resolution No. 2009-15 Section 4
Armando Cabrera
L
Ceremonial Role other ❑ Income ❑
If checking "Ceremonial Roza' or 'Olher" deacni below:
LQ Resolution No. 2009-15 Section 4
Demetria Pecina
Ceremonial Role 0 Other ❑ Income ❑
fl ehecking "Ceremonial Role" or "Other" describe below:
LQ Resolution No. 2009-15 Section 4
Name of outside Organization
C' {include address and description]
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: SGG)ASK-FPPC (8661275.3772)