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N OAQUIN COMMUNITY DEVELOPMENT DEPARTMENT <br /> SAJ <br /> - COMMUNITY <br /> N NTY MAP AMENDMENT <br /> Greotness grows here. <br /> FILE NUMBER: <br /> LEVINE ACT <br /> Effective January 1,2023,California Political Reform Act of 1974, Government Code§84308,known I have read and understand <br /> as the Levine 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 subject to these provisions: <br /> has received any political contributions from the owner, applicant, or agent for the owner or applicant <br /> totaling more than$250 in the 12 months before the decision(but not before January 1,2023)and for initial <br /> the 12 months following the decision.The Act also prohibits an owner,applicant,or agent for the owner <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. 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 /> relieve me of any obligation to indemnify,defend, and hold harmless the County. <br /> B. In the event of a disagreement between County and me regarding defense of any Claim,the County 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 /> 1,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, andthatthe foregoing application statements are true and correct. <br /> Print Name: �� rC m \O Signature: Date: S 2 N 23 <br /> t <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Page 2 of 2 <br /> 0312812023 <br />