CALIFORNIA LEVINE ACT STATEMENT
can
prohibit members of the City Council of the City of Visalia from participating in any action related to a contract if he or she receives any political contributions totaling more than $500 within the previous twelve (12) months, and for twelve (12) months following the date a final decision concerning the contract has been made, from the person or company awarded the contract. The Levine Act also requires disclosure of such contribution(s) by a party to be awarded a specific contract.
The following website contains a list of current Visalia City Council Members, https://www.visalia.city/government/city_council/default.asp. You are responsible for reviewing the names of Visalia City Council Members prior to making the following disclosure:
1. Have you or your company, or any agent on behalf of you or your company, made any political contributions of more than $500 to a Visalia City Council Member in the twelve (12) months preceding the date of the submission of your proposals or the anticipated date of any City Council action related to this contract? YES:_____ NO:_____. If yes, please identify the City Council Member(s) and date(s) of contribution in the space below:
Answering YES to the question above does not preclude the City of Visalia from awarding a contract to your firm or from taking any subsequent action related to the contract. It does, however, preclude the identified Visalia City Council Member(s) from participating in any actions related to this contract.
NOTICE: The disclosure duty under state law continues for twelve (12) months after the award.
If the above information regarding contributions changes during this time after the award, then the awardee is required to update this disclosure form. ________________________________________________ __________ Signature of Authorized Individual Date _________________________________________________ Printed or Typed Name of Authorized Individual _________________________________________________ Print or Type Name of Company