OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL MAYOR
September 11, 2013
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request ofthe Commissioner of Housing and Economic Development, I transmit herewith ordinances authorizing the sale of the city-owned property.
Your favorable consideration of these ordinances will be appreciated.
Very truly yours,
Mayor
AN ORDINANCE AUTHORIZING THE NEGOTIATED SALE OF 621 WEST 119TH STREET TO BRUCE HARDY
WHEREAS, the City of Chicago ("City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970 and, as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, pursuant to an ordinance adopted by the City Council of the City of Chicago ("City Council") on February 6, 2002 and published at pages 78512 -- 78637 of the Journal of the Proceedings of the City Council ofthe City ("Journal") of such date, a certain redevelopment plan and project (the "Plan") for the 119th and Halsted Redevelopment Project Area (the "Area") was approved pursuant to the Illinois Tax Increment Allocation Redevelopment Act, as amended (65 ILCS 5/11-74.4-1, et seq. (the "Act")); and
WHEREAS, pursuant to an ordinance adopted by the City Council on February 6, 2002 and published at pages 78638 - 78648 of the Journal of such date, the Area was designated as a "redevelopment project area" pursuant to the Act; and
WHEREAS, pursuant to an ordinance adopted by the City Council on February 6, 2002 and published at pages 78649 - 78658 of the Journal of such date, tax increment allocation financing was adopted pursuant to the Act as a means of financing certain Area redevelopment project costs (as defined in the Act) incurred pursuant to the Plan; and
WHEREAS, the City is the owner of the real property located at 621 West 119th Street, Chicago, Illinois, which is legally described on Exhibit A attached hereto (together with the improvements thereon, the "Property"), which Property is located in the Area; and
WHEREAS, the Property is currently improved with a 3,600 square feet portion of a 7,825 square feet building (such entire building, the "Building"); and
WHEREAS, the City owns such portion of the Building that is located on the Property; and
WHEREAS, the other portion of the Building is located on an adjacent lot and is owned by Bruce Hardy, 513 Marshall Avenue, Bellwood, Illinois 60104 (the "Purchaser"); and
WHEREAS, the Building is essentially indivisible, with a single front stairway serving second floor apartments on both the City and the Purchaser's portions of the Building; and
WHEREAS, the Building is vacant; and
WHEREAS, pursuant to an ordinance adopted by City Council, on May 12, 2010 and published at pages 91151 - 91154 of the Journal of such date (the "May Ordinance"), the City authorized the sale of the Property and other adjacent City-owned real property to the Purchaser; and
WHEREAS, the sale of the Property and other adjacent City-owned property to the Purchaser did not close within the time frame set out in the May Ordinance due to the Purchaser's financial constraints; and
WHEREAS, the Purchaser has offered to purchase the Property from the City for the purpose of
unifying ownership of the Building, which the Purchaser shall rehabilitate into commercial space; and
WHEREAS, the Purchaser has agreed to pay the City One and No/100 Dollar ($1.00) as consideration for the transfer ofthe Property, which is approximately $14,999 less than its appraised fair market value of $15,000; and
WHEREAS, By Resolution Number 13-CDC-10, adopted on April 9, 2013, the Community Development Commission authorized the Department of Housing and Economic Development ("DHED") to advertise its intention to enter into a negotiated sale with the Purchaser for the redevelopment of the Property, approved DHED's request to advertise for alternative proposals, and approved the sale of the Property to the Purchaser if no alternative proposals were received; and
WHEREAS, public notices advertising DHED's intent to enter into a negotiated sale of the Property with the Purchaser and requesting alternative proposals appeared in the Chicago Sun- Times, a newspaper of general circulation, on April 15, 22, and 29, 2013; and
WHEREAS, no alternative proposals were received by the deadline indicated in the aforesaid notice; and
WHEREAS, by Resolution Number 13-043-21, adopted on June 20, 2013, the Chicago Plan Commission recommended that DHED enter into a negotiated sale of the Property with the Purchaser; now, therefore,
Be It Ordained by the City Council ofthe City of Chicago:
SECTION 1. The City Council hereby approves the sale of the Property to the Purchaser in the amount of One and No/100 Dollar ($1.00).
