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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 I have reatl and understand <br /> s[ha Lavine Act,prohibits any San Joaquin County Board of Supervisor member from partiGpa[in9 In that[his application is <br /> any a9antla item Involving a discretionary lantl use permit or other andtlaments R[ha Board member subject[c these provlslpns: <br /> has received any political contributions from the owner,applicant.or agent for the owner or applicant K� ' <br /> totaling more than$250 in the �2 months before the tlacision(but no[before January t,2023)and for Initial <br /> the t2 months following the decision.The Act also prohlbita an owner,applicant,or agent for the owner / Z -z 3 <br /> applicant from making a contribution of more than$250 to a member of the Boats of Supervisors V � ' <br /> wNla[he item is pending and for the t 2 months fcllowln9 the date a final decision Is rendered. 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,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: �� ((1 /� a(u res Date: 2 <br /> Prin[Nama:M�\�\ MtCY\L'\\�� �.l'T�4�.�1 S19natura: Date: 3 <br /> Prins Nama: f / � '�^ � S19natura: Data: <br /> Print Name: ��fiL\I 5..�.SletSo.��A9'tn/ Signature: Date: <br /> J / / <br /> Print Nama: Signature: Date: <br /> Pages 4 of 4 <br /> aMYB/3a23 <br />