HomeMy WebLinkAboutSt. Patrick's Day Gala - 2024 SignedAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Dublin
Division. Denartment, or Reaion (ifanalicable)
Marsha Moore, City Clerk
4rea Code/Phone Number
(925) 833-6644
(Name, Title)
marsha.moore@dublin.ca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes ■ No ❑
Event Description: St. Patrick's Day Shamrock Gala
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ■ No ❑
Was ticket distribution made at the behest Yes ❑ No ■
of agency official?
Date Stamp
A Public Document
For Official Use Only
❑ Amendment (Must Provide Explanation in Part 3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $
Date(s) 03 / 15 1
If no:
Name of Source
If yes:
Official's Name (Last First)
75
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
Number
B. Name of Individual of Ticket(s)I Identify one of the following:
(Last, First) Passes
Ceremonial Role ® Other ❑ Income ❑
Hernandez, Melissa and one guest per FPPC 18942(13) 2 If checking "Ceremonial Role" or 'Other" describe belay:
Made Presentation to visitors from Sister City
Ceremonial Role ❑ Other ® Income ❑
Hu , Sherry 1 if checking 'Ceremonial Role" or °Other' describe below:
Promotion of City -sponsored activities - Sister City
Name of Outside Organization Number
of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
C. (include address and description)
Passes
4. Verification
1 have read and understand FPPC Regulations 18944.1 and 18942. 1 have verified that the distribution set forth above, is in accordance
with the requirements.
Linda Smith City Manager ( u %Zy
�i'n.tur.ofAgency Head or Designee Print Name Title (month, day, year) /
Comment:
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)
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.
Numhar
A. Name of Agency, Department or Unit
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
B. Name of Individual
(Last, First)
Number
of Ticket(s)l
Passes
Identify one of the following:
Mccorriston, Michael and one guest per FPPC 18942(13)
2
Ceremonial Role ❑ Other ® Income ❑
If checking "Ceremonial Role" or "Other' describe below:
Promotion of City -sponsored activities - Sister City
Qaadri, Kashef
1
Ceremonial Role ❑ Other ® Income ❑
If checking "Ceremonial Role" or `Other' describe below:
Promotion of City -sponsored activities - Sister City
Josey, Jean and one guest per FPPC 18942(13)
2
Ceremonial Role ❑ Other 0 Income ❑
If checking °Ceremonial Role" or "Other' describe below:
Promotion of City -sponsored activities - Sister City
Ceremonial Role ❑ Other ❑ Income ❑
If checking "Ceremonial Role" or'Other' describe below:
C. Name of Outside Organization
(include address and description)
Number
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)