Laserfiche WebLink
Tickets Provided by <br />Agency Report <br />1. Agency Name <br />City of Riverside <br />Division, Department, or Region (if applicable) <br />Development Dept. <br />Street Address <br />3900 Main St., Riverside, CA 92522 <br />951-826-5769 <br />(name and <br />A Public Document <br />phogan@riversideca.gov <br />TICKETS PROVIDED BY <br />AGENCY REPORT <br />a C Date Stamp California <br />. • <br />For Official Use Only <br />M A'vl 2 4 2010 <br />❑ Amendment (Must explain in Part 5.) <br />Date of Original Filing: <br />I (Month, day, year) <br />Pamela Hogan <br />2. Event For Which Tickets Were Distributed <br />Date(s) of Event: 02 103 10 Description of Event: Annie Play at Fox Performing Arts Center <br />02 ( 07 / 10 Face Value of Ticket: $ 75.00 <br />Agency Event ® Yes ❑ No (Identify source of tickets below.) <br />Name of Outside Source of Ticket(s) Provided to Agency: <br />Number of Tickets Received: Ticket(s) Provided to Agency: 9 Gratuitously ❑ Pursuant to Contract <br />3. Agency Official(s) Receiving Ticket(s) (use a continuation sheet for additional names) <br />Name of Official Number State Whether the Distribution is Income to the Official or <br />(Last, First) of Tickets Describe the Public Purpose for the Distribution <br />Adams, Steve <br />Bailey, Rusty <br />1 Promotion of City Profile <br />1 Promotion of City Profile <br />Davis, Paul J 1 1 Promotion of City Profile <br />4. Individual or Organization Receiving Ticket(s) (Provided at the behest of an agency official.) <br />Name of Behesting Agency Official: <br />Name of Individual or Organization: <br />Description of Organization: <br />Address of Organization: <br />Number and Street <br />City <br />Purpose for Distribution: (Describe the public purpose for the distribution to the organization.) <br />State Zip Code <br />5. Verification <br />! have determined that the distribution of tickets set forth above is in accordance with the provisions of FPPC Regulation 98944.9. <br />Deanna Lorson Director I <br />Signature of Agency Head or Designee Print Name Title (mo th, day, year) <br />Comment: (Use this space or an attachment for any additional information including amendment explanation.) <br />Number of Tickets: <br />FPPC Form 802 (Feli <br />FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) <br />