HomeMy WebLinkAboutRose Lounge Splatter 2024 SignedAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
1. Agency Name
City of Dublin
or
Marsha Moore, City Clerk
area Code/Phone Number
(925) 833-6644
(if applicable)
marsha.moore@dublin.ca.gov
2. Function or Event Information
Does the agency have a ticket policy? Yes 0 No ❑
Event Description: Rose Lounge - Splatter
Provide Titial Explanation
Ticket(s)/Pass(es) provided by agency? Yes N No ❑
Date Stamp
A Public Document
For Official Use Only
❑ Amendment (Must Provide Explanation in Part3.)
Date of Original Filing:
(month, day, year)
Face Value of Each Ticket/Pass $ 75
Date(s) 09/14/2024
If no:
Name of Source
Was ticket distribution made at the behest Yes ❑ No 0 If yes: Official's Name (Last, First)
of agency official?
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
B. Name of Individual of Ticket(s)/ Identify one of the following:
(Last, First) Passes
Ceremonial Role ❑ Other (♦ Income ❑
McCorriston, Michael and one guest per FPPC 18942(13) 2 If checking 'Ceremonial RoAe'or°Other describe below:
Promotion of City -controlled event
Ceremonial Role ❑ Other E Income ❑
Qaadri, Kashef and one guest per FPPC 18942(13) 2 If checking 'Ceremonial Role°or'Otherdescribe below:
Promotion of City -controlled event
Name of Outside Organization Number
C. (include address and description) of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy
Passes
4. Verification
I have read and understand FPPC Regulations 18944.1 and 18942. / have verified that the distribution set forth above, is in accordance
wi t e re it ents.
Colleen Tribby City Manager 10/23/2024
Sig a ure of Agency Hea or Des g Print Name Title (month, day, year)
Comment:
FPPC Form 802 (2/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772)
Agency Report of: California 802
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.
Number
A.
Name of Agency, Department or Unit
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency's policy
B.
N
Name of Individual
(Last, First)
Number
of Ticket(s)I
Passes
Identify one of the following:
Hu, Sherry and one guest per FPPC 18942(13)
2
Ceremonial Role ❑ Other ® Income
fir checking 'Ceremonial Role' or 'Other' describe below:
Promotion of City -controlled event
❑
Ceremonial Role ❑ Other ❑ Income
If checking"Ceremonial Role' or'Olher describe below
❑
Ceremonial Role ❑ Other ❑ Income
If checking 'Ceremonial Role' or'Olher describe below
❑
Ceremonial Role ❑ Other ❑ Income
If checking 'Ceremonial Role' or °Other describe betow
❑
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 (866/2753772)