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HomeMy WebLinkAbout2026 - St Patricks Day GalaCalifornia 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 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. 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) For Official Use Only Area Code/Phone Number Date of Original Filing: Ticket(s)/Pass(es) provided by agency? Was ticket distribution made at the behest of agency official? Title Ceremonial Role Events and Ticket/Pass Distributions Face Value of Each Ticket/Pass $ Event Description: If no: If yes: Amendment (Must Provide Explanation in Part 3.) Provide Title/ Explanation Name of Source Official’s Name (Last, First) 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 (Last, First) 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 Does the agency have a ticket policy?No No Income Other Other Ceremonial Role Ceremonial Role Income 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) 833-6650 marsha.moore@dublin.ca.gov n 75 Shamrock Gala 03 13 2026 n n City Manager's Office 8 City Sponsored Event/Table Hu, Sherry and one guest per FPPC 18942(13)2 n Speaker at event McCorriston, Michael and one guest per FPPC 18942(13)2 n Promotion of City Sponsored Event Colleen Tribby City Manager Print Clear Docusign Envelope ID: 3D000B2E-66D6-88AF-81FF-F2E914787826 5/5/2026 California Form 802Agency Report of: Ceremonial Role Events and Ticket/Pass Distributions A Public DocumentContinuation Sheet Agency Name If checking “Ceremonial Role” or “Other” describe below: If checking “Ceremonial Role” or “Other” describe below: If checking “Ceremonial Role” or “Other” describe below: If checking “Ceremonial Role” or “Other” describe below: Name of Agency, Department or Unit Name of Individual (Last, First) Name of Outside Organization (include address and description) 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 Income Income Other Other Other Other Ceremonial Role Ceremonial Role Ceremonial Role Ceremonial Role Income Income 3. A. B. C. 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.• • • FPPC Form 802 (2/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) City of Dublin Josey, Jean and one guest per FPPC 18942(13)2 n Promotion of City Sponsored event Qaadri, Kashef 1 n Promotion of City Sponsored event John Morada and one guest per FPPC 18942(13)2 Promotion of City Sponsored event Print Clear Docusign Envelope ID: 3D000B2E-66D6-88AF-81FF-F2E914787826