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This record contains private information, which has been redacted from public viewing.
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Type:
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Ordinance
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Status:
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Passed
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Title:
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Zoning Reclassification Map No. 3-F at 1010-1028 N Dearborn St - App No. 18514
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Topic:
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ZONING RECLASSIFICATIONS - Map No. 3-F
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FINAL FOR PUBLICATIO ORDINANCE BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO: SECTION 1: Title 17 of the Municipal Code of Chicago, Chicago Zoning Ordinance, is amended by changing all the RM5 Residential Multi-Unit District symbols and indications as shown on Map No. 3-F in the area bounded by: A line 300.5 feet north of and parallel to West Oak Street; North Dearborn Street; The alley next north of and parallel to West Oak Street; The alley next west of and parallel to North Dearborn Street to those of a RM6.5 Residential Multi-Unit District. SECTION 2: Title 17 of the Municipal Code of Chicago, Chicago Zoning Ordinance, is amended by changing all the RM6.5 Residential Multi-Unit District symbols and indications as shown on Map No. 3-F in the area bounded by: A line 300.5 feet north of and parallel to West Oak Street; North Dearborn Street; The alley next north of and parallel to West Oak Street; The alley next west of and parallel to North Dearborn Street to those of a Residential-Business Planned Development, which is hereby established in the area described, subject to such use and bulk regulations as are set forth in the attached Plan of Development. SECTION 3: This ordinance shall take effect upon its passage and due publication: Address(cs): 1010-1028 N. Dearborn St. 1149.0001 Page 1 of 1 Residential-Business Planned Development No. PLANNED DEVELOPMENT STATEMENTS The area delineated herein as Residential-Business Planned Development Number ("Planned Development") consists of approximately 29,869 net square feet (0.69 acres) of property which is depicted on the attached Planned Development Boundary and Property Line Map ("Property") and is owned or controlled by the Applicant, Lexington Dearborn L.L.C. (Subarea A), The Ruth Page Foundation (Subarea A, Subarea B), and the Palette And Chisel Academy Of Fine Arts (Subarea C). The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors. All rights granted hereunder to the Applicant shall inure to the benefit of the applicant's successors and assigns and, if different than the. applicant, the legal title holder and any ground lessors. Furthermore, pursuant to trie requirements of Section 17-8-0400 of the Chicago Zoning Ordinance, the Property, at the time of application for amendments, modifications or changes (administrative, legislative or. otherwise) to this Planned Development are made, shall be under single ownership or designated control. Single designated control is defined section 17-8-0400 ofthe Zoning Ordinance. All applicable official reviews, approvals or permits are required to be obtained by the applicant of" its successors, assignees or-'"panties'.'."gSiry"dedication'of vacation of streets Or alleys or grants of easements or any adjustment ofthe right-of-way shall require a separate submittal to the Department of Transportation on .behalf of the Applicant or its successors, assign or grantees.' Any requests for grants of privilege, or any items encroaching on the public way, shall be in compliance with the Plans. Ingress or egress shall be pursuant to the Plans and may be subject to the review and approval of the Departments of Planning , and Development and Transportation. Closure of all or any public street or alley during demolition or construction shall be subject to the review and approval of the Department of Transportation. All work proposed in the public way must be designed and constructed in accordance with the Department of Transportation Construction Standards for Work in the Public APPLICANT: ADDRESS: INTRODUCTION DATE: REVISED / CPC DATE: Lexington Dearborn L.L.C. 1010-1028 N. Dearborn St. September 24, 2015 February 18, 2016 1149.0001 Page 1 of 6 Way and in compliance with the Municipal Code ofthe City of Chicago. Prior to the issuance of any Part II approval, the submitted plans must be approved by the Department of Transportation. This Plan of Development consists of these 16 Statements and: Bulk Regulations and Data Table Existing Zoning Map Existing Land-Use Map Planned Development & Property Line Map Subarea Map Site Plan Site Plan (Subarea A) Landscape/Green Roof Plan (Subarea A) Building Elevations - East Elevation Building Elevation - (Subarea A) South Elevation Building Elevations - West Elevation Building Elevation - (Subarea A) North Elevation All prepared by Pappageorge Haymes Partners and dated February 18, 2016. In any instance where a provision of this Planned Development conflicts with the Chicago Building Code, the Building Code shall