EXHIBIT K
Califo
rnia Levine Act Statement
Califor
nia 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-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 pr oposal or application, or the anticipated date of a
ny City Council action?
___ YES
If yes, please identify the Council Member(s):
_x_ NO
2. Do you or y
our company, or any agency on behalf of you or your c ompany, anticipate or plan to make any pol
itical 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 y
es t
o 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 y
our proposal or application.
_H&H Auto Parts Wholesale_________
_ Company/Applicant
Name
_____________________________
S
ignature of Applicant
_4/15/2024____
Date
Attachment No. 2 Campaign Contribution Form