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Tickets Provided by <br />Agency Report A Public Document TICKETS PROVIDED AGEC REPORT <br />Agency Name <br />City of Riverside <br />or <br />Development Dept. <br />'treet Address <br />3900 Main St., Riverside, CA 92522 <br />\rea Code/Phone Number E-mail <br />951-826-5769 [ phogan@riversideca.gov <br />and <br />, ' <br />C Date Stamp California <br />For~m • <br />._IN E [":7 For Official Use Only <br />LAY r 4 2010 <br />❑ Amendment (Must explain in Part 5.) <br />Date of Original Filing: <br />(month, day, year) <br />Pamela Hogan <br />2. Event For Which Tickets Were Distributed <br />Date(s) of Event: 02 113 1 10 Description of Event: Natalie Cole Concert at Fox Performing Arts Center <br />~ I Face Value of Ticket: $ <br />77.00 <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: <br />Ticket(s) Provided to Agency: ® Gratuitously ❑ Pursuant to Contract <br />3. Agency Official(s) Receiving Ticket(s) (use a continuation street for additional names) <br />Name of Official I Number I 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 />Davis, Paul <br />1 Promotion of City Profile <br />1 Promotion of City Profile <br />Hart, Nancy I 1 I 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 h e determined that the distribution of tickets set forth above is in accordance with the provisions of FPPC Regulation 18944.1. <br />klm~~Z2~ Deanna Lorson Director ' I ' ( O <br />Signature of Agency Mead or Designee Print Name Title (mo th, day, ear) <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: 866fASK-FPPC (8661275-3772) <br />