OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR
September 24, 2015
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request of the Commissioner of Planning and Development, I transmit herewith ordinances authorizing 2016 budgets and service provider agreements for various Special Service Areas.
Your favorable consideration of these ordinances will be appreciated.
Mayor
Very truly yours,
ORDINANCE
WHEREAS, special service areas may be established pursuant to Article VII, Sections 6(1) and 7(6) of the Constitution of the State of Illinois, and pursuant to the provisions of the Special Service Area Tax Law, 35 ILCS 200/27-5 et seq., as amended from time to time (the "Act") and pursuant to the Property Tax Code, 35 ILCS 200/1-1 et seq., as amended from time to time (the "Code"); and
WHEREAS, on December 8, 2010, the City Council of the City of Chicago (the "City Council") enacted an ordinance (the "Establishment Ordinance") which established an area known and designated as City of Chicago Special Service Area Number 49 (the "Area") and authorized the levy of an annual tax, for the period beginning in 2010 through and including 2019, not to exceed an annual rate of two percent (2%) of the equalized assessed value of the taxable property therein (the "Services Tax") to provide certain special services in and for the Area in addition to the services provided by and to the City of Chicago generally (the "Special Services"); and
WHEREAS, certain funds in Fund A96 ("Fund A96") in the amount of $8,554 are available for use in connection with the Area; and
WHEREAS, the Establishment Ordinance established the Area as that territory consisting approximately of Exchange Avenue from the south side of 71st Street to 79th Street; 75th Street from the east side of Paxton Avenue to west side of South Shore Avenue; 79th Street from the east side of Paxton Avenue to the west side of South Shore Avenue; and
WHEREAS, the Special Services authorized in the Establishment Ordinance include, but are not limited to: recruitment of new businesses to the Area, rehabilitation activities, maintenance and beautification activities, security, coordination of promotional and advertising activities, strategic planning for the Area, and other technical assistance activities to promote commercial and economic development (which may include, but are not limited to, streetscape improvements, strategic transit/parking improvement including parking management studies, and enhanced land use oversight and control initiatives); and
WHEREAS, the Establishment Ordinance provided for the appointment of the South Shore/Exchange Special Service Area Commission (the "Commission") to advise the City Council regarding the amount of the Services Tax to be levied and for the purpose of recommending to the City Council: (1) a yearly budget based upon the cost of providing the Special Services; (2) an entity to serve as a service provider (the "Service Provider"); (3) an agreement between the City and the Service Provider for the provision of Special Services to the Area (the "Service Provider Agreement"); and (4) a budget to be included in the agreement between the City and the Service Provider (the "Budget") (the aforementioned items 1 through 4 shall be known collectively herein as the "Recommendations"); and
WHEREAS, the Commission has been duly appointed and qualified and has heretofore prepared and transmitted to the Commissioner of the Department of Planning and Development
2015SSA49-Levy Ord.doc
(the "Commissioner") its Recommendations to the City Council, including the Budget attached hereto as Exhibit A and hereby made a part hereof; now, therefore
Be It Ordained by the City Council of the City of Chicago:
SECTION 1. Incorporation of Preambles. The preambles of this ordinance are hereby incorporated into this text as if set out herein in full.
SECTION 2. Appropriations. There is hereby appropriated the following sums in the amounts and for the purposes necessary to provide the Special Services in and for the Area, the estimated amounts of miscellaneous income and the amounts required to be raised by the levy of the Services Tax indicated as follows:
SOUTH SHORE/EXCHANGE SPECIAL SERVICE AREA COMMISSION SPECIAL SERVICE AREA BUDGET
For the fiscal year commencing January 1, 2016 and ending December 31, 2016.