SECTION 2. The Mayor or his proxy is authorized to execute, and the City Clerk or Deputy City Clerk is authorized to attest, a quitclaim deed conveying the Property to the Purchaser, or to a land trust of which the Purchaser is the sole beneficiary, or to an entity of which the Purchaser is the owner and controlling party. Such deed shall include a covenant obligating the Purchaser to use the Property only for use consistent with the land uses permitted under the Plan. The Purchaser's acceptance of the City's deed shall constitute the Purchaser's agreement to such covenant. Such deed shall further require the Purchaser to comply Section 2-45-110 of the Municipal Code of the City (the "Affordable Requirements Ordinance") if the Purchaser develops the Property, or any portion thereof, with a residential housing project.
SECTION 3. If the Purchaser has not closed on the purchase of the Property by December 31, 2013, this ordinance shall be null and void, and the City shall have no authority to thereafter convey the Property to the Purchaser. Notwithstanding the foregoing, such December 31, 2013 date may be extended by the Commissioner of DHED, in the Commissioner's sole discretion, by one extension period up to six (6) months in length.
SECTION 4. This ordinance shall take effect immediately upon its passage and approval.
SECTION 5. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.
SECTION 6. All ordinances, resolutions, motions or orders inconsistent with this ordinance are hereby repealed to the extent of such conflict.
EXHIBIT A
Legal Description (subject to title commitment and survey):
LOT 9 IN BLOCK 9 IN THE RESUBDIVISION OF THAT PART OF WEST PULLMAN LYING IN THE NORTHWEST Va AND THE WEST Vi OF THE NORTHEAST Va OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14 EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address:
621 West 119th Street Chicago, Illinois 60628
Property Index Number: 25-28-103-002
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Check ONE ofthe fallowing three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
- f/{ the Applicant
lameof the
OR
- [ ] »legal entity holding a direct or indirect interest in the Applicant State the legal
Applicant in which the Disclosing Party holds an interest
OR
3. [] a legal entity with aright of control (see Section 113.1.) State the legal name of entity in
which the Disclosing Party holds a right of control:
B. Business address of the Disclosing Party:
Fax:
Email:
C. Telephone:
D. Name of contact person: jO^CC fifiJLA^^-
E. Federal Employer Identification No. (if you have one):
F. Brief description of contract, transaction or other undertaking (referred to below as the "fatter") to which this EDS pertains. (Include project number and looation of property, if applicable):
H^otirt^ SAL^ofMl W< lljU^StWtK Chic^ . xv.
Q. Which City agency or department is requesting this EDS? OepfirtfiVjit f)f fjpu^ Aid
If the Matter ia a contract being handled by the City's Department of Procurement Servic bs, please complete the following:
and Contract #
Specification #.
Vtr. Ol-Ai-U
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY 1. Indicate the nature of the Disclosing Party:
(c)(3))?
[t^f Person
] Publicly registered business corporation
] Privately held business corporation
] Sole proprietorship
] General partnership
] Limited partnership
] Trust
[ ] Limited liability company [ ] Limited liability partnership [ ] Joint venture [ ] Not-for-profit corporation (Is the not-for-profit corporation also a 50
[ ] Yes [ ] No
[ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
Ulh
3. For legal entities not organized in the State of Illinois: Has the organization register :d to do business in the State of Illinois as a foreign entity?
