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2025 American Express Golf Tournament - Day Tickets - StaffAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of La Quinta Division, Department, or Region (if applicable) Designated Agency Contact (Name, Title) Jon McMillen Area Code/Phone Number E-mail 760-777-7030 1 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 A Public Document Date Stamp RECEIVED FEE 2 1 2025 CITY OF LA QuINTA CITY CLERK DEPARTMENT For Official Use Only ❑ Amendment (Must Provide Explanation in Part 3.) Date of Original Filing: (month, day, year) Face Value of Each Ticket/Pass $ ___ 114.00 Dates) 01 1 16 1, 2025 011 19 / 2025 If no: American Express Name of Source Was ticket distribution made at the behest Yes ❑ No ■ If yes: Otlicial'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. Use 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 City Manager LQ Resolution No. 2009-015 Section 4 22 City Clerk LQ Resolution No. 2009-015 Section 4 8 B. Name of Individual Number of Ticket(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 checln'ng "Ceremonial Role" or "Other" describe below: Name of Outside Organization C. g Number of Ticket(s)l Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 4. Verification l have read and understand FPPC Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance vith the requirements. r-- -%. l eA Sigpa of Agency Head or Designee Print Name Title (month, day, year) Comment: FPPC Form 802 (212016) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions Form 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 organization. A. Name of Agency, Department or Unit of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes Public Works LQ Resolution No. 2009-015 Section 4 24 Design and Development LQ Resolution No. 2009-015 Section 4 43 Finance LQ Resolution No. 2009-015 Section 4 10 Community Services LQ Resolution No. 2009-015 Section 4 24 B. Name of Individual Number of Ticket(s)l 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: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: C. Name of Outside Organization Number of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Passes FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Amex Golf Tournament 1/16/25-1/19/25 — Continued Name of Individual, Agency, Department or Unit Number of Ticket(s)/Passes Describe the public purpose made pursuant to the agency's policy Public Safety 16 LQ Resolution No. 2009-15 Section 4