Levine Act Disclosure Statement

Levine Act Disclosure Statement

Levine Act Disclosure Requirement for Parties to a Proceeding 
The Levine Act requires a Party in a Proceeding before the County of Sonoma that involves any action related to their contract, license, permit, or use entitlement to disclose any campaign contributions to County elected or appointed officials (e.g. Board of Supervisors, Clerk-Recorder-Assessor, Auditor-Controller-Treasurer-Tax-Collector, Sheriff, District Attorney) totaling more than $500 within the 12 months prior to the County decision. A party is any person, company, or organization that files an application for, or is the subject of, a proceeding involving a contract license, permit, or other entitlement for use. The contributions of a party must be aggregated with those of their agents and business entities majority owned by that individual. This means, for example, that if an individual’s company, organization, or other legal entity submitted a campaign contribution, individually or jointly exceeding $500, but the individual is the recipient of the potential benefit, the Levine Act requires a disclosure form to be submitted. Participants to a Proceeding may voluntarily report a campaign contribution on this form. 
 
When The Levine Act Form Must Be Completed 
The form must be completed (1) by the party to a contract with the County of Sonoma (“County”) (or that party’s agent) at the time the party submits a response to a Request for Proposals or other competitive solicitation, enters into contract negotiations with the County, or executes a contract with the County, whichever is earliest, or (2) by a party to a license, permit, or other entitlement proceeding before the County at the time the party (or their agent) submits the license, permit, or entitlement application for to the County. The requirement to submit this form applies where a party (or that party’s agent) has contributed more than $500 to members of the Board of Supervisors, members of boards or commissions, or to other appointed officers if they may participate in taking action the proceeding, within the prior 12 months of the proceeding. The party (or their agent) must submit a supplemental form if they make any new reportable contributions while the contract, license, permit, or other entitlement is being considered.   
 
The party (or their agent) may also use this form to correct or supplement any previously submitted disclosure.   
 
Parties are solely responsible for completing this form accurately.  If you are uncertain about whether you are required to disclose or combine a contribution, please consult with your attorney.    
 
The foregoing statements do not constitute legal advice and individuals are urged to consult with their own legal counsel regarding the requirements of the law. 
 
Submit separate forms for each County officer to whom a contribution was made. 
 
The completed form submitted to the County of Sonoma is a public record. 

Section 1

Have you or your company/organization, or any agent on behalf of you or your company/organization, made any campaign contributions of more than $500 to any County of Sonoma member of the Board of Supervisors, member of boards or commissions, or to other appointed County officers in the 12 months preceding the date of submission of your application, contract, or proposal related to this contract, license, permit, or other use entitlement?
County or Specific Quasi-Judicial Body

Section 2

By signing below, I certify that the statements made herein are true and correct and that, as the party or agent to a party, I represent will comply with California Government Code section 84308. I also agree to disclose any contributions made to any County of Sonoma member of the Board of Supervisors, member of a board or commission, or other appointed party that participates in this proceeding. 

If a subsequent contribution occurs within the 12 months of official approval, a subsequent form should be submitted.