□ Yes []No (jjK/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below the full names and titles of all executive officers and all directors of the < ntity NOTE: For not-for-profit corporations, also list below all members, if any, which are lega entities. If there are no such members, write "no members." For trusts, estates or other similar entitle!], list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing, member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Title
Name
2. Please provide the following information concerning each person or entity having a Idirect or indirect beneficial interest (including ownership) in excess of 7.5% of the Disclosing Party Examples of such an interest include shares in a corporation, partnership interest in a partnership or j( int venture,
Page 2 of 13
interest ofa member or manager in a limited liability company, or interest of a beneficiary estate or otheT similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-03( Municipal Code of Chicago ("Municipal Code"), the City may require any such additional from aay applicant which is reasonably intended to achieve full disclosure. Name Business Address Percentage Interest in the ,.i Disclosing Party A//A |
>f a trust, ofthe information |
/ y f, ___ ___________________ |
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SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIAL Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 oft! Code, with any City elected official ic the 12 months before the date this EDS is signed? [] Yes |HNo If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(s): f A |
S e Municipal |
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|
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINE The Disclosing Party must disclose the name and business address of each subcontracto: lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party 1 or expects to retain in connection with the Matter, as well as the nature of the relationship, amount of the fees paid or estimated to be paid. The Disclosing Party is not required to dis employees who are paid solely through the Disclosing Party's regular payroll. "Lobbyist" means any person or entity who undertakes to influence any legislative or ad action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid himself. "Lobbyist" also means any person or entity any part of whose duties as an employ another includes undertaking to influence any legislative or adniinistrative action. If the Disclosing Party is uncertain whether a disclosure is required under this Section, t Disclosing Party must either ask the City whether disclosure is required or make the discloi Page 3 of 13 |
) PARTIES ; attorney, las retained and the total close ministrative basis, or (2) ee of le ure. |
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate
retained or anticipated to be retained)
Address (subcontractor, attorney, lobbyist, etc.)
whether
,_,le response.
paid or estimated.) NOTE: "hourly rate" cjr "t.b.d." is not an accei
W/'LUc XSlunk Hl,3(*V-Wtekiyh^ Che**-* G*K*»L
ns ot entities.
(Add sheets rf necessary) [ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such pers< SECTION V - CERTIFICATIONS A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
with *s term.
co itract
Under Municipal Code Section 2-92-415, substantial owners of business entities that the City most remain in compliance with their child support obligations throughout the contract
< eclared in
Has any person who directly or indirectly owns 10% or more ofthe Disclosing Party been arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[]Yes
the
f/^No [ ] No person directly or indirectly owns 10% or more o:
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all suppoj t owed and is the person in compliance with that agreement?
[] Yes [JNo
B. FURTHER. CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article D(which the Applicant shonld consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosinf Parry submitting this EDS is the Applicant and is doing business with the City, then the Disclosii g Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicts I or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision fc r, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee ofthe Chy or any sister agency and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing rec airement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent ci impliance timeframe in Article I supercedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
' 2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section E.B.L of this EDS:
a criminal with: transaction or fraud; false
a. are not presently debarred, suspended, proposed for debarment, declared ineligible dY voluntarily excluded from any transactions by any federal, state or local unit of government;
>
have not, within a five-year period preceding the date of this EDS, been convicted offense, adjudged guilty, or had a civil judgment rendered against them in connectiojn obtaining, attempting to obtain, or performing a public (federal, state or local) contract under a public transaction; a violation of federal or state antitrust statutes; embezzlement; theft; forgery, bribery; falsification or destruction of records; making statements; or receiving stolen property;
c.
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any ofthe offenses set forth in clause B.2.b. of this S ection V;
mblic
have not, within a five-year period preceding the date of this EDS, had one or more transactions (federal, state or local) terminated for cause or default; and
have not, within a five-year period preceding the date of this EDS, been convicted, Adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, includ ng actions concerning environmental violations, instituted by the City or by the federal goverru lent, any state, or any other unit of local government.
