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Attachment 2 - Levine Act forms

Norwalk City Council
February 6, 2024

Document
Attachment 2 - Levine Act forms
Meeting
February 6, 2024
Body
Norwalk City Council
Original file
1.5 MB
Text extracted from the city's file for reading and search. Open the original on norwalk.primegov.com. That file is the official record.

CITY 7N,

NORWALK
A Connected Community
California Levine Act Statement
California Government Code Section 84308, commonly referred to as the "Levine Act," prohibits any Norwalk City Council Member 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 three months following the date a final decision from the business or applicant.

The Levine Act also requires a member of the Norwalk City Council who has received such a contribution to disclose the contribution on the record of the proceeding.

Current Norwalk City Council Members are listed at:
https://www.norwalk.org/city-hall/mayor-and-city-counci l-information-copy 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 on behalf of you or your company, made any political contributions of more than $250 to any Norwalk City Council Member in the 12 months preceding the date of the submission of your proposal or application, or the anticipated date of any City Council action?
YES If yes, please identify the Council Member(s):

NO

2. Do you or your company, or any agency on behalf of you or your company, anticipate or plan to make any political contribution of more than $250 to any Norwalk City Council Member in the 12 months following any City Council action related to your proposal or application?
YES If yes, please identify the City Council Member(s):
')< NO
Answering yes to either of the two questions above does not preclude the City Council from awarding a contract or approving an application or any subsequent action. It does however, preclude the identified City Council Member(s) from participating in any actions related to your proposal or application.

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Signature of Applicant Company/Applicant Name
- 30
Date
Attachment No. 2
California Levine
Act Statement
California Government Code Section 84308, commonly referred to as the "Levine Act," prohibits any Norwalk City Council Member 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 three months follo wing the date a final decision from the business or applicant.

The Levine Act also requires a member of the Norwalk City Council who has received such a contribution to disclose the contribution on the record of the proceeding.

Current Norwalk City Council Members are listed at:
https://www.norwalk.org/city-hall/mayor-and-city-council-information-copy 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 on behalf of you or your company, made any political contributions of more than $250 to any Norwalk City Council Member in the 12 months preceding the date of the submission of your propos al or application, or the anticipated date of any City Council action?
___ YES If yes, please identify the Council Member(s):
__X_ NO

2. Do you or your company, or any agency on behalf of you or your company, anticipate or plan to make any political contribution of more than $250 to any Norwalk City Council Member in the 12 months following any City Council action related to your proposal or application?
___ YES If yes, please identify the City Council Member(s):
_X__ NO
Answering yes to either of the two questions above does not preclude the City Council from awarding a contract or approving an app lication or any subsequent action. It does however, preclude the identified City Council Member(s) from participating in any actions related to your proposal or application.
_____________________________ Raymond James / Jose Vera Signature of Applicant Company/Applicant Name
_____1/30/2024_______
Date

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