The URL can be used to link to this page

Home My WebLink AboutFPPC - Form 801 (blackberry tablets) 2012Gift to Agency Report A Public Docume 1. Agency Name City of Seal Beach Division, Department, or Region (if applicable) Street Address 211 Eighth Street, Seal Beach, CA 90740 Area Code /Phone Number E -mail 562 - 431 -2527 jingram @sealbeachca.gov Agency Contact (name and title) Jill Ingram, City Manager 2. Donor Name and Address FEB 21 2013 CITY CLERK I( OF SEAL BEACH GIFT TO AGENCY REPORT For Official Use Only ❑ Amendment (explain in comment section) Date of Original Filing: (month, day, year) ❑ Individual I ❑x Other League of California Cities Last Name First Name Name 1400 K Street, Suite 400 Sacramento CA 95814 Address City State Zip Code The League of CA Cities is an association of CA city officials working together to share resources & information. If "Other' is marked, describe the entity's business activity (if business) or its nature and interests. If applicable, identify the name of each source and the amount(s) solicited or received by the donor for this gift: Name Amount Name Amount 3. Payment Information Date and Amount of Payment (other than travel) 09 -07 -2012 $ $1,593 (month, day, year) (Round to whole dollars) Travel Payment Information (Round to whole dollars) Location of Travel N/A N/A $ N/A $ N/A $ N/A $ N/A $ N/A Date(s) of Travel Transportation Expenses Lodging Expenses Meal Expenses Other Expenses Total Expenses Provide a specific description of the nature and use of the payment for official agency business: 4 -32GB Blackberry Tablets (estimated value of $249 each) & 3 -16GB Blackberry Tablets (estimated value of $199 each) Identify the officials for whom the payment was used: SEE ATTACHED Last Name First Name Last Name First Name 4. Verification Title Title Department./Division Department./Division 1 have determined that it is in the interests of the agency to accept this gift and use it for the official agency business described above. I 1 City Manager �- Signature o Agency He (d jor esignee Print Na a Title (i onth, d , year) Comment: (use this s or an attachment for any additional information.) See attached list of individuals to whom this donation was given. FPPC Form 801 (June /08) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) o�� Report `�,u��=��u��.~ Instructions APublic DocymeDf This form is for use by all state and local government agencies ho disclose payments made io the agency when the payments provide a personal benefit toan official of the agency. Examples may include travel, meals or other benefits. Under certain c|noumzbsnnma' these payments will not result inm gift ho the official, but will be considered a gift bo the agency. The payments must be used for official agency business and must meet other requirements that are set out in FPPC Regulation 18044.3, which is available unthe FPPC vvebsiha m/wwfpc.oe.Awx When to File This form must be filed within 30days of the use of the payment. Reports may be faxed, mailed, personally delivered or e-mailed. Where to File State Agencies: File this form with the Fair Political Practices Commission ("FPPC"). 428 J Street, Suite 02O' Sacramento, CA 05814. Fox: 916-322-0880 E-mail: FormGO1@fppo.ma.gov Local Agencies: File this form with the official that maintains the agency's statements ofeconomic interests (Form 700). Wmbsite Posting: Each agency that maintains a vvebmite must also post the form or the information contained on the form nn its mmbsite within 3Odays of the use of the payment. Local agencies that donot maintain ovxaboibe must forward the form to the FPPC for posting on its vvebnite. Part 1. Agency Identification List the agency's name and address and the name nfan agency contact. Mark the amendment box ifchanging any information ono previously filed form and include the date of the original filing. Part 2~ Donor Information Disclose the name and address of the donor, If the donor ia not on individual, identify the business activity or nature and interests of the entity. K the donor received payments from other sources that were used in connection with the activity, disclose the name and payment information for each source. Part 3. Payment UMformation Report the date and amount of each payment. For travel payments, also disclose the |noadon(a),and a breakdown uf the expenses. Provide ospecific description of the use of the payment and the intended purpose. List each agency official for whom the payment was used. Example: Abuaness entity paid for anagency employee bz travel to attend an informational seminar on solar energy projects inVVashinQ1onD.C. The description should read: "Travel to attend an EPA co- sponsored solar energy seminar held in Washington, Part 4. Verification The agency head or his or her designee must sign the General Information Gifts to agencies nn/ot meet the following requirements: • The agency head or designee must determine and control the agency's use of the payment. • The payment must be used for official agency business. • The donor may identify a purpose for the gift but may not designate by nome, title, o|oas or otherwise, an official who may use the payment. • The agency official who determines who will use the payment may not select himself or harse|f. Travel payments must also meet these requirements: • A payment for travel may not be used bya state or local elected officer or by the state, county, and city officials who hold positions ||nhad in Government Code Section 8720O. • A payment for travel may not exceed the agency's own reimbursement rates for travel, or the State per them or IRS reimbursement rates if the agency has no policy. • The agency head or designee must preopprnve travel paid for bya third party before travel commences. Travel payments made bva federagovernmmntagency in connection with education, training, or other inter- agency For further information onfiling this report or for general information, contact the FPPC. FPPC Form 8N(June/08) Gift to Agency Report –Attachment California Form 801 La—st _Na_ -me Deaton Firs - t - N - am - e Title Department/Division Type of Donation Ma 32GB Blackberry Tablet Levitt Michael C ouncilman _q0tLCouncJI 32GB Blackberry Tablet __Uiller Gary - Ma)pr_____ City Council 32GB Blackberry --Tablet Shanks I Gordon Councilman q 6GB Blackben� Tablet Sloan — ------ - -David Councilman City Council _32GB 11 Blackberry_j�blet Two 18GBBlackberry tablets were also donated to: Interval House Crisis Shelters ATTN: Ms. Kelly Nguyen 6615 East Pacific Coast Highway, Suite 170 Long Beach, CA 90803