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SAN . JOAQUIN
<br /> COMMUNITY DEVELC VENT DEPARTMENT
<br /> SUBDIVISION
<br /> FiLE NUMBER
<br /> Portion of APN 257 = 130 =09 and 257 - 130 - 10
<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 t.
<br /> the 12 months following the decision . The Act also prohibits an owner , applicant , or agent for the owner Initial
<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 /> AUT14ORIZATION 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 (wit hF counsel reasonably approved by County ) , and hold harmless the County
<br /> and its officers , officials , employees , agents , boards ,rand 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 /> 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 petit oner .
<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 an ,r 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 /> Q 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 /> Ida Mae Teicheira, Trustee of the Ida Mae Teicheira Survivor' s Trust as Est. in the Teicheira Living Trust Dated October 31 , 1991 , 50% Interest
<br /> Ida Mae Teicheira, Trustee of the Manuel Teicheira Family Trust as Est. in the Teicheira Living Trust Dated October 31 , 1991 , 3 . 60 % Interest
<br /> Ida Mae Teicheira , Trustee of the Manuel Teicheira Marital Trust as Est. in the Teicheira Living Trust Dated October 31 , 19917 46.40% Interest
<br /> Print Name : Richard Teicheira , Co-Trustee Signature : ���-� � _ � FL ;",o riot C ,lie Date :
<br /> Print Name : Marlene Harris , Co-Trustee Signature 1 r . _ _ :( _ - i _ � c , �;:�_: ; L� Date : I 1C :1 bb 4 '
<br /> Print Name : Carol Moberly , Co -Trustee Signature : 1. Uu- Lt � � � c' � � l .ru Date : t � � , C r
<br /> 2023-58 (One of Five)
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