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Tickets Provided byAgency Report

RECEIVEDA Public Doc&Tn\i CLERK TICKETS PROVIDED BY

AGENCY REPORT

1. Agency Name Date Stamp

City of Pomona 2011 EP 29 PM 5' 25 911 •

For Official Use OnlyDivision, Department, or Region (d applicable)

Human Resources

Street Address

505 S. Garay Avenue, Pomona, CA 91766Area Code /Phone Number E -mail

1 Amendment (Must explain in Part S)

909)620- [email protected] of Original Filing:

month, day, year)Agency Contact (name and title)

Sandra Piva, Human Resources Manager

2. Event For Which Tickets Were Distributed

Date(s) of Event: 09 1 _03 / 11

10 / 02 / 11

Description of Event: Los Angeles County FairFace Value of Ticket: $

12 -14

Agency Event Yes x No (Identify source of tickets below.)

Name of Outside Source of Ticket(s) Provided to Agency: Los Angeles County FairNumber of Tickets Received:

1244Ticket(s) Provided to Agency: X Gratuitously Pursuant to Contract

3. Agency Official(s) Receiving Ticket(s) (use a continuation sheet for additional names)

Name of Official

INumber

IState Whether the Distribution is Income to the Official or

Last. First) of Tickets Describe the Public Purpose for the Distribution

Refer to attached list of individuals

4. Individual or Organization Receiving Ticket(s) (Provided at the behest of an agency official.)

Name of Behesting Agency Official: Refer to attached list of individuals who received tickets Employees /Commissioners

Name of Individual or Organization: City of Pomona

Description of Organization: Munic

Number of Tickets: 2 /each

Address of Organization: 505 S. Ga AvPCA 91766Number, and Street City Slate Zip Code

Purpose for Distribution: (Describe the public purpose for the distribution to the organization.)

Received gratuitously.

5. Verific Ion

1 have armined the the dist(b ton of tickets set forth above is in accordance with the provisions of FPPO Regulation 18944.1.I

Susan Paul Human Resources Director 09/29/11

Signature of Agency Head or Print Name Title ( month, day, year)

Comment: (Use this space or an attachment for any additional information including amendment explanation.)

FPPC Form 802 (Feb /09)FPPC Toll -Free Helpline: 8661ASK -FPPC (866/275 -3772)

LA COUNTY FAIR TICKET DISTRIBUTION

Em are allowed to pick up for their own tickets unless they bring appropriate release form.Check ID before releasing tickets.

Last Name

ABDUL - RAHMAN

First Name

CAROLINE

of Tickets

pc-

Date ISignature

1- L1640vABRAMS YVONNE'

ABUNDIS MARIA

ACEVES

ACOSTA

DANIEL

DEBRA Z 3'

