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2025 American Express Golf Tournament - Day Tickets - Boards & ComissionsAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name Date Stamp California City of La Quinta RECEIVED Form 802 Division, Department, or Region (if applicable) For Official Use Only FEE 2 1 2025 OF LA QUINTA Designated Agency Contact (Name, Title) CITY CLERK DEPARTMENT Jon McMillen Area Code/Phone Number 760-777-7030 jmcmillen@laquintaca.gov 2. Function or Event Information Does the agency have a ticket policy? Yes ■ No ❑ Event Description: American Express Golf Tournament Provide Title/Explanation Ticket(s)/Pass(es) provided by agency? Yes ❑ No ■ ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) Face Value of Each Ticket/Pass $ 85.00 Date(s) 01 / 16 i 2025 01 19 f 2025 If no: American Express 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. tlse Section C to identify an outside organization. Number A. Name of Agency, Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes B. Name of Individual Number of Ticket(s)I Identify one of the following: (Last, First) Passes Ceremonial Role 0 Other ❑ Income ❑ Biondi, Gayle 1 If checking"Ceremonial Role"or"Other"describe below: LQ Resolution No. 2009-015 Section 4 Ceremonial Role 0 Other ❑ Income ❑ Kiehl, Jeff 1 if checking"Ceremonial Role"or"Other"descrlbebelow., LQ Resolution No. 2009-015 Section 4 Name of Outside Organization C. g Number of Ticket(s)1 Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 4. Verification / have read and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance w h-the lemenfs. s Jon McMillen City Manager -Z-1 ZO Z� ig ure of Agency Head or Designee Print Name Title (month, day, year) Comment: FPPC Form 802 (212016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions MEN= 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 Ticket(sy Passes Describe the public purpose matte pursuant to the agency-s poucy B.- Name of Individual (Last, First) Number of Ticket(s)l Passes Identify one of the following,. Paltin, Priscilla 1 Ceremonial Role Other ❑ income ❑ If checking 'Ceremonlal Role' or -Other" describe below. LQ Resolution No. 2009-015 Section 4 Batavick, George 1 Ceremonial Role 0 Other ❑ Income ❑ If checking 'Ceremonial Rofa' or'Other" describe below. LQ Resolution No. 2009-015 Section 4 Nieto, Stephen 1 Ceremonial Role M Other ❑ Income ❑ It checking 'Ceremonial Role or'Other describe below. LQ Resolution No. 2009-015 Section 4 Hassett, Doug 1 Ceremonial Role Other ❑ Income ❑ If checking 'Ceremonial Role- or'Other"desaibe below. LQ Resolution No. 2009-015 Section 4 C. Name of Outside Organization (Include address and description) Number of Ticket(s)/ Passes Describe the public purpose made pursuant to the agency's policy FPPC Form 802 (212016) FPPC Toll -Free Helpline- 8661ASK-FPPC (8661275-3772)