EXPENDITURES
Service Provider Agreement for the provision of Special Services
TOTAL BUDGET REQUEST
SOURCE OF FUNDING Tax levy at an annual rate not to exceed two percent (2%) of the equalized assessed value, of the taxable property within Special Service Area Number 49
Fund A96
Carryover funds currently available from prior tax years
Late collections received by the City of Chicago attributable to the levy of the Services Tax in prior tax years, along with interest income thereon, if any
2015SSA49-Levy Ord.doc
SECTION 3. Levy of Taxes. There is hereby levied pursuant to the provisions of Article VII, Sections 6(a) and 6(l)(2) of the Constitution of the State of Illinois and pursuant to the provisions of the Act and pursuant to the provisions of the Establishment Ordinance, the sum of $449,047 as the amount of the Services Tax for the tax year 2015.
SECTION 4. Filing. The City Clerk of the City (the "City Clerk") is hereby ordered and directed to file in the Office of the County Clerk of Cook County, Illinois (the "County Clerk") a certified copy of this ordinance on or prior to December 29, 2015, and the County Clerk shall thereafter extend for collection together with all other taxes to be levied by the City of Chicago, the Services Tax herein provided for, said Services Tax to be extended for collection by the County Clerk for the tax year 2015 against all the taxable property within the Area, the amount of the Services Tax herein levied to be in addition to and in excess of all other taxes to be levied and extended against all taxable property within the Area.
SECTION 5. Service Provider Agreement. The Commissioner, or a designee of the Commissioner (each, an "Authorized Officer"), are each hereby authorized, subject to approval by the Corporation Counsel as to form and legality, to enter into, execute and deliver a Service Provider Agreement as authorized herein with Far South CDC, an Illinois not-for-profit corporation, as the Service Provider, for a one-year term in a form acceptable to such Authorized Officer, along with such other supporting documents, if any, as may be necessary to carry out and comply with the provisions of the Service Provider Agreement. The Budget shall be attached to the Service Provider Agreement as an exhibit. Upon the execution of the Service Provider Agreement and the receipt of proper documentation the Authorized Officer and the City Comptroller are each hereby authorized to disburse the sums appropriated in Section 2 above to the Service Provider in consideration for the provision of the Special Services described in the Budget. The Department of Planning and Development shall promptly make a copy of the executed Service Provider Agreement readily available for public inspection.
SECTION 6. Enforceability. If any section, paragraph or provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such section, paragraph or provision shall not affect any of the remaining provisions of this ordinance.
SECTION 7. Conflict. This ordinance shall control over any provision of any other ordinance, resolution, motion or order in conflict with this ordinance, to the extent of such conflict.
SECTION 8. Publication. This ordinance shall be published by the City Clerk, in special pamphlet form, and made available in her office for public inspection and distribution to members of the public who may wish to avail themselves of a copy of this ordinance.
SECTION 9. Effective Date. This ordinance shall take effect 10 days after its passage and publication.
2015SSA49-Levy Ord.doc
EXHIBIT A
Budget
2015SSA49-Levy Ord.doc
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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:
fCv Sot^i QhC.
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this,EDS is: Applicant
OR
2. [ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Parry holds an interest:
OR
3. [ J a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control: ,
B. Business address of the Disclosing Party: B- f-/^8^C) 0f -./ktiiG, b
Telephone: hlS)^ ' JfB '< '3 Fax:rn3) Qh\ SOS*. Email: WWlkforSetmdte-Of^
Name of contact person: /-fbmlX^wVl b> LCtW[
Federal Employer Identification No. (if you have one):,
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains (Include project number and location of property, if applicable): ,
\ULi\i*j0l Ch,cu,n m orxter r^-' ^'idP; QotyucxA atA tOa*i„t ^firf
Which City agency or department is requesting this EDS? If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of I 3
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NA'I URI: OK IT IE DISC! OSING P ARTY
1. Indicate the nature of" the Disclosing Party;
[ } Person [ ] Limited liability company
[ | Publicly registered business corporation [ | Limited liability partnership
[ | Privately held busin-esh corporation [ ] Joint venture
[ J Sole proprietorship |vK$<>t-for-profit corporation
[ 1 General paitnership (Is the notrfor-profit corporation also a 501(c)!. V))'"
[] Limited partnership as [JNo
[ | Trust |'| Other (please specify)
2. For legal entitle-;, the state (or foreign country) of incorporation or organization, if applicable-
X^Wvli
.V For legal eniities not organized in the State of lllinois. Has the organization registered to do business in the State of Illinois as a foreign entity''
[lYes {JNo li^N.-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 entity. NOTE: For not-for-profit corporations, also list below ali members,.if any., whiclvare Legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, 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.
