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<br /> JOAOUINCOMMUNITY DEVEL ( WENT DEPARTMENT
<br /> say
<br /> suBDivisIoN
<br /> FILE NUMBER .
<br /> APN 257 = 130 =02 W
<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 the 12 months following the decision . The Act also prohibits an owner , applicant , or agent for the owner initial
<br /> or applicant from snaking a contribution of more than $ 250 to a member of the Board of Supervisors � i � ,� � � 0*4L, �
<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 /> 1 , 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 /> 'l . 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 /> I , further , certify under penalty of perjury that I am (check one ) :
<br /> E1 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 /> Richard M . Teicheira , Trustee of the Richard Teicheira Revocable Trust dated November 23, 2015 , 10 . 50167% interest
<br /> Print Name : Richard M . Teicheira , Trustee Signature : . LC *C' �� ,c° ��` F"' Date :11M
<br /> Marlene M . Harris , Trustee of the Marlene M . Harris Trust as set fgrth in the Harris Family Trust dated August 23, 1993 , 10. 50 67% interest
<br /> Print Name : Marlene M . Harris , Trustee Signature .L�'_ rf ' �� r: rs ./� �� L. Date : r f 2c),
<br /> Carol A . Moberly , Trustee of the Carol A. Moberly Trust as set forth in the Moberly Revocable Trust dated February 17, 2016, 10 . 50167%
<br /> interest
<br /> Print Name : Carol A . Moberly , Trustee Signature : i `! Date :
<br /> 202358 (Four of Five )
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