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HomeMy Public PortalAbout01-23-12 - Acosta, Jackie, V Agency Report of: Ceremonial Role Events and TicketlAdmission Distributions 1. Aeencv Name Page 1 of - 2 RECEIVED CITY CLEO A Public Document City of Carson/Carson Redevelopment Agency r Division, epartment, or Region (if applicable) Economic Develooment 701 E. Carson Street, Carson, CA, 90745 Jackie Acosta, Administrative Services General (310) 952-1755 I jacosta@carson.ca.us [=unction, Event, or Ceremonial Role Information Title Eddy Awards Description Business friendly cities awards ' .1 Date Stamp + ■ • i. For pflldal Use Only I3 Amendment (Mat provide expfanailm in Part s.) flat# of Original Filing: (monthy, yseq Face Value of Each Admission $ 320.00 Date(s)I 1 1 3 1 11 1 1 Ticket(s)tAdmission(s) provided by agency? Yes p No p If no: Name of Source Was the distribution to persons identified below made at the behest of an agency official? Yes p No p If yes: Olftctal's Name (Leaf, First) ane True The identity of recipients) and the explanation: Name • Check shp income. bgx f( the agarcy *Moil clal mik admission a� (Lasi, First) Nuletib[t pf Ag6ncy ta,tablq IncOme. Hthe agency pfNclll.0ortalmed d deraminlal rdhi O,rgarllzatlori Adrnbslgn[sil Offielgl � lde des 'Igo.pioy4 ert.-. . �on. • lr not Incams; sacrlbe the PgbBc pGrpbee, lneleding (HaIhQ, Addr�ss; boshriptloh) TICket s) i aerirrybnlsl roleq, {Ierforinsd tri an, egsncy cRlclal, Individual, or e as lien. Yes p Income Dear, Jim 1 No 0 El Yes p Income Ruiz-Raber, Julie 2 No p I] Yes p Income Gipson, Mike 2 No 0 p Yes p Income Davis -Holmes, Lula 2 No ❑ El Yes p Income No p p 3. Verification 1 have read and understand FPPC Regulations 98944.1 and 18942.1 have verified that the distribution of admisslons, set forth above, Is in accordance with the provisions. /&./ C David Biggs City Manager 1-19-12 pnature of Agency Ha d ar Designee Pdnt Nam* Tike (month, day, year) Comment: (Use this space or an attachment far any additional Information Indudtng amendment explanation.) FPPC Form 802 (2111) FPPC Tall -Free Helpline: 8661ASK-FPPC (88612275.7772) f • i Agency Report of: Ceremonial Role Events and Ticket/Admission Distributions 1. Agency Name City of Carson/Carson Redevelopment Association Divlslon, Department, or Region (ifapplicableJ Economic Deve.ropment 701 E. Carson 90745 Jackie Acosta, Administrative Services General (310) 952-1755 j Jacosta@carson.ca.us 2. Function, Event, or Ceremonial Role Information Title Eddy Awards _ Description ,Business friendly cities awards Page 2 of 2 A Public Document Date Stamp7F,,r0ffid.71Use0.WIy © Amandrnont (Must provide explanallon In Part 1) Date of Original Filing: (many day, year) Face Value of Each Admission $ 320.00 Date(s)11 1 3 1 11 1 Ticket(s)/Admission(s) provided by agency? Yes ❑ No ❑ If no: Name of Source Was the distribution to persons Identified below made at the behest of an agency official? Yes p. No p If yes: Official's Name (Last, Firs() and True The identity of recipients) and the explanation: Nettie ' + Check toe Income beg It the agency olnclp} Clasips admNialon as "[Capt, karst} F t3u4ntaer of Ageltcy texapla}ncomd: If the ageOdy. official pi6rined a ceroinonfol rale, t Pr Admfgbfoq(su OHfclai also provide: d deserlpilon. , drga0lXation t (AAsrna, Adorasr, bdecrlpllonl Tickal[a} • If not Inconia, ddscrlf» the public pu�poear Including' Ceremonial roles; paifgrmed by aii pgencyotSiglaf, IWI.vtdual, or ., oigarilzatlon. Yes El Income Cruz, Zarah 1 No p 0 Yes p Income Waite, Barry 1 No ❑ p Yes p Income No p ❑ Yes p Income No p p Yes p Income No p E3 3. Verification 1 have read and understand FPPC Regulations 18944.1 and 489421 have verified that the distribution of admissions, set forth above, Is In s rdance with the provisions. G W David Biggs City Manager 1-19-12 Signature of Agency Head or Designee Pdnt Name THIe (mw1h, deg year) Comment; (Use this space or an attachment for any addlllonal Information Including amendment explanation.) FPPC Form 802 (2111) FPPC Toll -Free Helpline: 8681ASK-FPPC (866127a-3772}