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K B ~141 Print Name Trtle (Month, Day, Year)

K B ~141 Print Name Trtle (Month, Day, Year)

Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public Document 1. Agency Name California 802 City of West Sacramento Form Division, Department, or Region (if applicable) For Official Use Only City Manager' Office JUN 1 3 2019 Designated Agency Contact (Name, Title) Kryss Rankin, City Clerk · Explanation in Part 3.) Area Code/Phone Number E-mail Date of Original Filing:------­ (916) 617-4500 [email protected] (month, day, year) 2. Function or Event Information 1 Does the agency have a ticket policy? Yes~ No Face Value of Each Ticket/Pass$ Parking@ $ 0 each Event Description: River Cats Baseball Game Provide Title/ Explanation Ticket(s)/Pass() provided by agency? Yes~ No D If no: ______Name of Source If yes: Jacobson, Katy Was ticket distribution made at the behest Yes ~ No D Official's Name (Last, First) of agency official?

3. Recipients • Use Section A to identify the agency's department or unit. • Use Section to identify an individual. • Use Section to identify an outside organization. Number A. Name of Agency, Department or Unit of Ticket(s)I Describe the public purpose made pursuant to the agency's policy Passes City of West Sacramento Recognizing/Rewarding exemplary service by a City City Manager's Office 1 employee or retiree City of West Sacramento Recognizing/Rewarding exemplary service by a City Economic Development & Housing \ employee or retiree Number B. Name of Individual of Ticket(s)I Identify one of the following: (Last, First) Passes

Ceremonial Role D Other D Income D If checking ·ceremonial Role" or "Other" describe below:

Ceremonial Role D Other D Income D If checking ·ceremonial Role" or "Other" describe below:

Number Name of Outside Organization C. of Ticket(s)I Describe the public purpose made pursuant to the agency's policy (include address and description) Passes I Beckman Coulter Promotion of local and regional businesses, economic 1584 Enterprise Bl, WS 95691 \ development and tourism activities within the City Hampton Inn Promotion of local and regional businesses, economic 800 Stillwater Ct, WS 95605 \ development and tourism activities within the City 4. Verification I have read and understand FPPC Regulations 18944. 1 and 18942. I have verified that the distribution set forth above, is in accordance with the requirements. ~ Kryss Rankin City Clerk B ~141 Print Name Trtle (month, day, year)

Comment: ______

FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: California 802 Ceremonial Role Events and Ticket/Pass Distributions Form Continuation Sheet A Public Document

Agency Name City of West Sacramento 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)/ Identify one of the following: (Last, First) Passes

Ceremonial Role D Other D Income D If checking ·ceremonial Role" or ·other" describe below:

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other" describe below:

Ceremonial Role D Other D Income D If checking ·ceremonial Role" or ·other" describe below:

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other" describe below:

,. Number I• C. Name of Outside Organization of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Passes 11 Nuseed Promotion of local and regional businesses, economic 2945 Ramco St, #150, WS 95691 \ development and tourism activities within the City

Lyon Real Estate Promotion of local and regional businesses, economic 3170 Jefferson Bl, WS 95691 I development and tourism activities within the City

Mikuni Color Promotion of local and regional businesses, economic 855 Riverside Pkwy, WS 95605 I development and tourism activities within the City

La Mesa RV Promotion of local and regional businesses, economic 1060 Riverside Pkwy, WS 95605 development and tourism activities within the City

FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Agency Report of: California 802 Ceremonial Role Events and Ticket/Pass Distributions Form Continuation Sheet A Public Document

Agency Name City of West Sacramento 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 Tlcket(s)/ Identify one of the following: (Last, First) Passes

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other" describe below:

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other" describe below:

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other" describe below:

Ceremonial Role D Other D Income D If checking "Ceremonial Role" or "Other'' describe below:

Number C. Name of Outside Organization of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy (include address and description) Passes TOMRA Promotion of local and regional businesses, economic 875 Embarcadero Dr, WS 95605 l development and tourism activities within the City

Venture Management Specialists Promotion of local and regional businesses, economic 681 West Capitol Av, WS 95691 1 development and tourism activities within the City

FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)