AGUTAR RICHARD

AGUILAR M. MAYELA O\ 3

AGUIRRE TIM

ALCALA III EMILIO

ALCALA JR. EMILIO

ALCANTARA CARMEN

ALCARAZ JOSE

LIa

ALEMAN - RAMIREZ JORGE

ALEXANDER PAUL

ALLISON VELICIA

ANDERSON ROBERT

ANGULO NORMA

ANTUNEZ RODOLFO

ARENDS ILONA I

ASCENCIO MARINA

ASTORGA HECTOR

AVILES FRANK

BACA TOM

BAILEY JODY

BAKER ROBERT

BAKER TERESA

BALDONADO INORBERT L

I

Last Name First Name of Tickets Date ISignature

BOSTROM ALYSSA

BO DANEI7E

BRANNON MELISSA Z ObIStI

BRAUN MAXINE

BRINGAS

BROWN

MELISSA

DEON

i I ( II (

BURKETT LAURIEQ

BUTLER

BYL

JAMES

TRACY rl;BYRNE LINDA

CABADA JAVIER

CABALLERO CARLOS

CABALLERO CHRISTOPHER

CABRERA JOAQUIN pO

CALKINS IMARILYN

CALLAGHAN KAREN

CAMACHO

CAMPBELL

NORMA

SANDRA

CANO MARTIN

CAPOGNI DON

CAPRARO CAMMA

CAPRARO PAUL2

CARDENAS JESUS

CARMONA SYLVIA

CARRIGAN

CARVER

CASILLAS

CASTILLO

SONIA

JULIE

SERGIO

JOSEPH

EC'3I •

CASTILLO RUBEN

Last Name First Name I#ofTickets Date Signature

CORTEZ MARIA

COTE DON

CRAVENS JAMES Z 3LCROSS MABEL

CRUZ ALICE

CRUZ ARTURO

CRUZ JAVIER S• Z T /

CRUZ JAVIER J,

CRUZ LUCY

CURIEL ROBERTO

CURRY ALEX

DAMICO

DAVID

COLLEEN

ROBERTA

DAVIS STEVEN

DE HATE ERIC Z O /

DE LA ROSA !'

