Levine_Act_CCSR_jr
LEVINE ACT DISCLOSURE
General Form – PW Staff Report
California Government Code Section 84308, commonl y referred to as the "Levine Act," prohibits any Lancaster oႈcial 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 ıĺIJťēŜϙċĺīīĺſĖIJČϙťēôϙîÍťôϙÍϙƱIJÍīϙîôèĖŜĖĺIJϙĖŜϙŘôIJîôŘôî. The Levine Act also requires a Lancaster City oႈcial who has received such a contribution to disclose the contribution on the record of the proceeding. x Current Lancaster City Council Members are listed at:
ēťťŕŜϡϯϯſſſϟèĖťƅĺƲÍIJèÍŜťôŘèÍϟĺŘČϯČĺŽôŘIJıôIJťϯèĖťƅ-oႈcials/city-council-copy x Current Planning Commissioners are listed at:
ēťťŕŜϡϯϯſſſϟèĖťƅĺƲÍIJèÍŜťôŘèÍϟĺŘČϯČĺŽôŘIJıôIJťϯèĺııĖŜŜĖĺIJŜ-appointments/planning Proposers are responsible for accessing the above links 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 $25 0 to any Lancaster City Council Member or other City oႈcial in the 12 months preceding the date of the submission of your proposal or application, or the anticipated date of any Council action?
܆܆NO
܆YES If yes, please identify the Council Member(s)/City official(s):
_____________________________________________________________________________
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 o ႈcial in the 12 months following any Council action related to your proposal or application?
܆NO
܆YES If yes, please identify the Council Member(s)/City official(s):
_____________________________________________________________________________ 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 an y subsequent action. It does, however, preclude ťēôϙ ĖîôIJťĖƱôîϙ
ĺŪIJèĖīϙ aôıæôŘϼŜϽϙ ċŘĺıϙ ŕÍŘťĖèĖŕÍťĖIJČϙ ĖIJϙ ÍIJƅϙ ÍèťĖĺ IJŜϙ ŘôīÍťôîϙ ťĺϙ ƅĺŪŘϙ proposal or application.
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DATE SIGNATURE OF AUTHORIZED INDIVIDUAL
__________________________________________________________
COMPANY / APPLICANT NAME
________________________________________________ ________________ _____________ ______1/2/25 DMR TEAM INC./ Sam Talebian
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