Name Title
_ Js*^$v^ud,te.<> ilSAti- ffr> trrf.^V^ffi .
2 Please piov-ule '.be follow me. information concerning each person nr entity having a direci or indirect beneficir.! micro-: | including ow neisbip) in C\re-;s of 7 >",, of the Disclosing Parts lAiunplcs o; such an intercut mciiulc si-.are^ m :\ coiporation. pailneiship interest in a part no '.ship or joint venture.
Page 2 ol I -.
Chairman
Leon Walker
President
LeRoy Chalmers
Secretary
John Chenier
Treasurer
Dennis O'Vlalley
Director
Jackie Johnson-Sample Director
Major David Harvey Director
Rev. Leonardo Gilbert
Director
Phillip Snorden
Ahciliam D. I.aey Executive Director
W>:.1 S I lalstcd Street. Suite D ; C'hicngo. II. 60628 I O: (773) v 11 -48.31 , F: (773) 04 |-5252 ! E
Lilt'\r/I"arsouiheiieoru raj-NOuthetle^rg ; uuw j)annor>jHvlij!.pre
mreres' i'f\i member or manrieer m a limited liability company, or interest ol a PenefiiTary ol a tuisi. estateui:oi!ie-i--^Miu-iar-e-nl-M-y -ll--none,; state"" No it; .'v'- V(") ITC/PiTi'sVialif Lo Section 2-1 s-J-O.ifi oi the Municipal Code of Chicago i "Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achie\e full disclosure
Name business Address Percentage Interest in the
Disclosing Party
j^-GAiL :
SECTION HI - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship;,'' as defineiFin Chapter !2-156 of the rVlunicipal Code, with any City elected official in the 12: months before the date this EDS is signed?
If yes. please identify below the name(s) of such City elected offieial(s) and describe such relationship!*).
SECTION I\' - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who aie paid solely through the Disclosing Party's regular payroll.
¦"Lobbyist" means any person oi entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: {I) a not-for-profit entity, on an unpaid basis, or |2) himself Lobbyist" also means any person or entity any purl of whose duties as an employee ot another includes undertaking to influence any legislative or administrative action
If the Disclosing Party is unceitam \\ hetiier a disclosure is required under this Section, the Disclosing Party must either ask the C ity whether disclosure is required or make the disclosure
Page * of 1.1
Name (inuicatv wncthci Business Relationship to Disclosing Pariv Fees (indicate whether
.ictained-oi-anMcipalcc Address "' (subcontractor, attorney, paid or estimated ) NO I F.
to he retained) lohhyisi. etc,) '"hourly rale" or "i b d " is
not an acceptable response
-ki-^kUji^:
(Add sheets if necessary I
| ] Check lie re il' the Disclosing Party has not retained, nor expects to retain, any such persons or entitle SECTION V - CERTIFICATIONS
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under 'Municipal Code Section 2-92-4115, s.u feistawitel^-wnef^ of business entities that contract with the City must remain in compliance with their child support obligations throughout the Contract's term
Mas any person who directly or indirectly owns 10% or more of the Disclosing Party been declared tn arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ j Yes [ ] No [vT'No"person directly or indirectly owns 1 0% or more of the
Disclosing Party.