3. The certifications in subparts 3,4 and 5 concern:
- the Disclosing Party;
- any "Contractor" (meaning any contractor or subcontractor used by the Disclosing PaAy in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
- any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, i nder common control of another person or entity. Indicia of control include, without limitatk n: interlocking management or ownership; identity of interests among family members, sht red facilities and equipment; common use of employees; or organization ofa business entity followin j the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineli| ible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that direc tly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under co nmon control of another person or entity;
- any responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliate 3 Entity, acting pursuant to the direction or authorization ofa responsible official ofthe Disclosin g Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Apr UO IO U».^Oa VVIIIIfcl CX3III\£> \IO\tt£3£!)0 p.r
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Dis or any Contractor nor any Agents have, during the five years before the date this EDS is sij respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during t before the date of such Contractor's or Affiliated Entity's contract or engagement in connec Matter: a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or atten bribe, a public officer or employee ofthe City, the State of Illinois, or any agency of government or of any state or local government in the United States of America, in 1 or employee's official capacity; b. agreed or colluded with other bidders or prospective bidders, or been a party to any: agreement, or been convicted or adjudged guilty of agreement or collusion among b prospective bidders, in restraint of freedom of competition by agreement to bid a fix otherwise; or c. made an admission of such conduct described in a. or b. above that is a matter of rec have not been prosecuted for such conduct; or d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinam 4. Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employ agents or partners, is barred from contracting with any unit of state or local government as engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or ofthe United Stab America that contains the same elements as the offense of bid-rigging or bid-rotating. 5. Neither the Disclosing Party nor any Affiliated Entity is listed on any of the followit maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury Bureau of Industry and Security of the U.S. Department of Commerce or their successors: 1 Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and Debarred List. 6. The Disclosing Party understands and shall comply with the applicable requirement; 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental E Municipal Code. 7. If the Disclosing Party is unable to certify to any of the above statements in this Part Certifications), the Disclosing Party must explain below: |
;losing Party ned, or, with ie five years ion with the tpting to the federal jat officer's rcch idders or id price or ord, but e). es, officials, i result of -rotating in :s of ig lists or the he Specially the of Chapters hies) of the B (Further |
A / / t |
|
A' /7 |
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/x / r\ |
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( Page 6 of 13 |
|
fVUIJO UQMAO
If the letters "NA," the word "None," or no response appears on the lines above, it will be cbnehisivery presumed that the Disclosing Party certified to the above statements.
is a the 12-official,
8. To Ac best ofthe Disclosing Party's knowledge after reasonable inquiry, the following complete list of all current employees of the Disclosing Party who were, at any time during month period preceding the execution date of this EDS, an employee, or elected or appointed ofthe City of Chicago (if none, indicate with "N/A" or "none").
Njh
is a
during the
) anything
in the none, indicate
9. To the best of the Disclosing Party' s knowledge after reasonable inquiry, the followfcig complete list of all gifts mat the Disclosing Party has given or caused to be given, at any 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: ( made generally available to City employees or to the general public, or (ii) food or drink provided course of official City business and having a retail value of less than $20 per recipient (if with "N/A" or "none"). As to any gift listed below, please also list the name ofthe City recipient
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
- The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is is not
a "financial institution" as defined in Section 2-32-455(b) ofthe Municipal Code.
- If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 ofthe Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a pre datory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a1 »rcdatory lender or becoming an affiliate of a predatoiy lender may result in the loss of the privilege < >f doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as de fined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Ch apter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page? of 13
p.s
If the letters *NA," the word "None," or ho response appears on the lines above, h will he conclusively presumed that the Disclosing Party certified to the above statements,
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the sam< meanings when used in this Part D.
- In accordance with Section 2-156-110 of the Municipal Code: Does any official or ejmployee ofthe City have a financial interest in his or her own name or in the name of any other pert an or entity in the Matter?
( ] Yes No
NOTE: If you cheeked "Yes" to Item D. 1., proceed to Items D.2. and D 3. If you checked] "No" to Item D.l., proceed to PartE.
- Unless sold pursuant to a process of competitive bidding, or otherwise permitted, nd City elected official or employee shall have a financial interest in his or her own name or in the lame of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, ox (iii) is sold by virtue of legal process at the suit of the City (col ectrvely, "City Property Sale"). Compensation for property taken pursuant to the City's eminent don ain power does not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale?
