HomeMy WebLinkAboutAZARA'S CATERINGGift to Agency Report
'I. Agency Name
CITY OF TUSTIN
Division, Department, or Region (if applicable)
City Clerk
Street Address
300 Centennial Way, Tustin, CA 92780
Area Code/Phone Number E-mail
(714) 573-3010 i mhuizar@tustinca.org
Agency Contact (name and title)
Maria Huizar
2. Donor Name and Address
^ Individua{ ~ Other Azzara's Catering
Last Name First Name Name
721 W. First Street Tustin CA 92780
Address City State Zip Code
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
For Official Use Only
CITY OE' TUST'1
1006 DEC 2 P 3~ 35
^ Amendment (explain rn comment section)
Name
Date of Original Filing:
(month, day year)
GIFT TO AGENCY REPORT
Amount
3. Payment Information
Date and Amount of Paymenfi (other than travel) 12/16/2008 8
(monfh, day. year)
$210.00
(Round to whose dollars)
Travel Payment information (Round to whole dotrarsl Location of Travel
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:
Identify the officials for whom the payment was used:
Last Name First Name Title
Last Name First Name Title
DepartmentlDivision
Department/Division
-- -- -- __
4. VerlflCatlOn
1 have determh~ed that it is in the interests of the agency to accept this gift and use it for the official agency business described above.
Q/Iti~ ~ Maria Huizar
Signature of Agency Head or De ee Print Name
Deputy City Clerk
Title
Comment: (Use this space or an attachment for any additional information.)
12/17/2008
(month, day, year)
A Public Document
Date Stamp
FPPC Form 801 (June108)
FPPC Toll-Free Nelpiine: 866/ASK-FPPC (866!275-3772)