If "Yes." has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with lhal agreement?
f 1 Yes f j No
H FURTHER CERTIFICATIONS
1 Pursuant to Mumcipa)'Code Chapter 1-23. Article 1 ("Article l")(whieh the Applicant should consult for defined terms (e.g "doing business"') and legal requirements), if the Disclosing Party submitting 'bis FDS is the Applicant and is doing business with the City, then the Disclosing Parts-certifies us follows, (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of. or has ever been convicted of. or placed under supervision for. anv criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjtiiy. dishonesty or deceit against an officer oi employee ol'lhe City or any sister agency: and [ill the Applican! understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City NOT! . If Article I applies to the Applicant, the permanent compliance timeframe m Article i supersedes some fi\e-\eai compliance time frames m ceritficaitons 2 and below
R^RSOUT44
Community Development Corporation
SSA#49 List of Retained Parties - 2016
SubcxSitractd^;;; . rio,000
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: ,!\Rublic WayjlMalnVrijjnce:
vi;?'i; •.'.v;oj. Customer Attraction
i;5^,WVbiv«^^«;;C)iiago, IL'60639:^ .-.-.r • -^Subcontractor 10,000 |Fpf6?Bo*43i^
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9923 S. Halsted Street, Suite D | Chicago, IL 60628 | 0: (773) 941-4833 | F: (773) 941-5252 | E: info@farsouthcdc.org | www.farsouthcdc.org | www.ssa45.org | www.ssa49.org | www.partnersportal.org
2 1 he Disclosing fail} and, if the Disclosing Parly is .1 legal entity, all ut t.'iose |H'1mhn or entities
idciljjJj.Cfi :.n .Set 1.0.11_1 ] .ii ...i O.I- till* i IDS, - - - ~'"
nit' nol presently debarred, suspended, ptoposed lor debarment, declared ineligible 01 volunlariU excluded trom any transactions by any federal, stale or local unit of gov ernment.
have not, withm a five-year period preceding the dale of this EDS* been convicted ofa criminal offense, adjudged-guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing;a public (federaf. state or.local) transaction or
contract under a public transaction, a violation of federal or slate antitrust statutes, fraud; embezzlemen-. theft; forgeiy. bribery ; falsification or destruction of records, making false statements; or rteeising stolen property;
are not presently indicted for. or ciiminally or civilly charged by. a governmental entity (federal, srate or local ) with committing any of the offenses set forth in clause B-.2.b, of this Section V:
have not. within a five-year period preceding the date of th.is EDS, .hail one or more public transactions (federal, slate or local 1 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, including actions
concerning environmental violations, instituted by the City or by the federal government, 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 Party in connection with ihe Matter, including but not limited to all persons or legal eniities disclosed under Section IV. 'Disclosure of Subcontractors and Other Retained Parlies");
any "Affiliated l-'ntily" (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, under common control of another person or entity. Indicia of control include, without limitation interlocking management or ownership; identity of interests among family members, shared facilities and equipment: common use of employees: or organization ofa business entity following the ineligibility ofa business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or piincipals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Counselor, ts controlled by it, or. with the Contractor, is under common control of anothei person or entity.
any responsible ofb.eial of the Disclosing Party. any Contractor or any Affiliated Enlity or anv other official, agent ot emp'oyec of ihe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the directum or auiho: i/atmn ofa responsible official of the Disclosing Parry, anv Contrac lor or any \ (filiated Intitv ii.oileedv civ "Agents").
Neither the Disclosing Party. nor any (. oiiirae:or, no; any Affiliated L ntitv ol cither the Disclosing Panv
or any-Contiactor noi ¦ ny Agents have, du:lug/ the'!i\e yeaTs^lieTtTreTJie^ale !h'is~FDN is signed, or. >.v nil
lespeer to a (' ontractoi. an Alfilialcd bntity. or an Affiliated Lntity ofa Contractor during the five years belorc the dale or such Contractor's- or Affiliated entity's contract or engagement in connection with the Matter
bribed or attempted to bi ihe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government oi of any state or local government in the United States of America, in that officer's or employee's official capacity:
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or ad judged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise: or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the pro\ isioiis of Municipal Code Section 2-l>2-f)K> (Living Wage Ordinance).