JORGE71i`•o 3/ //

DE LA VEGA THOMAS

l

DE LEO JOSEPH

DEASON

DEFRANK

DEREK

BENITA 3IIDEPOLIS JOHN L

Ew

DEVEE

DEWALD

ROBERT

JOHN

DIAMOND SHAUN

DIAZ LUIS

DIAZ SALVADOR

DICKEY MARK

DIMALANTA RICHARD

DINH IBILLY

i i • i0

Last Name First Name of Tickets Date Sign re

FOSSETT LETITIA

FREEMAN GREG

FUENTES RUBEN

GARAY RUDOLFO Zf'9 /

GARCIA JESUS

GARCIA JOSE

GARCIA JULIE

GARCIA MANUEL

GARCIA INANCY

GARCIA NANCY

U _ o-

GARIBAY ALMA

GARIBAY RAUL

GARMAN- PAMELA _

I

GAUDIOSO MADELINE

GIBSON JAMES

GIRON JOHN

GIRTEN ELEANOR

fi5- V

GLUBA MARK

GOMEZ DANIEL

GOMEZ MICHAEL

GOMEZ ORTEGA JORGE

GONZALES MICHAEL 2 n

GONZALES SEAN

GONZALEZ LILY Z y31'llGONZALEZ NOHEMI 311

GONZALEZ TINA

GRAHAM BRETT

GRANDE GERARDO

7Z j1GRANT JEFFREY I

i i • i0

Last Name First Name of Tickets Date 1 Signa

HERRERA ERIKA c2 1,14/1HERRING DOREEN

HESS SCOTT

HOBBY MONA

HOLTZ JENNIFER

HOOKS GISLAINE

HORTON NICHOLE

HSU CHRISTIAN pZ

HURST JEANIE

INTERLICCHIA JASON

IPPOLITO LAURA

IWIG ROGER

IZABAL ROBERT

JACKSON DAVID

JAUREGUI LISA

JENSEN BLAKE

JENSEN CHAD

JENSEN

JIMENEZ

JIMENEZ- ROBLES

JOHNSON

NANCY

DANIEL

LANI

BEVERLY

JOHNSON BRADFORD

JOHNSON DARYLL

JOHNSON TRAVIS J - / / SsJONES KIMBERLY

JOSEPH

JUAREZ

JUNG

THEOPHILUS

CECELIA

HARRY

KAY SHEREE 2

11

Last Name

LOPEZ

First Name

BEATRIZ

of Tickets Date Signature

LOPEZ ISHMAEL

LOPEZ

LOPEZ

JESSE

JOHN

LOPEZ LETICIA

LOPEZ LUPE

LOPEZ RICHARD

LOWRY LINDA

LUNA ANTHONY

LYCETT-BUSH

LYTLE

MACDONALD

CAROLE

NANCY

ADAM

9oiuP I3 11

64l••• CCC

MACHADO RICHARD

MACIAS MARIE

MACKAY TIMOTHY

MADRID IRENE

MALLORY MORGAN

MANGRICH KATHLEEN 3MANN

MARQUEZ

ROBERT

DAISY

MARTIN STEVEN

MARTINEZ DAMIAN

MARTINEZ GABRIEL

MARTINEZ

MARTINEZ

JACKIE

JAMIE

Z 8 .3(- Il

MARTINEZ RICHARD

MATA JUAN

MATAVAO EPATI

MATAVAO SOPA

11

13

Last Name First Name of Tickets Date Signature

MUNiZ CESAR

MUNOZ VANESSA

MURILLO

NEADERBAOMER

ALFREDO

MICHAEL

NELMS SHARI

NEVAREZ ROBERT

NGO DIANA

NGUYEN

NICOMEDE

MY

KENNIE

O'MALLEY PATRICK

OBENCHAIN

OLIVER

0LIVIERI

THOMAS

ROBIN

MICHAEL

ORELLANA SHERI

ORTEGA DAVID

OSBURN DUSTIN

OSMUNDSON MICHAEL

OUTLEY

OVIEDO

ROZALUTA

RUBEN

PADILLA EDGARD

PADILLA

PAGTAKHAN

PARASKA

PATINO

THERESA

CHRISTIAN

STACIE

SI]IFREDO

PAUL SUSAN

PAULSON RANDALL

PAZ

PERAZA

STEPHEN

CARL

PEREYRA DAVID

13

15


RICHARDSON DANIEL

RICHARDSON

RICO

JAMES

ANDREA

RIDEAU DAMON

RILLORAZA ALEXANDRO

RIOS ERNESTO

RIVERA CESAR

RIVERA

RIZZO

RALPH

MARY PAtAROBBINS LOIS 10ROBLEDO MARK

ROBRIGADO ANDREA II PQ_{

ROCHA CARRIEU

ROCHA GENOVEVA

ROCHA LUIS

ROCHA ROGER

RODRIGUEZ ADRIAN

RODRIGUEZ

RODRIGUEZ

BARBARA

ELIZABETH

RODRIGUEZ GREGORY

RODRIGUEZ HECTOR

RODRIGUEZ MICHAEL

RODRIGUEZ RYAN

ROMAN TIMOTHY

ROMERO BENJAMIN

RUIZ

RYAN - FLUKER

RYAN ;

