For use with Licenses, Permits, POs, and RFPs
California Levine Act Statement
California Government Code Section 84308, commonly referred to as the "Levine Act," prohibits any Lancaster official from participating in any action related to a contract or application if he or she receives any political contributions totaling more than $250 within the previous twelve months, and for twelve months following the date a final decision is rendered.
The Levine Act also requires a Lancaster City official who has received such a contribution to disclose the contribution on the record of the proceeding.
Current Lancaster City Council Members are listed at:
https://www.cityoflancasterca.org/government/city-officials/city-council-copy Current Planning Commissioners are listed at:
https://www.cityoflancasterca.org/government/commissions-appointments/planning Proposers are responsible for accessing this link to review the names prior to answering the following questions.
1. Have you or your company, or any agent/board member on behalf of you or your company/entity, made any political contributions of more than $250 to any Lancaster City Council Member or other city official in the 12 months preceding the date of the submission of your proposal or application, or the anticipated date of any Council action?
•YES If yes, please identify the Council Member (s)/city official(s):
DINO
2. Do you or your company/entity, or any agency on behalf of you or your company/entity, anticipate or plan to make any political contribution of more than $250 to any Lancaster City Council Member or other city official in the 12 months following any Council action related to your proposal or application? YES If yes, please identify the Council Member(s) /city official(s):
NO (Please note that if this is a contract lasting more than one (1) year that you must update this form if there are any contributions made after the contract is awarded) Answering yes to either of the two questions above does not preclude the Lancaster City Council from awarding a contract or approving an application or any subsequent action. It does however, preclude the identified Council Member (s) from participating in any actions related to your proposal or application. 02/12/25
Date Signature of authorized individual
INSITE DEVELO MINT
Company/Applicant Name