A, Neither the Disclosing Party. Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local (government as a result of engaging iii or being convicted of (I) bid-rigging inviolafton of 710 ILCS 5/33B-3; (2) bid-rotating in violation of 720 ILCS 5'eo!£-4; or |3) any similar otTense irfany state>or of the United States of
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 follovying lists maintained by ihe Office of Foreign Assers Control oi'lh.c U.$. Department of the Treasury or the Bureau of Industry and Security of the U S, Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the
Debarred I ist.
6, The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General). 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
7 If the Disclosing Parly is unable to certify to any of the abene statements in this Part B (Further Certifications), the Disclosing Paily must explain below.
Pai.v 6 "f 1 -
j r rhe-tellers-"the lines aho\ e. it vvi.T he conclusn i-l\ presumed that die Disclosing P.iriv certified lo the above statements.
S lo the best of the Disclosing Party's knowledge after reasonable inquiiy. the following is a complete list oi all current employees of the Disclosing Party who were, at any time during the 12-month period piccedtrg the execution date of this EDS. an employee, or elected or appoinLed official, of the City of Chicago (if none, indicate with "N'A" or 'none").
—dfe, 1_ -
9. To the best of the Disclosing Parly's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the I 2-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 ihis statement, a "gift" does nol include: ii) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than S20 per recipient (if none, indicate with "N "A" or "none"). As to anv uiff listed below, please also list the name of the Citv recipient.
M-jfi- - i. :
C CERTIFICATION OF STATUS AS FINANCIAL INST1TU HON
The Disclosing Party certifies that the Disclosing Party (check one) [ j is Ivr'ts^not
a "financial institution" as defined in Section 2-32~4fo(b) of the Municipal Code.
If the Disclosing Paity IS a financial institution, then the Disclosing Parly pledges
"We are nol and will no" become a predatory lender as defined in Chapter 2-32 of the Municipal Code We further pledge that none of our affiliates is. and none of them will become, a predatory lender as denned in Chapier 2-V2 of the Municipal Code. We understand lhat becoming a predatory lender or becoming an affiliate ofa predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-*2-455(b) oft ie Municipal Code l is a predatory lender within the meaning of Chapter 2-i2 of ihe Municipal ( ode. explain here (attach additional pages if necessary>
If tlu- letters "NA." the word "None." or no response appears on the lines above, it will be 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 same meanings when used in this Part D.
In accordance with Section 2-l5b-l 10 of the Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter? ^.
I 1 Yes [v^fo
NOTE: If you checked "Yes" to Item D.l proceed to Items D 2. and D 3. If you checked "No" to Item D.l., proceed to Part E.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (fyhelorvgs to the .City, or (ii.) is sold for taxes or assessments, or (iii) is sold by virtue of legal process afihe suit oT.fhe City (collectively. "City Property Sale"). Compensation for property tak;en pursuant tp?the: City's eminent domain power does not constitute afinancial interest within" the meaning of tfris 1*a.rtF&.
Does the Matter involve a City Property Sale.'
[ I Yes I ) No
3 If you checked "Yes" to Item D I ., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature oi'Interest
4. The Disclosing Party fuither certifies that no prohibited financial interest m the Matter will be acquired by any City official or employee
I- CER I IMC VI ION REGARDING SI A>. FRY ERA BUS1NFSS
Please cheek eithct I or 2 bc!o-.\ It 'he Disclosing Party checks 2 . the Disclosing Patty nuis: disclose heiou or in a:i a't.iehir.eni :o liiix I DS all information required In paragraph 2 Failure lo
PaueHol H
comply with these disclo-unc ivo,i ore meets may make any contract entered into ye.ttli iheXity in - ¦ coiVneetun\ \vVtiY ;IVe Vlittei voidable hy die (.'uy.
V I. The Disclosing I'ariy verifies that the Disclosing Paily has searched any and .ill recouis ol' the Disclosing I'ariy and any and all predecessor entities regarding iccords ol" investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to 01 injury or death of their slaves), and the Disclosing Party has found no such records.