BAMBI

SALCEDA JUAN

D1USALCIDO ALBERT

15

17


STANLEY

STEVENSON

PATRICE

TREVOR

SrIRES GLENN

STONE MATTHEW

STONE SHAWN

SUAREZ JOHN

SUESS JAMES

SUGIKI

SUTHERLAND

SUTTON

GLENN

BRENDA

LAWRANCE

TAFOYA MICHAEL

TANADA SUSANn

TANG MARIA

TAPIA ABEL ZQ

TAPIA ADAM

TAYLOR JAMES

TEAGUE

TERRELL

THIBAULT

TONTHAT

ALLISON

HOWARD

NOEMI

CAROLINE

g /3i///f

TORRES ANGELA

TORRES FELIPE

TORRES MANUEL

TORRES REYES

TSAI

TUCKER

RAUL

TERRI

WILLIAM

TURPIN JENNIFER

UGARTE DIANA

UGARTE TIMOTHY

17

19

Last,Name First Name of Tickets Date Signature

WATKINS DANIEL

WATKINS ROSE

WEAVER

WEAVER

DAVID

JOSEPHCl

WEIDNER LINDA

WESTERN

WHITFIELD

PAUL

PATRICIA

WILKIN TIMOTHY

WILLIAMS MYRA

WILT

WI

WONG

ANICE

DEBORAH

JOAQUIN L I 511

YBARRA LISA

ZANE KAREN

Count: 534

19

v ITABUL HAI ROBERT of tickets Date Si nature

AGUILAR MARTHA

ALDECOA ALEJANDRA

ANABTAWI NANCY

AVILA COLLETTE

AYALA IACKELINE

BARAWID MELENCIO

BARKLEY SYLVIA

BECHET LEONARD

BETKEY SHERYL

BISCAYA JOE

BLAKE KENDRA

BOTTS DELIA

BOWLER JOHN

BRIONES REYNALDO

BRISENO JACQUELINEV

CARRENO GABRIELA -

CASEY - AGGERS MAUREEN

CASILLAS YVETTE

CASTILLO MARSHA

CASTRO PRIMITTVO

CESENA RICARDO

CHAVEZ JOSE

CHAVEZ JUAN

CHEN CHI

CORONA MARIA

Count: 104

vJ ,Dci6,pNk

CUMMINGS DARRELL

L Chrlslrnn

lZof

DE ALBA ROSA

DIAZ VLADIMIR ir

DYE JEFFREY

ELMORE ROBYN

ESPINOSA DAMIEN

ESPINOSA GERTRUDE

FANCE T DEBORAH

GAETA ROSIE

GALLEGOS RAMON

GARCIA MARIA

GARCIA MARIA

GONZALES SOCORRO

GOVER LESLIE

GUSS JAMES

GUTIERREZ SALINA

GUZMAN MARIA

GUZMAN VALERIE

HAMILL GREGORY

HARO PATRICIA

HARRIS JOHN

HAUPTMANN FRANK

HERNANDEZ ANNETTE

I 1

HERNANDEZ LANAE

HERNANDEZ VANESSA

HERNANDEZ DE CUEVAS MARTHA

HOANG KIM

Land a, poi5\IL Chrlslrnn

lZof

q 15111

a c IhSlkl

1 «Iq 2,

HOLYFIELD SAMUEL

HOUR SOK

MARRA PEGGY

JOHNSON SANDRA

JUAREZ PRISCILLA

Last Name First Name

LEWIS ANDREW

LOPEZ -HARD WILFRIDO

LUNA KAROL

MACIAS CLARA

MARES CARLOS

MAR UEZ GERTY

MARTIN DELANAC

MARTIN DELANA

MC CARTHY TERRENCE

MC CORMACK DOUGLAS

MC DOW DONNA

MCGREGOR LIZEITE

MEZA KAREN

MONDRAGON SARA

MONTAGUE KENNETH

MUNOZ SILVIA

MURILLO EDGAR

MURILLO ZORAIDA

NEWELL DEBORAH

OLACHEA CHRISTINA

OLIVA MARVIN

Lopmz, Pablo 2 911 -

Z Tic 4 (

v 9 /is --CAY-Alc>

OROSCO CRYSTAL

PASINI CHRISTOPHER

PATINO SDI

PENA MARTHA

PEREZ LILIANA

POOL SINDY

RODRIGUEZ MARIA

ROSS KIUESHA

SAMSON ROSA MARIA

SERPAN KENNETH

SHOEMAKER GARY

SMITH JOHN

SMITH MELISSA

SUAREZ -MUNOZ CHRISTINA

TAYLOR JAMES

VARELA AMY

VELASCO CARMEN

VONG DANNY L

WASHINGTON BETTY

WELCH SHARON

WHITE MARILYN

WOOD KENNETH

WRAY STEVEN

YEH AREN

ZENDEJAS LAURA a- GI (

W\4xN aNnk I °

Last Name First Name of tickets Date Si nature

BAKER JOHN

BARAIAS JUAN

BEARDSLEY WILLIAM

BERGER CAMILLA

CERVANTEZ OMAR

CORRALES MARIO

DE LA ROSA JUAN

DRAKE DANNY

DUENAS DARLENE

FIGUEROA ALDO

HERZOG GENEVIEVE

l

IBARRA PEGGY

JIMENEZ PORFIRIO

KEENE ANGELINA

KILCOYNE KEVIN

LARIOS CECILIA

LEW CAMERON

JG

MACIAS CLARA

MARTIN DELANA

MATAVAO ULA

MENDOZA ROGELIO

ORNELA MONICA

PALATINO ANNE

PENA MARTHA

RAMIREZ CRISTIAN

TAMBURRO MELODY

Mul y CNRfs A 9 //y 9 7-

W' V

AUTHORIZATION TO RECEIVE L.A. COUNTY FAIR TICKETS

The employees listed below authorize 4y'eVj eV 1 to pick uptheir allotted Fair tickets from the Human Resources Department.

Print Name) Signae

Print Name) Signature)






I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to the above employees.

Print Name)

Date:

bSignature)


The employees listed below authorize AN , 1 Lcie - I to pick uptheir allotted Fair tickets from the Human Resources Department.

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Date: 91111SP/


The employees listed below authorize lE/l2. EGG S6 >.

their allotted Fair tickets from the Human Resources Department.

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I understand that I am responsible for the safe eeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to the above employees.

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Date: 7 —

to pick up


The employees listed below authorize 141mer to pick uptheir allotted Fair tickets from the Human Resources Department.

