HomeMy WebLinkAbout2023 Wine Passport - Signed Form 802California
Form
Agency Report of:
1. Agency Name
Designated Agency Contact (Name,Title)
Date Stamp
E-mail
Division, Department, or Region (if applicable)
2. Function or Event Information
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with the requirements.
Signature of Agency Head or Designee Print Name
Comment:
FPPC Form 802 (2/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
(month, day, year)
802
(month, day, year)
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Area Code/Phone Number
Date of Original Filing:
Ticket(s)/Pass(es) provided by agency?
Was ticket distribution made at the behest
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Ceremonial Role Events and Ticket/Pass Distributions
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If no:
If yes:
Amendment (Must Provide Explanation in Part 3.)
Provide Title/ Explanation
Name of Source
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If checking “Ceremonial Role” or “Other” describe below:
If checking “Ceremonial Role” or “Other” describe below:
Name of Agency, Department or Unit
Name of Outside Organization
(include address and description)
Name of Individual
/DVW)LUVW
Number
of Ticket(s)/
Passes
Number
of Ticket(s)/
Passes
Number
of Ticket(s)/
Passes
Describe the public purpose made pursuant to the agency’s policy
Identify one of the following:
Describe the public purpose made pursuant to the agency’s policy
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No
Income Other
Other
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&HUHPRQLDO5ROHIncome
No
Yes
Yes
Yes
Date(s) ////
3.
A.
B.
C.
4.
A Public Document
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.• • •
City of Dublin
Marsha Moore, City Clerk
(925) 833-6644 marsha.moore@dublin.ca.gov
■300
Livermore Valley Wine Community Wine Passports 07 14 2023 12 31 2023
■Livermore Valley Wine Community (City is Member)
Hu, Sherry and one guest per FPPC 18942(13)2
■
Public Purpose - Promotion of local and regional businesses and economic activities
Linda Smith City Manager
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