- If you checked "Yes" to Item D.l., provide the names and business addresses of thejCity officials or employees having such interest and identify the nature of such interest:
Name
Nature of Interest
Business Address
4. The Disclosing Party further certifies that no prohibited financial interest in the Master will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Part / must disclose below or in an attachment to this EDS all information required by paragraph 2. F#ure to
Page 8 of 13
p.iu
r »tint? i_K3iirw
comply with these disclosure requirements may make any contract entered into with the Ci$r in connection with the MBtter voidable by the City.
j6
rec >rds
of profits
1. The Disclosing Party verifies that the Disclosing Party has searched any and all
i r
the Disclosing Party and any and all predecessor entities regarding records of investments from slavery or slaveholder insurance policies during the slavery era (including insurance dolicies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 abdve, the Disclosing Party has found records of investments or profits from slavery or slaveholder in rcrance policies. The Disclosing Party verifies that the following constitutes full disclosure of all s ich records, including the names of any and all slaves or slaveholders described in those recoit s:
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is aotjfederatly funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by tl e City and proceeds of debt obligations of the City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
with
1. List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Parrj respect to the Matter (Add sheets if necessary):
"None" entities
cr
behilf ofthe
(If no explanation appears or begins on the lines above, or if the letters "NA" ox if the woh appear, it will be conclusively presumed that the Disclosing Party means that NO persons registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on Disclosing Party with respect to the Matter.)
finds
»p:ty
to pay any
defined by of a
any
renew,
2. The Disclosing Party has not spent and will not expend any federally appropriated any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to person or entity to influence or attempt to influence an officer or employee of any agency, applicable federal law, a member of Congress, an officer or employee of Congress, or an employee member of Congress, in connection with the award of any federally funded contract, makir g federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, amend, or modify any federally funded contract, grant, loan, or cooperative agreement
Page 9 of 13
y. i i
- The Disclosing Party will submit an updated certification at the end of each calendai quarter in which there occurs any event that materially affects the accuracy ofthe statements and information set forth in paragraphs A.1. and AJ2. above.
- The Disclosing Party certifies that either: (i) it is not an organization described in se* tion 501(c)(4) ofthe Internal Revenue Code of 1986; or (ii) it is an organization described in se stion 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
equal in awards any the n request.
fir
5. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certificatio is form and substance to paragraphs A.l. through A.4. above from all subcontractors before r subcontract and the Disclosing Forty must maintain all such subcontractors' certifications duration ofthe Matter and must make such certifications promptly available to the City upt
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outs* t of negotiations.
Is the Disclosing Party the Applicant?
£ ] Yes Qtfe if "Yes," answer the three questions below:
- Have you developed and do you have oq file affirmative action programs pursuant t > applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes [ ] No
- Have you filed with the Joint Reporting Committee, the Director of the Office of Fe leral Contract Compliance Programs, or the Equal Employment Opportunity Commission all rep oris due under the applicable filing requirements?
[ ] Yes [ ] No
- Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
(]Yes [ ] No
If yon checked ^o" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
A. The certifications, disclosures, and acknowledgments contained in this EDS will becom; part of any contract or other agreement between the Applicant and the City in connection with the Mat er, whether procurement, City assistance, or other City action, and are material inducements to the City s execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
2-164 of contracts, available on , 740 N.
tnd
Cry
B. The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 the Municipal Code, impose certain duties and obligations on persons or entities seeking work, business, or transactions. The full text of these ordinances and a training program is line at www.ciryofchicaeo.org/Ethics, and may also be obtained from the City's Board
of E hies.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
inaccurate, >r be void or or
Matter and/or at
of treble
Ri medies:
C. If the City determines that any information provided in this EDS is false, incomplete or any contract or other agreement in connection with which it is submitted may be rescinded voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded void), at law, or in equity, including terminating the Disclosing Party's participation in the declining to allow the Disclosing Party to participate in other transactions with the City, law for a false statement of material fact may include incarceration and an award to the Cit damages.
npon may be
or possible information submitted
any
D. It is the City's policy to make this document available to the public on its Internet site add/or request. Some or all of the information provided on this EDS and any attachments to this made available to the public on the Internet, in response to a Freedom of Information Act request, otherwise. By completing and signing this EDS, the Disclosing Party waives and releases rights or claims which it may have against the City in connection with the public release of contained in this EDS and also authorizes the City to verify the accuracy of any informatioi in this EDS.
