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Tickets Provided by <br />A Public Document TICKETS PROVIDED BY <br />Agency Report AGENCY REPORT <br />1. Agency Name s[~tgsta~',~ < <br />City of Riverside - • <br />Divislon, Department, or Region (ifapplicable) j For Official use only <br />Development Dept. <br />Street Address <br />3000 Main St., Riverside, CA 92522 <br />Area CodelPhone Number E-mail <br />E] Amendment (Must explain in Part 5.) <br />951-826-5769 phogan@riversideca.gov <br />Agency Contact (name and title) Date of Original Filing: <br />(month, day, year) <br />Pamela Hogan <br />2. Event For Which Tickets Were Distributed <br />Date(s) of Event: 05 101 1 10 Description of Event: Kenny Rogers Concert at Fox Performing Arts Ctr <br />I I Face Value of Ticket: $ <br />73.00 <br />Agency Event M 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: x❑ 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 />Bailey, Rusty <br />Hart, Nancy <br />1 Promotion of City Profile <br />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 />Number of Tickets: <br />Address of Organization: <br />Number and Street City State Zip Code <br />Purpose for Distribution: (Describe the public purpose for the distribution to the organization,) <br />5. Verification <br />1 have determined that the distribution of tickets set forth above is in accordance with the provisions of FPPC Regulation 18944.1. <br />~j Deanna Lorson Director <br />Signature of Agency Head or Designee Print Name Title (month, day, year) <br />Comment: (Use this space or an attachment for any additional information including amendment explanation.) <br />FPPC Form 802 (Feb109) <br />FPPC Toll-Free Helpline: 8661ASK-FPPC (86612753772) <br />