_? The Disclosing Party verifies that, as a result of conducting the search in step I above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records'
SECTION VI -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE. If the M atter is federally funded, complete this.Section VL rf the Matter is not federally funded, proceed to Section VII. For purposes of this SccTten VI. tax-Credits allocated by the City and proceeds of debt obligations of the City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1 List below the names of all persons or entities registered under the federal Lobby ing Disclosure Act of 1°95 who have made lobbying contacts on behalf of ihe Disclosing Parly with respect to the Matter- (Add sheets if necessary).
( If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be concli.sively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1 u05 have made lobbying contacts on behalf of the Disclosing Party wuh respect to the Matter )
2. Ihe Disclosing P.oty has nol spent and will not expend any federally appropriated funds to pay any person or cntily listed in Paragraph A I above for Ins or hei lobbying activ ities oi to pav anv person or entity hi influence oi aiieiv.pt to influence an officer or employee of,my agency, as defined by applicable federal law . a mem bet ol Congress. n officer ot employee of ( ongress, or an employee ol a member of ( oiigtess m eomect .on v\ i!h the award of any fcdeiallv funded contract, making an\ lederally luuded giant o lo.n. entering into ,.mv inoperative agreement, or to extend, continue, renev amend or modny anv l'cdei;,Fv :ui;ded co-iti-let. gram. loan or cooperative agreement
Page l> ol H
""""3 TlVoT')"i"sc"!osiheTcirt\ w iii uibinil an updated certification at the end of each calendar quaitcr in u Inch (here occur* aiv, even; (ha: materially affects the accuracy of the statements and in formation set forth in paragraphs A I and A 2 above.
4 The Disclosing Party certifies that either: (i) it is not an oiganization described in section 501 (c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not cngaged and will not engage t;i "Lobbying Activities".
5. If the Disclosing Parry is the Applicant, the Disclosing Pftrty,:mM equal in
form and substance ro paragraphs A.l. through A.4. above from all s^\ae6ntt'^Qtors:b.^,ihxc it'awafds any
subcontract and the Disclosing Party hru.st mainuiin al^ for the
.duration of the Matter and muslmake such certifications promptly available to the City upon request.
B CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require the Applicant arid. a|f proposed subcontractors tri submit the following information with their bids or io Vvrifihg at tlie outset of
negotiations.
Is the Disclosing .Party the Applicant .'
I I Yes [] No
If "Yes," answer the three questions below;
1 Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 C FR Part 60-2.)
1. 1 Yes f j No
Have you filed u ith the Join? Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements'.'
[ I Yes [ ] No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause'*
i I Yes 1 ; No
II you checked "No" to t ucstion 1. oi 2 above, please provide an explanation'
Page 10 ot I^
SECTION "\ Tl '-- \C KNOW IF DO ME N IS, CON I KA( T 1NCOR \ HON. C OM 1*1.1.ANC E. I*EN A I,TIES, DISC I.OSCRE
I'he Disclosing Party i, nclcr.slan tls. and a gives thaf
A.- The ecilifications. disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and the City m connection with the Mattel, whether piocuremenr. City assistance, oi othei City action, and are material inducements to the City's execution ol' any contract or taking other action with respect to the Matter The Disclosing Party understands thai it must comply with ail statutes, ordinances, and regulations on which this EDS is based.
R. The City's Governmental Ethics and C anipaign Financing Ordinances. Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. I he full text of these ordinances and a training program is available on line at www.ciiyofchica.tio.orti/Eihics . and may also be obtained from the City's Board of Ethics, 740 N,
Sedgwick St Suite >0('!. Chicago IL 60610, (3 12.) 744-9660. The Disclosing Party must comply fully with the applicable ordinances
(.'. If the City determines that any information provided in this FDS is false, incomplete or inaccurate, any contract or other agreement in connection with which il is 'submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement {if not rescinded or void), at law. or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statemeru or material fact may include incarceration and an award to the City of treble damages.
D It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of 1 he information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise By completing and signing this FDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the Ciiy in connection with the public release of information contained in this F DS and also authorizes the City to verily the accuracy of any information submitted in this EDS.
