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2023 LQ Art Celebration - November - Event TicketsAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of La Quinta Division, Department, or Region (irapplicable) uesignated Agency Gontact (P1ame,Title) Jon McMillen, City Manager CI Area CodelPhone Number E-mail 760-777-7030 jmcmillen@laquintaca.gov 2. Function or Event Information Does the agency have a ticket policy? Event Description: LQ Art Celebration A Public Document REOBVED , California; rm DEC 0 5 2023 For Official Use Only CITY OF LA QUINTA ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) Yes ■ No ❑ Face Value of Each Ticket/Pass $ Date(s) 11 1, 17 / 2023 Provide Title/ Explanation Ticket(s)/Pass(es) provided by agency? Yes ❑ No ■ If no: Name of Source Was ticket distribution made at the behest Yes ❑ No ■ If yes: Official's Name (Last, First) of agency official? 156.00 1� 19 1 2023 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. A. Name of Agency, Department or Unit Number of Tlcket(s)l Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Tickst(s)1 Identify one of the following: (Last, First) Passes Ceremonial Role Other ❑ Income ❑ Evans. Linda 1 If checking 'Ceremonial Role"or"Other"describebelow: LQ Resolution No. 2009-15 Section 4 Ceremonial Role E Other ❑ Income ❑ Sanchez, Steve 1 If checking "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(sy Describe the public purpose made pursuant to the agency's policy Passes 4. Verification I have read and understand FPPC Regulations 18944.1 and 18942. l have verified that the distribution set forth above, is in accordance with the requirements. _ 1 �/ y /u � Jon McMillen City Manager ftnature of Agency Head or Designee Print Name Title (month, day, year) Comment: FPPC Form 802 (212016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Agency Report of: 'California 80211 Ceremonial Role Events and Ticket/Pass Distributions Form Continuation Sheet A Public Document Agency Name City of La Quinta 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section B to identify an individual. Use Sectlon 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 Identify one of the following: B. Name of Individual (Last, First) Number of Ticket(s)l Passes Pena, John 1 Ceremonial Role Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: LQ Resolution No. 2009-15 Section 4 Fitzpatrick, Kathleen 1 Ceremonial Role Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: LQ Resolution No. 2009-15 Section 4 McGarrey, Deborah 1 Ceremonlal Role N Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: LQ Resolution No. 2009-15 Section 4 McMillen, Jon 1 Ceremonial Role N Other ❑ Income ❑ If checking "Ceremonial Role" or "Olher' describe below: LQ Resolution No. 2009-15 Section 4 C. Name of Outside Organization (include address and description) Number of Ticket(sy Passes Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name City of La Quinta Division, Oepartment, or Region (ifapplicable) DEC 0 5 2023 For Official Use Only Designated Agency Contact (Name, Titie) CITY OF LA QUINTA CrrY CLERK DEPARTMENT Jon McMillen, City Manager ❑ Amendment (Must Provide Explanation in Part 3 ) Area CodelPttane Number E-mail 760-777-7030 jmcmillen@laquintaca.gov Date of Original Filing: (month, day, year) 2. Function or Event Information 30.00 Does the agency have a ticket policy? Yes ■ No ❑ Face Value of Each Ticket/Pass $ Event Description: LQ Art Celebration Nov. 2023 Date(s) 111 17 r 2023 11 t 19 1 2023 Provide Title/ Explanation Tickets)/Pass(es) provided by agency? Yes ❑ No ■ If no: Name of Source Was ticket distribution made at the behest Yes ❑ No ■ If yes: of agency official? Official's Name (Last, First) 3. Recipients • Use Section A to identify the agency's department or unit. • Use Section S to identify an individual. Use Section C to identify an outside organization. Number A. Name of Agency, Department or Unit of Ticket(s)I Describe the public purpose made pursuant to the agency's policy Passes City Manager LQ Resolution No. 2009-15 Section 4 11 Community Servicves LQ Resolution No. 2009-15 Section 4 6 B. Name of Individual Number of Tlcket(s)I 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: Name of Outside Organization C. (Include address and description) Number of Tickags)I Describe the public purpose made pursuant to the agency's policy Passes 4. Verification I have read and understand FPPC Regulations 18944.1 and 16942. l have verified that the distribution set forth above, is in accordance with the requirements. _ Jon McMillen City Manager Sigrk"of Agency Head or Designee Print Name The (rrnnih, dby,, year) Comment: FPPC Form 802 (212016) FPPc Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: California 802 Ceremonial Role Events and Ticket/Pass Distributions Form Continuation Sheet A Public Document Agency Name City of La Quinta 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 Tlcket(s)l Passes Describe the public purpose made pursuant to the agency's policy Public Safety/Code Compliance 12 LQ Resolution No. 2009-15 Section 4 City Clerk 6 LQ Resolution No. 2009-15 Section 4 Planning/Building 19 LQ Resolution No. 2009-15 Section 4 Public Works 17 LQ Resolution No. 2009-15 Section 4 B. Name of Individual (Last First) Number of Tlcket(s)/ Passes Identify one of the following: 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 C. (Include address and description) Number of rs)/ Passe Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) LQ Art Celebration Nov. 2023 — Continued Name of Agency, Department or Unit Number of Ticket(s)/Passes 9 Describe the public purpose made pursuant to the agency's policy Finance LQ Resolution No. 2009-15 Section 4