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s., SAN.:;�10AgU1N coavoavaasnaA�-v o�v�LOPa�a�e�ar oe=�aa��nr�a=soar
<br /> . —__..—COI.JNTY-..-..._- �IAh Aavia=_aa®ae�aa�r.ar
<br /> G t ._... .) vs Aare•.
<br /> FILE NUMBER:
<br /> -.12EVINE ACT �ti
<br /> Effective January "I, 2023, Cal forma Polit cal Reform Ac[of 1974, Gove ent Cotle§ 84308 known I hav d and u dersia nd
<br /> s the Levine Act, pro M1ibi<s any San Joaquin Cou n[y Board of Supervisor member from partic pat ng in tM1 i LM1Is applic [ion Is
<br /> any agenda item involving a discretionary lantl use permit or other enhuamants if fM1e Board member su bjact to(Mesa provisions:
<br /> has received any political contributions from the owner, applicant, or agent for the owner or applicant /,�I{JG
<br /> totaling mora than $250 in the 12 months before the tlecision(but not before January 1,2023)and for Initial
<br /> the 12 months following the decision. The Act also prohibits an eq applicanF, or agent for the ow er �/
<br /> applica n[from making a onhibu[ion of m a than$250 to a m tuber of fM1e Board of Supervisors n ,! -/�—
<br /> while fM1e item is pending and for the 12 months following fM1e tla[e a final decision is antlered. pate
<br /> AUTHORIZATION ISIGNATU RES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHO RIZEDLPiG ENTMAV FILE AN APPLICATION
<br /> I, Iha Owner/Applican VAgant agrees[o indemnify, defend (witM1 c sel r nobly approved by County), antl hold harmless the County
<br /> ntl its offioara, officials, amploya¢a, a9ants, boards and oomm�ssians(collactivaly"County")as follows:
<br /> 1. INDEMNITY:
<br /> A. From antl against any and aIlclaims, demands, actions, proceeding s, lawsuits, losses, damages,judgments and/or
<br /> liabilities arising out of, related to, or In connection with th8 applidation and applied for prdjact op to attack, set asltle,void, o annul, in
<br /> wholes or in part, an approval of fM1e appliedfor project by the Cburi[y, tM1eatlopLon bf environmental reOlewtlocumahts relatetl to the
<br /> applietl for project,and any related tlevalbpmant approvals or projabf conditions for the applied for project(hereinafter."Claim");
<br /> B. For any and all costs and expenses incu red by fM1e County on account of any Glaim. except wheresuch intlemnificationia
<br /> prohibited by law, indutling but not limi[atl Yo damages rcos[s, expanses, attorney's foes,o expert wiMess costs that may be a sorted
<br /> by any person o an[iry, private attorney general fees claimed by or awarded to any party against the County, antl the County's costs
<br /> Incurred in preparing an administrative record which a not pard by[ha petitioner.
<br /> C. Except as fo the County's sola negligence or willful misconduct.
<br /> 2. DEFENSE:
<br /> A fM1e County may parttcipaia or direct[he defense of espy Claim. fM1e County's actlons In tlafansa of any claim shall not
<br /> relieve m of any obligation to Indemnify, tlafentl, and hold harmlaSSYM1e-County.
<br /> ¢ B. Inthe even<of a disagreement between County and rna regarding tle(ansa of any Claim,the County shall M1ave fM1e
<br /> authority to control-the ling allor antl make litigation decisions, inducting, but not limited fo, ihamanner In which[ha defense is
<br /> COnd VCfad.
<br /> C. If[ha County reasonably tleterminas that M1¢Nng common counsel presents such counsel with a conflict of interest,or if 1
<br /> tail to promptly assume the defense of any Claim or to promptly em cloy c unsel reasonably satisfactory fo iha County,than County may
<br /> utilize[he Odlca of the County Gounsal or employ sapamte outside ounsel to represent or tl¢fand the County, and I shall pay iha
<br /> aasonable attorneys'fees and costs of such counsel.
<br /> rl, further, certify under penalty of paryury iha[I am(check one):
<br /> ��/�Legal property owner(owner includes partner,frusta¢,trustor, or corporate officer)of the property(s)involvetl in this application, or
<br /> �yagal agent(attach proof of Nta owner's consent to the application oT the properties Involved in this application)and have been
<br /> authoriza'd/to file on[heir behalf, and that fM1e foregoing application statements ere frua and correct.
<br /> Print Name: /�E/�l/�� Su/�/(TtSA''� Signature: Data: � �z ZL
<br /> Print Names: Signature' Date:
<br /> Print Name: signature: Data:
<br /> Prins Name: Signature: Data:
<br /> Print Name: Signature: Date
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