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Ticket Provided by TICKETS F*a OVII6 BY <br />Agency Report A Public Document AGENCYRF-P(MT <br />Lily of Riverside 11 <br />Division, Department, or Region rrraarapojrawr) <br />Development Depadment <br />3900 Main Street, RiveFSide, Cdr 92522 <br />951-826 5649 1 mhauot:5 <br />Data` Stan, n <br />Fr 1 ZG 4G <br />Amendroncnt a MI OxPiM AM €&I e.i <br />Kato o•t Qtigq nal filing: 2'11 1`10 <br />,rrrr.~.•r.ra ;.Ijq y. iVW) <br />Margie HaLif.at• Interim Project Manager <br />2. Event For Which Tickets Were Distributed <br />Date(s) of Everil 11 + 7 0' 09 Gcscriplion of Everil- Festival of Lights - I+ Skating Rink <br />1 +3 -J 10 Face vaIueof Trrkel: S 13.10 <br />Agency Event [9 Yes 8 No (Identify source of tickets below-) <br />Larne of Outside Source of Ticket(s) Provided to Ageancy <br />Number of `pickets Received: Ticket(s) Phoviaded to Agency 0 ratudoiusly M Pursuant to Contract <br />3. Agency Official(s) Receiving Ticket(s) [the a continualion sheet fat addilioraar narnes) <br />Name of Oftial Numoer I State'iarbhemer the anslribution is Income to the Of jal or <br />1I_tari. F,r%lj of Tickets Describe the Public Purpose for the Disiribution <br />Sae anachied list <br />4. Individual or Organization <br />Name of Rehresling Agency Official: <br />Name of Individual or Organization: <br />DesGrlplion of Organization: <br />Dumber of Tickets: <br />Adi1ress of Organization: <br />' •l itll'ItNrlf and Sirw C-ty Sr <br />Purpose for D[striba,lion (Clescrit the public purpozm (or that d,stributiDn in the of anizauon.) <br />5. Verification <br />r de€vrmr nvd rhal the distliibt4iorr of li kers set forttr above is in afic rtant wont the provisions of FPPG Rr3gufation 18944-1. <br />Deanna Lorson Development Director <br />S,va:me nrAgz` Heai:l >.-r L]est_-rte Praq Nzsr o , I <br />Comment,. (f,fsq fhis space ar ara arta chmerrf for any addi~Cacartj.' informablan vdud~nq arraPyMmetil exp4abmbon-) <br />Pot <br />(Prpvnd.W at the behest of an agency official.) <br />FPPC Form H2 J'Pablo% <br />FP':F'c Toll-Free Helprino. UWASK-FPF+C (866;375.37721 <br />