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:Arjl,illi/ COMMUNITY DEVELOPMENT DEPART\ R SENT' <br /> SONQUIN <br /> S<< . : . . . . A REVISIONS OF APPROVED ACTIONS <br /> CGU NTY <br /> r <br /> :.:. -�Y�� �a �- taatr� � 5y c� rr� �i � Ile? , e : <br /> -- -' FILE NUMBER . <br /> Tllr <br /> WON <br /> , . .: . . . <br /> - <br /> have read and understand <br /> Effective January 1 , 2023 , California Political Reform Act of 1974 , Government Code § 84308 , known that this application is <br /> as the Levine Act , prohibits any San Joaquin County Board of Supervisor member from participating in subject to the provisions : <br /> any agenda item involving a discretionary land use permit or other entitlements if the Board member <br /> has received any political contributions from the owner, applicant, or agent for the owner or applicant fl � <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 /> z UTWQRi ►T ON SIQNA�' UR Will <br /> - . <br /> SHE . OWNER :C F :TH>E:.R1Rf3P. .ERTY ' RAN=A TN� RtZ>=D . SSE T MA1 Ft�.E AN. APPL;I!CATIQH <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 /> " <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 /> I fees claimed by or awarded to any party against the County , and the County' s costs <br /> by any person or entity , private attorney genera <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 /> INEEMEN <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 /> I , further, certify under penalty of perjury that l 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 /> Robert Brown Signature : Date : <br /> rPrintma : vr'ame ; Signature : Date : <br /> Print Name : Signature : Date : <br /> Print Name : Signature : Date : <br /> Print Name : Signature : Date : <br /> Page 3 of 3 03/2812023 <br />