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and distribution of Fair tickets

nsibility if these tickets are lost

Mll"Wnil IIIIM101

Date: 9 le I

ible for the safekeepingnnel. I accept full respoto the above employees.

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The employees listed below authorize i ")Igl11 560Y to pick uptheir allotted Fair tickets from the Human Resources Department.

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Date: 9 — 4 -11


The employees listed below authorize 6 . N WK S to pick uptheir allotted Fair tickets from the Human Resources Department.

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I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to th above employees.

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The employees listed below authorize 9. 3ADQW--s — to pick uptheir allotted Fair tickets from the Human Resources Department.

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full responsibility if these tickets are lostmployees.

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AUTHORIZATION TO RECEIVE -,L.A. COUNTY FAIR.TICKETS

The employees listed below authorize \&AAi'z .jS 1 E- 11z2 to pick uptheir allotted Fair tickets from the Human Resources Department.


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Date: 9 1 I l 1


The'employees listed below authorize to pick uptheir allotted Fair tickets from the Human Resources Department.

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understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsi ' ity if these tickets are lossbefore II am

ableto deliver ahem to the above employees.

7rfciil Y e-z -aoL —Print Name) ' ( Signature)

Date: / —/ — /,/


The employees listed below authorize Ai <dia Vt ,e jaA2, to pick uptheir allotted Fair

tickets fromthe Human ResourcsDepartmen

J ,v r 2 a AlPrint Name) ( Sig atur


Ci"'' /I - > / a -/KPrint Name) W ature)

J)Aoib - SAtK , o4Print Name)

Print Name)

L, Aydro LevUavePrint Name)

J2SvSPrint Name)

I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibili if these tickets are lostbefore I am able to deliver them to the above employees.

7i +U D yi/GZci eLPrint Name) ( Signature)

Date: 7 - /— //

ignature) IL


The employees listed below authoriz d to pick uptheir allotted Fair tickets from the Human Resources Department.

a+ i. e 2Print Na(me) ( Si atur







I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to th e above employees. / ,

Q


Date: / 1112WI


The employees listed below authorize /V0/' /- to pick uptheir allotted Fair tickets from the Human Resources Department.

Print Name)

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Signature)

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ArW.P ,el &Icl Yac o

Print Name)

Date: 3 ?Ull

Signature)

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The employees listed below authorizetheir allotted Fair tickets from the Human

P6 re D iomay 30z-gGResources Department. _

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to pick up

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I am responsible for the safekeeping an distribution of Fair ticketsabove personnel. I accept full responsibility if these tickets are lostdeliver them to the above employees.

u)j G, HI understand that

designated for thebefore I am able to

Print Name)

Date: U'3y"

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The employees listed below authorize Y'Lw tVU ,EfrtlD,e, to pick uptheir allotted Fair tickets from the Human Resources Department.

Print Name) U ( Sign

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Date: Z /3////


The employees listed below authorize S ye- 1Wi7GeiPi to pick uptheir allotted Fair tickets from the Human Resources Department.

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hl"779 4 B4Ar'CARPrint Name)

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Date: V /. / / / /

Signature)


The employees listed below authorize S-4UL Mt4 to pick uptheir allotted Fair tickets from the Human Resources Department.

Ci9 v its f/ ia Ld_ ( J


Ai//t6 FT iD6Print Name)

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s .r7`/1,;6,--Print Name)

Date: o13,W P


The employees listed below authorize %-)their allotted Fair tickets from the Human Resources

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Print Na e)

ry



Date:


The employees listed below authorize n4(14, PI to pick uptheir allotted Fair t' kets from the Human Resources Department.

Print Name) Signature)/








Name) ( Signature)

Date: 3 / / /



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4. yrLIZ SPrint Name)

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PAUL FERO NOEZ-Print Name)

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Signature)

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Date:


The employees listed below authorizetheir allotted Fair tickets from the Human Resources

Name) Signatu

to pick up

Prin(Name) ( Signature)


Print Name)

Print Name)

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Signature)

Signature)

Signature)



Date: OY1/


The employees listed below authorizetheir allotted Fair tickets from the Human Resources Department.

