1CAO:650-90/tmn/Legal Files\Levine Act - Applications
LEVINE ACT DISCLOSURE FORMCalifornia Government Code section 84308 (Levine Act) prohibits any Thousand Oaks City Council member from participating in any action related to a contract, agreement, or franchise agreement (excluding labor or competitively bid contracts) if the Council member receives a campaign contribution totaling more than $ (aggregated) from the party to the contract, agreement or franchise agreement, their agents, or any financially interested participant who actively supports or opposes the matter within the previous twelve (12) months. Council members must also disclose any eligible campaign contribution received on the record of the proceeding.Council members are prohibited from accepting, soliciting, or directing a campaign contribution of more than $ (aggregated) from a party, their agent/representative, or a financially interested participant during a proceeding and for 12 months following the date a final decision is made. In addition, a party, their agent/representative, or a financially interested participant is prohibited from contributing more than $ (aggregated) to a Council member during a proceeding and for 12 months following the date a final decision is made.The Levine Act also requires parties to certain contracts, agreements, or franchise agreements to disclose any campaign contribution over $(aggregated) within the preceding twelve (12) months by the party to the agreement, contract, or franchise agreement and their agents. The Levine Act does not apply to competitively bid, labor, or personal employment contracts.The Levine Act (Gov Code § 84308) DOES NOT apply to this proposal/applicationThe Levine Act (Gov Code § 84308) DOES apply to this proposal/application and the required disclosure is set forth below:1. Have you or your company, or any agent on behalf of you or your company,made campaign contributions totaling more than $ (aggregated) to anycouncil member in the 12 months preceding the date you submitted yourproposal/application, the date you completed this form, or the anticipateddate of any Council action related to this proposal/application?YESNOCouncil Member Name Payee Name Payment Date Payment Amount EXHIBIT "C"
2. Do you or your organization, or any agency or representative on behalf ofyou or your organization, anticipate or plan to make any campaigncontributions of more than $ (aggregated) to any City Council memberin the 12 months following any City Council action related to thisproposal/application? ** There may be legal restrictions on makingcontributions during the 12 months following City Council Action. Itis recommended that you consult with your own legal counselregarding the requirements of law. YES NO Council Member Name Payee Name Payment Date Payment Amount Answering YES to either question above does not preclude the City of Thousand Oaks from entering into or taking any subsequent action related to this proposal/application. However, it may preclude the identified Council member(s) from participating in any actions/decisions related to this proposal/application. ____________ ______________________________ _______________________ Date Printed Name/Title of Authorized Name of Business/Legal Representative Entity ____________________________________________________________________________Signature You must submit a supplemental form if you make any new reportable contribution(s) while the proposal/application is being considered*