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COMMUNITY DEVELOPMENT DEPARTMEN I <br /> SAN CANCELLATION <br /> W � � � � AM � ON AST CONTRACT <br /> FILE NUMBER * 200017�------------- <br /> LEVINE ACT <br /> Fthe <br /> January 1 , 2023 , California Political Reform Act of 1974 , Government Code § 84308 , known I have read and understand <br /> vine Act , prohibits any San Joaquin County Board of Supervisor member from participating in that this application is <br /> any agenda item involving a discretionary land use permit or other entitlements if the Board member 7nthese provisions : <br /> has received any political- contributions from the owner , applicant , or agent for the owner or applicant <br /> totaling more than $250 i.n the 12 months before the decision (but not before January 1 , 2023 ) and for <br /> the 12 months following the decision . The Act also prohibits an owner , applicant , or agent for the - owner Initial <br /> or applicant from making a contribution of more than $ 250 to a member of the Board of Supervisors <br /> while the item is pending and for the 12 months following the date a final decision is rendered . Date <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> I , the -Owner/Applicant/Agent agrees to indemnify , defend (with counsel reasonably approved by County) , and hold harmless the County <br /> and its officers , officials , employees , agents , boards and commissions (collectively " County") as follows : <br /> 1 . <br /> INDEMNITY : <br /> A . From and against any and all claims , demands , actions , proceedings , lawsuits , losses , damages , judgments and/or <br /> liabilities arising out of , related to , or in - connection with the application and applied for project or to attack , set aside , void , or annul , in <br /> whole or in part , an approval of the applied for project by the County , the adoption of environmental review documents related to the <br /> applied for project , and any related development approvals or project conditions for the applied for project ( hereinafter " Claim " ) ; <br /> B . For any and all costs and expenses incurred by the County on account of any Claim , except where such indemnification is <br /> prohibited by law , including but not limited to damages , costs , expenses , attorney ' s fees , or expert witness costs that may be asserted <br /> by any person or entity , private attorney general fees claimed by or awarded to any party against the County , and the County ' s costs <br /> incurred in preparing an administrative record which are not paid by the petitioner. <br /> C . Except as to the County ' s sole negligence or willful misconduct . <br /> 2 . DEFENSE : <br /> A . The County may participate or direct the defense of any Claim . The County ' s actions in defense of any claim shall not <br /> re.lieve me of any obligation to indemnify , defend , and hold harmless the County . <br /> R . In the event of a .disagreement between Co inty and me regarding riefenCe of any Claim , the C of inty shall have the <br /> authority to control the litigation and make litigation decisions , including , but not limited to , the manner in which the defense is <br /> conducted <br /> C . If the County reasonably determines that having common counsel 'presents such counsel with a conflict of interest , or if I <br /> fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to the County , then County may <br /> utilize the Office of the County Counsel or employ separate outside counsel to represent or defend the County , and I shall pay the <br /> reasonable attorneys ' fees and costs of such counsel . <br /> I , further , certify under penalty of perjury that I am (check one ) : <br /> ❑ Legal property owner ( owner includes partner , trustee , trustor , or corporate officer) of the property ( s ) involved in this application , or <br /> ❑ Legal agent ( attach proof of the owner's consent to the application of the properties involved in this application ) and have been <br /> authorized to file on their behalf , and that the foregoing application statements are true and correct . <br /> — -- — -signature: — Date : <br /> - F' rint Name : — A � ; -- - -- <br /> Print Name : Signature : Date : <br /> Print Name : Signature : Date : <br /> Print Name : Signature : Date : <br /> Print Name : Signature : Date : <br /> Page 6 of 6 <br /> 09/ 12/2023 <br />