Print Name)

V;: Z-Print Name)

Pr-in -Name)

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Print Name)

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to pick up

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ignature)Zt c cSignature)

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Date: ?/ Q



to pick up

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f6l d l /LTCI ey,Print Name)

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I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am ablE to deliver them to the above employees.


Date: 11 ;?$I"

C,-S ture)



2ioryme-- Uri hgPrint Name)

WVAI-e- l,ePrint Name)

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sa cam: 6- uT -7WL- -

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to pick up

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Date: V, n



2 ,w ,, (Lo S40MPrint Name)

1 I_iS0. JQ,tl,ffu;

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MONICA \&MalhPrint Name)

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Date: ?" aII

Signature)



to pick up

AuW"I`Print Name) ( Signature

oMARIA TitrlGPrint Name) ( Signature)

N1IGHALL ELSPrint Name)

Print Name)

elf• aaPrin Name)

Print Name)

Print Name)

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amgL


Date:

Signature)


The employees listed below authorize Avs ,Ce1G to

pick up their allotted Fair tickets from the Human Resources Department.

Two Fair Tickets

Print Name)

KimberlyPrint Name) re)

Print Name)

Print Name)

Signature)

Signature)




I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility these tickets are lostbefore I am able to deliver them to the above

employees

Print

Name) U (

Signature)

Date: hl 11


The employees listed below authorize . Pk-S to pick uptheir allotted Fair tickets from the Human Resources Department.


ANOrzEW warm. L"OL(I









Date:



yRJ acs NVIS!nPrint Name)

N&IITW, a - 9 0 , 10121041M

L.Mint Name

to pick up

Print Name) ( ignLure)

Print Name)

Na

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Print Name)

re)

re)

I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full rpsl?onsibility if these tickets are lostbefore I am able to deliver them to the above emoloVed! /

tiyvyV L A LoyA M-

Print Name)

Date:

Signature)




M ," 6Pii-razA-1 5;:.Print Name) ( S gnature)


poih O \%V-crPrint Name)

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Print Name)

V "Signature)

Si

71XSignature)


understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibilitybefore I am able to deliver them to the above er

Print Name)

Date:

if these tickets are lost


The employees listed below authorize & 4 --Y i L /c y 60 to pick uptheir allotted Fair tickets from the Human Resources Department.

xPrint Name) ( Signature)

R< AAPCIPrint Name) Signature)

lUiE 4. L2r2Print Name) nature)

Pr' Name) ( Si nat


Print Name)

Print Name)

Signature)

Signature)



Date: Y -3 (-


The employees listed below authorize ,2/ 254e to pick uptheir allotted Fair tickets from the Human Resources Department.

Print Name)







I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if use tickets are lostbefore I am able to deliver them to the above emplovees.

Print Name) ( Sign

Date: 0


The employees listed below authorizeth allotted Fair tick is from the Humar

n 5

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Print Name)

All It LPrint Name)

D " ( I l t l l WPrint Nam

Print Name) nat

Print Name)

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lFA LIOPe z

nature

I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to the above employe


Date: y( —

toiynawic/


The employees listed below authorize AS o

their allotted Fair tickets from the Human Resources Department.to pick up


Print

Name)VEPet"L Sr//lJPrint Name)

Print Name)

Print Name)

Print Name)

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c

Signature)

Signature)

Signature)

Signature)

Signature)


Print Name) eure)Date: ' ( — I


The employees listed below authorize 02017 to pick uptheir allotted Fair tickets from the Human Resources Department.

ymon 0i1Print Name)

Print Name)

Print Name)

Print Name)

Print Name),

Print Name)

Print Name)

Signature)

Signature)

Signature)

Signature)

Signature)

Signature)


Print Name)

Date: Al ) I


I-A.*JAC #eoe kAo z_

The employees listed below authori 1(af

their allotted Fair tickets from the Human ReSOI

yzz &kt/ Aces bPrint Na e)

Print Name

JoPrint Name)

to pick up

PrintName) ( Signature)

C onrr4l)


dEZT GLlEi/'.PE

Print Name)

Proft'Napfie)

I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets are lostbefore I am able to deliver them to the above er~'

Lana %, Lnand Uoaf1,I Ln 1C

Sul LltYvr—

PrintNane)

Date: SIQ DQ iY h L , 0 1

S!0ature)


The employees listed below authorize !/ Atheir allotted Fair tickets from the Human Res

c.

e r IM z

Print Name)

i

Print Name)

John S\ (6Print Name)

Print Name)

10 Quy uPrint Name)

S- e-YA `Print Name)

f wAXI l kt,$4Print Name)

E; 1 -ft0 /AAIpEZ to pick upources Deoattment.

