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p JAIIIIINN COMMUNITY DEVELOPMENT DEPARTMENT
<br /> REVISIONS OF APPROVED ACTIONS
<br /> FILE NUMBER
<br /> LEVINE ACT
<br /> i=. ffc calve January 1 2023 . California Political Reform Act of 19 -i 4 . Government Code § 34308 , known I have read and understand
<br /> f, i �. Lev .A ca . prohibits, any San Joaquin County Boaid of Supervisor member from pailicipating in that this application is
<br /> : ; riv ayern7rr item involving a discretionary land use F} ermit car ot !icr entitlements if the Board member sul ject to these provisirr s
<br /> as icic,eived anv political contributions from the owner applicant , or agent for the owner of applicant j
<br /> + iir + ci 171ore than $ 250 in the 12 months before the decision ( but not before January 1 . 2023 ) and for ; - - jL� - - -- - - ----
<br /> c months follow mg the decision The Act also prohibits an owner . applicant , or agent for the owner Initial
<br /> : r c, ppitcant from making a contribution of more than $ 250 to a niember of the Board of Supervisors � 1 t r �, �, / � v ,4
<br /> while the item is pending and for the 12 months following the date a final decision is rendered . I Date
<br /> AUTHORIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION
<br /> the ) viper / Applicant/Agent agrees to indemnify . defend ( with counsel reasonably approved by County ) . 8rrc-1 hold harrnless th (- (; ocPnty
<br /> sand its officers , officials , employees , agents , boards and commissions ( collectively " County " ) as follows ;
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<br /> 1 . INDEMNITY
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<br /> A . From and against any and all claims demands , actions , proceedings , lawsuits , losses , damages , judgments and /or
<br /> a � rabilities 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 top the
<br /> -lorlied for project . and any related development approvals or project conditions for the applied for project ( hereinafter ' Claim " )
<br /> t3 . For any and all costs and expenses incurred by the County on account of any Claim , except where such indemnification r �..
<br /> prohibited by law , including but not limited to damages , costs , expenses , attorney ' s fees , or expert witness costs that may be asserted
<br /> Ley 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 /> � . 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 harniless the County .
<br /> B . In the event of a disagreement between County and me regarding defense of any Clairn , the Gounty shall have the
<br /> �: uthority to control the litigation and make litigation decisions . including , but not limited to . the manner iii which the defense is
<br /> condcicted
<br /> C . If the County reasonably determines that having common counsel presents such counsel with a conflict of interest or 0 1
<br /> rail to promptly assume the detense of any Claim Or to promptly employ counsel reasonably satisfactory to the County , then County
<br /> K 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 rther . certify under penalty of perjury that I am ( check one )
<br /> [I i_ egal properly owner ( owner includes, partner trustee trustor , or corporate officer ) of the property ( s ) involved in dais appiicalion +: +
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<br /> L k _ egal agent ( attach proof of the owner' s consent to the application of the properties involved in this application ) and have been
<br /> authorised to file on their behalf , and that the foregoing application statements are true and correct .
<br /> S even M . Moberly , Sr . and Carol a , Moberly , Trustees of the Moberly Revocable Trust dat d Feb( nary 17 , 2016
<br /> Print. f� Dine . Steven M . Moberly , Sr . Trustee Si nature . � ' ' . . Mfr Date . I � " — , '
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<br /> f=' + ir, t Nane Carol A , Moberly , Trustee Signature . _ Date . t IJ lc
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<br /> Print N ,ainci - Signature - -- - - - - — Date . - -
<br /> flrlt t `•i ,7nle _- - _ - Signature' _ .
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