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COMMUNITY DEVELOPMENT DEPARTMENT
<br /> M
<br /> SAN JOAQUIN AP AMENDMENT
<br /> FILE NUMBER :
<br /> LEVINE ACT
<br /> Effective January 1 , 2023 , California Political Reform Act of 1974 ; Govemment Code 84308 , known I have reed and understand
<br /> as the Levine Act , prohibits any San Joaquin County Board of Supervisor member from porticmipatind 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 polftical contributions from the owner , applicant , or agent for the owner or applicant yl
<br /> totaling more than $ 250 in the 12 months before the deciwon ( but not before January 1 , 2023 ) and for
<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 follooring 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 /> I , the Owner/Applicant/Agent agrees to indemnify , defend (with counsel reasonably approved by County ) , and hold harmless the County
<br /> and its officers , off uals , employees , agents , boards anti wmrrnssiun .tk twllec Lively " County ) as follows .
<br /> 1 . INDEMNITY
<br /> A . From and against any and all claims , demands . actions , piaceedings , lawsuits , losses , damages , judgments and /or
<br /> liabilities arising out of , related to . or in wnne0on 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 .1ccr3j.tr1 of any Claim exrept where such indemnification is
<br /> prohibited by law , including but not limited to damages , costs , expenses , attomey0s fees , or expert witness costs that may be asserted
<br /> by any person or entity , pnvate attomey general fees claimed by or awarded to any party against the County , and the County ' s costs
<br /> lnCurr�"d in Fie 'r an adrr►ar95tratil� ta carori W) . rh are rr�l pa.d bj the Pet�ticcwy
<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 indemnity , defend , and hold harmless ire Coun4
<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 net 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 /> fall 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 of-Aside counsel to represent or defend the County , and I shall pay the
<br /> reasunably attorneys • fees and costs of such counsel .
<br /> 1 , further, certify, under penalty oaf perjury that I acct (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 /> Print Name ; /'t ( � I k? dam, �' r; � � Signature : y _ Date : 7 "
<br /> Print Name : Signature : Date : T
<br /> Print Name : Signature : _ Date : _
<br /> Print Name : Signature : _ Date :
<br /> Print Name : Signature : Date :
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