Signature)

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A2 /!1grfature)

1

Signature)

J-Signatur'

I understand that I am responsible for the safekeeping and distribution of Fair ticketsdesignated for the above personnel. I accept full responsibility if these tickets,are lostbefore I am able to deliver them to the above employees.


Date:


The employees listed below authorizetheir allotted Fair tickets from the Humai

int Name)

PIcint Name)

Print Name)

r I

Print Name)

1AA)" M5N4A) aFZ to pick upi Resources Department.

nat e)

Signature)

Signature)

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x,46,, H4 rrKw SPrint Na e) ( Signature)

Print Name)

Print Name)

Signature)

Signature)



Date:


The employees listed below authorize _their allotted Fair tickets from the Human

1 yxlPrint Name)

Daisy Mci g uvaPrint N me) Signature)

to pick up







E j (fLli E S app') awv,Print Name) ( Signature)

k0C US

Date: ( /(, / z




Print Name)

Print Name)

Print Name)

Print Name)

Print Name)

Print Name)

Signature)

Signature)

Signature)

Signature)

Signature)

Signature)


MA(ZINpA Ac5;r - Pnc;C)Print Name) ( Signatu e)

Date: Q / F /(F 111


The employees listed below authorize d Y\F-yj r-nk-/ to pick uptheir allotted Fair tickets from the Human Resources D art ent.

t cPrint Name) ( Signal

Print Name)

1 1GH- Mr -- I rsPrint Name)

Print Name)

Print Name)

Print Name)

Print Name)

Signature)

Signature)

Signature)

Signature)

Signature)

Signature)


Print Name) ' ( Signature)

Date:


The employees listed below authorizetheir allotted Fair tickets from the Human Reso

r.:Print Name)

to pick upurces Department.

Signature)

t6 cqer7 - F - f - 6,q, cL, . e --


AbAVA t1G ISANI£L

Print Name) ( Signs re)

sa . naraw _ . L _ WOVi!Imne Egg Z'

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a(w)Print Name)

Signature)

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Print Name) (' gnature)


Print Name)3d- -eL "

Signature)

Date: %— l —

s

Fair Tickets Sign -Out SheetCommissioners

First Last of Tickets Date Signature

Candace Barry 2Q

Daryl Beans 2

Antonia Brookshire 2

Rochelle Bryant 2

Diana Butcher 2

Andi Cam o none 2

Manuel ICastillejos 2

Kenneth Coble 2p

s

Dena Davis - Island 2

Frank Delgado 2

Douglass Dorado 2

Peter Dumaual 2

Demecio Mitch Elias 2 C7 /

Juan Carlos Garcia 2

Ethel IGardner 2

Carlos Go tia 2

Anthony Granillo 2

Valerie Guzman 2

Leslie IHedges 2

Maricruz Hernandez 2

Mary Hurtado 2

Arturo Jimenez 2

Kimberly Johnson 2

Kathleen liones 2 I L

Bao Tam Le 2

Page 1 of 2

Fair Tickets Sign -Out SheetCommissioners

First Last of Tickets Date Signature

Nancy Leanos 2

Jacqueline Macias 2

Douglas Malo 2

Stephanie Marin 2

Debra Martin 2

Joy McAllister 2

Veronica Michalowski 2

i

Joseph Mladinov 2

Cindy Moore 2

Denton Mosier 2

r

Helen Mosier 2

Jerry Perez 2 97

Rebecca Ramos 2 1 /

Ranie Riley 2

Adriana Robledo 2 I I 1Rita Romero 2

i

Andrew Santa Cruz 2

Michael Schowalter 2

r

Rory Smith 2 7 /

Edward Starr 2

Mario Suarez 2

Lar Taylor 2

Robert Torres 2

DeAndre Valencia 2

Page 2 of 2

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