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2018 - Disneyland 1-day Park Hopper PassAgency Report of: Ceremonial Role Events and Ticket/Pass Distributions 1. Agency Name City of Gilroy Division, Department, or Region (if applicable) Fire Deparment Designated Agency Contact (Name, Title) Shawna Freels, City Clerk Area Code /Phone Number E -mail 408 - 846 -0204 shawna.freels @cityofgilroy.org 2. Function or Event Information Does the agency have a ticket policy? Yes ® No ❑ Event Description: Disneyland 1 -day Park Hopper Pass Provide Title / Explanation Ticket(s) /Pass(es) provided by agency? Yes ❑ No El t' A % 2 2018 CITY CLERK'S OFFICE GILROY,CA is Document • Pr Official Use Only Provide Explanation in Part 3.) Date of Original Filing: March, 16, 2018 (month, day, year) Face Value of Each Ticket/Pass $ $167 ea Date(s) I -/ _J____j, If no: Disneyland Name of Source Was ticket distribution made at the behest Yes ❑ No ® 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. A. Name of Agency, Department or Unit Fire Department (see attached) B. Name of Individual (Last, First) C. Name of Outside Organization (include address and description) Number of Ticket(s)f Describe the public purpose made pursuant to the agency's policy Passes 42 As special recognition for meritorious service by a City employee 5.3 (g) Number of Ticket(s)/ Identify one of the following: Passes Ceremonial Role ❑ Other ❑ Income ❑ If checking 'Ceremonial Role" or "Other' describe below: Ceremonial Role ❑ Other ❑ Income ❑ If checking "Ceremonial Role" or "Other" describe below: Number of Ticket(s)/ Describe the public purpose made pursuant to the agency's policy Passes 4. Verification /have read and understand FPPC Regulations 18944.1 and 18942. /have verified that the distribution set forth above, is in accordance with the requirements. - --� �- Gabriel A. Gonzalez City Administrator 3/eJ2018 Signature of Agency Head or Desi nee Print Name Title (month, day, year) Comment: FPPC Form 802 (2/2016) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Disneyland Tickets Bebee, Kevin 2 Buessing, Jim 2 Butler, Paul 2 Cooper, Thomas 2 Faddis, Tomas 2 Garrett, Nicolas 2 Guerriera, Joshua 2 Hayes, Steven 2 Lee, Herb 2 Lozano, Daniel 2 MacDonald, Scott 2 MacPhail, Jeff 2 Maibaum, Heinz 2 Main, Casey 2 Nguyen, William 2 Pardini, Michael 2 Peyghambary, Shaun 2 Stelling, Marc 2 Teresi, Kris 2 Valverde, Joshua 2 Wong, Randy 2 Total Tickets Provided 42