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SAN:_JOAQUIN COMMUNITY DEVELOPMENT DEPARTMENT
<br />cot�nlTv MAP AMENDMENT
<br />FILE NUMBER:
<br />LEVINE ACT
<br />Effective January t, 2023. California Political Rafonn Act of t974. Government Coda § 84308, known
<br />I have reatl and understand
<br />that [his application is
<br />s [ha Lavine Act, prohibits any San Joaquin County Board of Supervisor member from partiGpa[in9 In
<br />subject [c these provlslpns:
<br />any a9antla item Involving a discretionary lantl use permit or other andtlaments R [ha Board member
<br />K�
<br />has received any political contributions from the owner, applicant. or agent for the owner or applicant
<br />totaling more than $250 in the � 2 months before the tlacision (but no[ before January t, 2023) and for
<br />Initial
<br />the t2 months following the decision. The Act also prohlbita an owner, applicant, or agent for the owner
<br />/ Z -z 3
<br />V
<br />applicant from making a contribution of more than $250 to a member of the Boats of Supervisors
<br />wNla [he item is pending and for the t 2 months fcllowln9 the date a final decision Is rendered.
<br />Data
<br />AUTHORIZATION SIGNATU RES
<br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION
<br />I, [ha Owner/AppllcanVAgent agrees to intlemnify, dafentl (with counsel reasonably approved by County), and hold harmless [he County
<br />and its omcara, officials, employees, agents. boards and commissions (cotlec[Iyaly "County") as follows:
<br />t. INDEMNITY:
<br />A. From and a9alns[ any antl all claims, demands, actions, proceed(ngs, lawsuits, losses, damages, judgments and/or
<br />liabilities arisln9 out of, related [o, or In connactlon wkh [ha application and applied for project or fo attack, sat aside, Vold, or annuli in
<br />whole or In pert, an approval of [ha applied Tor project by the County, the atloptlon of environmental review documents related to [he
<br />appllatl for project and any r®feted tlavalopmen[ approvals or project contlltiona for [ha appllad for project (haralnafter "Claim');
<br />B. For any and all costs antl expenses incurred by the Goun[y on account of any Claim, except where such Intlamniflcation is
<br />prohibited by law, including but not Ilml[atl to damages, coats, expanses, s¢omay s teas, o expert witness coats that may ba asserted
<br />by any parson or anhty, private attorney general fees claimatl by or awarded to any party against the County, antl [ha County's costs
<br />ncurratl in preparing a administrative record which a not paid by the palitloner.
<br />C. Except as [p [he County's sola nagligan a or willful misconduct.
<br />2. DEFENSE:
<br />A. The County may participate or tliract the dafansa of any Claim. Tha County's ac[lona in defense of any claim shall not
<br />relieve ma of any obligation [o indemnify, tlafantl, antl holtl harmless the Goun[y.
<br />B. In [he avant of a disagreement between County and me regarding dafansa of any Claim, [he Goun[y shall have the
<br />authority to control the Iltl9a[lon and make OOgation decisions, including, but not limi[atl to, [ha manner m whicM1 the defense is
<br />conducted.
<br />C. If [M1a County reasonably determines that having common counsel presents such counsel with a conflict of interest or If I
<br />fall [o promptly assume the dafansa of any Glalm or tc promptly employ counsel reasonably satisfactory to the Cou n[y, than County may
<br />uHliza the Office of the County Counsel or employ separate outside counsel [o represent or tlafand [ha County, and I shall pay [M1a
<br />aasonable attorneys' fees and costs of such counsel. —
<br />rl,
<br />further. certify under penalty of perjury IM1a[ 1 am (check Dna):
<br />� Legal property owner (owner includes partner. trustee, trustor, or corporate afFlcar) of [ha property(s) InyoNetl in this applica[lon. or
<br />La9ai agent (attach proof of [ha owner's consent to the application of [ha propartlas Involved in this application) and have bean
<br />authorized to fila on their behalf, and [hof fha foragoingl pplicaLon statements ere true and correct.
<br />Print Nama: a(u res Date: 2
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<br />Prin[Nama:M �\�\ MtCY\L'\\�� �.l'Ti4�.�1 S19natura: Date: 3
<br />Prins Nama: f / � '�^ � S19natura: Data:
<br />Print Name: ��AribV Sa�.4atSps��ATtn/ Signature: Date:
<br />/
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<br />Print Nama: Signature: Date: /
<br />Pages 4 of 4
<br />aMYB/3a23
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