E. T he information prov uled in (his EDS must be kept current. In the event of changes, the Disclosing Party musl supplement this EDS up to the tune the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract lequues NOTE: With respect to Matters subject to Article I of Chapter 1-2.1 ol'lhe M unci pa I ( ode (imposing PERMANENT INELIGIBILITY lor certain specified offenses), the information pto\ uled herein teyarding eligibility must be kept current for a longer period, as required by ( haplei 1-2 > and Section 2-1 54-020 of Ihe Municipal Code
The Disclosing Patty represents am' v. an ants ;hat
Pane 11 of le
¦Evl j he Dise losing 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 water charges, sewer charges, license fees, parking tickets, 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 equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent 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 certifications. -
NOTE: If the Disclosing Party cannot certify as to any of the items in F. 1 F.2. or F.3. above, 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 to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
(Print or type name of Disclosing Party)
By:
(Print or type name of person signing) (Print or type title of person signing)
Signed and sworn to before me on (date) <-^Xep/f~ IO^ <^mY^
at C;~± (state).
otary Public.
ILL:
Commission expires:
OFFICIAL SEAL SHARONE R JOHNSON Notary Public - State of Illinois My Commission Expires Oct 5, 2017
^ i u u u
¦V V V V
Page 12 of 13
CITY OF C 11TCACO" ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL R E L AT IONSIII PS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015. the Disclosing Party must dii5cj.6se whether
Or any¦'""Applicable Party'' or any Spouse or Domestic P^|)n^r-ttteCi^f'eun,iMtiy!iia^J; v'Ia'mtlia1 relationship" with
any elected city.otiicial or department head. A "familial relationship' crisis,^(^o^th?date fills EDS is
signed, the Disclosing Party or any " Applicable Party" pr any-Spouse of .DoiViestjc Partner tliereof is related to
the mayor, any.alderman, the city clerk, the city treasurers'ii'hy«U^djB^^n.I heacl-as spOusc or domestic
partner or as any of the following, whether by blood or adoption:;pawnty emTdv ^ aunt or uncie,
niece or nephew, grandparent, grandchild, father-in-law. iuoiher-in^la\y. spn-inrlaw.'daugiUer^in-law. stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or halfrSister.
"Applicable Party'" means {I) all executive officers ol'lhe Disclosing Party listed in Section fl. B. I .a., if the Disclosing Party is a corporation: all partners of the Disclosing Party, if the Disclosing Party is a general partnership: all general partners and limited partners of the Disclosing Paffy. it* Uie Disclosing Party is limited partnership: all managers, managing members and members of the DiselpsmgParty, if the Disclpsing Party is a limited liability company: (2) all principal officers of the Disclosing Paifyv0il:t$) any persoiv'havingrmore than a 7,5 percent ownership interest in the Disclosing Part}. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary ofa legal entity or any person exercising similar authority.
Does the Disclosing Party or tiny " Applicable Parly"' or any Spottse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
L | Yes
If yes, please identify below I 11 the name and title of such person. (2) the name of the legal entity to which such person is connected. (?) ihe name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the pi ease nature of such familial relationship.
Pane le of {}
CUT OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX 13
HIT I .DING CODE SCOFFLAH/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only-by (a) Ihc Appiicant, sin d (b) any legal entity yv'liicli has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owner"). IfTs not to be completed by any legal entity wliicl^lias only an indirect ownership interest in Ihe Applicant.
1 Pursuant ^Municipal Code Section 2-154-010, is the>A|ij^lit^tso^alrj^-O^acr-tttonjliRed.ns-.a building code scofflaw or problenr landrbrd-purSuaht
Code''
MThe Applicant is a legal entity publicly traded on any exchange, is anv officer or director of the Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-116 of the Municipal Code "
3 If yes to (I) or (2) above, please identify below the name ofthe person or legal entity identified as a building code scofflaw or problem landlordand; die address ,of the butk
buildings to which the pertinent code violations apply
FILLING OFT TIMS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO. AND MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.