Disclosing atter is a must I of specified period,
Party
cert tin
k nger
E. The information provided in this EDS must be kept current. In the event of changes, the Party must supplement this EDS up to the time the City takes action on the Matter. If the IV contract being handled by the City's Department of Procurement Services, the Disclosing update this EDS as the contract requires. NOTE: With respect to Matters subject to Articl< Chapter 1-23 ofthe Mnnicipal Code (imposing PERMANENT INELIGIBILITY for offenses), the information provided herein regarding eligibility must be kept current for a as required by Chapter 1-23 and Section 2-154-020 ofthe Municipal Code.
The Disclosing Party represents and warrants that:
Page II of 13
F. 1. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all watej charges, sewer charges, license fees, parking rickets, property taxes or sales taxes.
F.2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications < qual in form and substance to those in F.l. and F.2. above and will not, without the prior written cc nsent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifies! ions
NOTE: If the Disclosing Party cannot certify as to any ofthe items in F. 1., F.2. or F.3. abo^e, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized ti ► this EDS and Appendix A (if applicable) on behalf ofthe Disclosing Party, and (2) warrant > certifications and statements contained in this EDS and Appendix A (if applicable) are true and complete as of the date furnished to the City.
(Print or type name of Disclosing Party)
execute that all accurate
By:
(Sign here) ^
(Print or type name ofperson signing) (Print or type title of person signing)
Notary Public.
Signed and sworn
Commission expires: //yV ^ //3
Signed and sworn to before rn^oTT(date)
Page 12 of 13
Apr uo 10 U3.<iaa vvimo Danivs
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMEI IT HEADS
has a direct entitv
It gal
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which ownership interest in the Applicant exceeding 7.5 percent It is not to be completed by any which has only an indirect ownership interest in the Applicant
with
$DSis
related to domestic or uncle, -, stepfather
, aurt -la v,
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "femilial relal ionship' any elected city official or department head. A 'familial relationship" exists if as ofthe date mis signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof Is the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Parry" means (1) all executive officers ofthe Disclosing Party listed in Section UJ i.i.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a gi neral partnership; all general partners and limited partners ofthe Disclosing Party, if the Disclosing Part r is a limited partnership; all managers, managing members and members of the Disclosing Parry, if the Disclos og Party is a limited liability company; (2) all principal officers ofthe Disclosing Party, and (3) any person havi ig more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, c nef operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity c r any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
[ ]Yes
ryfNo
to which whom such
entity
If yes, please identify below (1) the name and title of such person, (2) the name ofthe legal such person is connected; (3) the name and title ofthe elected city official or department head to person has a familial relationship, and (4) the precise nature of such familial relationship.
Page 13 of 13
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested. This recertification is being submitted in connection with _
[identify the Matter]. Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS recertification on behalf of the Disclosing Party, (2) warrants mat aQ certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as of the date furnished to the City and continue to be true, accurate and complete as ofthe date of this recertification, and (3) reaffirms its acknowledgments.
(bRac.r. \Aa^Aj/ Date: % j^il I &
(Print or type legal name of Disclosing Party)
By:
(sign here) Print or type name of signatory:
Tide of signatory:
Signed and swom.tp before me on fdatel Q>' 23* (3 , by
tC£. tfCtrdy , at fog- County, [state].
Notary Pubb'c.
OFFICIAL SB*!. ZAMBIA SANDERS NotuyfuMe-State of IWnofc My Cwwnlnton ExpJrw Aug 23,2016 m~^^^>w w w m m mm m<
Commission expires: I
Vcr.U-41-OS
ZIZ
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