control. This Planned Development conforms to the intent and purpose of the Zoning Ordinance, and all requirements thereto, and satisfies the established criteria for approval as a Planned Development. In case of a conflict between the terms of this Planned Development Ordinance and the Zoning Ordinance, this Planned Development Ordinance shall control. The following uses are permitted in the area delineated herein as a Residential-Business Planned Development: Subarea A: Residential - Multi-Unit (3+ units) Parking - Accessory (including accessory parking for Subarea B) Wireless Communication Facilities - Co-located Accessory Uses (as defined in § 17-17-0206 of the Chicago Zoning Ordinance) Subarea B: Cultural Exhibits and Libraries APPLICANT: ADDRESS: INTRODUCTION DATE: REVISED / CPC DATE: Lexington Dearborn L.L.C. 1010-1028 N. Dearborn St. September 24, 2015 February 18, 2016 1149.0001 Page 2 of 6 School Artist Work or Sales Space Entertainment (limited to small and medium cultural and performing arts venues) Parking, Accessory Personal Service (limited to dance studios and related exercise and performing aits) Sports and Recreation, Participant (limited to dance related events) Accessory Uses (as defined in § 17-17-0206 of the Chicago Zoning Ordinance), including but not limited to accessory office and accessory retail sales Subarea C: Cultural Exhibits and Libraries School Artist Work or Sales Space Parking, Accessory Personal Service (limited to art studios and arts related instruction) Accessory Uses (as defined in § 17-17-0206 of the Chicago Zoning Ordinance), including but not limited to accessory office and accessory retail sales All off-street parking spaces within the Planned Development shall be designated as accessory parking. On-Premise signs and temporary signs, such as construction and marketing signs, shall be permitted within the Planned Development, subject to the review and approval of the Department of Planning and Development. Off-Premise signs are prohibited within the boundary of the Planned Development. For purposes of height measurement, the definitions in the Zoning Ordinance shall apply. The height of any building shall also be subject to height limitations established by the Federal Aviation Administration. The maximum permitted Floor Area Ratio ("FAR") for the site shall be in accordance with the attached Bulk Regulations Table. For the purposes of FAR calculations and measurements, the definitions in the Zoning Ordinance shall apply. The permitted FAR identified in the Bulk Regulations Table has been determined using a net site area of 29,869 square feet. APPLICANT: Lexington Dearborn L.L.C. ADDRESS: 1010-1028 N. Dearborn St. INTRODUCTION DATE: September 24, 2015 REVISED / CPC DATE: February 18, 2016 1149.0001 Page 3 of 6 The PD's underlying FAR for purposes of possible future development is 8.25, pursuant to § 17-2-0304-C. Unused FAR / buildable floor area (28,961.23 sf) shall be retained in and subject to the control of Subarea C. Upon review and determination, "Part II Review", pursuant to Section 17-13-0610 of the Zoning Ordinance, a Part II Review Fee shall be assessed by the Department of Planning and Development. The fee, as determined by staff at the time, is final and binding on the Applicant and must be paid to the Department of Revenue prior to the issuance of any Part II approval. The Site and Landscape plans shall be in substantial conformance with the Landscape Ordinance and any other corresponding regulations and guidelines. Final landscape plan review and approval will be by the Department of Planning and Development. Any interim reviews associated with site plan review or Part II reviews, are conditional until final Part II approval. The Applicant shall comply with Rules and Regulations for the Maintenance of Stockpiles promulgated by the Commissioners of the Department of Streets and Sanitation, and the Department of Fleet and Facility Management, under Section 13-32-125 of the Municipal Code, or any other provision of that Code. The terms and conditions of development under this the Planned Development ordinance may be modified administratively, pursuant to section 17-13-0611-A ofthe Zoning Ordinance by the Zoning Administrator upon the application for such a modification by the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors. The Applicant acknowledges that it is in the public interest to design, construct and maintain the project in a manner which promotes, enables and maximizes universal access throughout the Property. Plans for all buildings and improvements on the Property shall be reviewed and approved by the Mayor's Office for People with Disabilities to ensure compliance with all applicable laws and regulations related to access for persons with disabilities and to promote the highest standard of accessibility. The Applicant acknowledges that it is in the public interest to design, construct, renovate and maintain all buildings in a manner that provides healthier indoor environments, reduces operating costs and conserves energy and natural resources. Aspects of the proposed Planned Development that bring it into compliance with the Sustainable Development Policy include the following: APPLICANT: Lexington Dearborn L.L.C. ADDRESS: 1010-1028 N. Dearborn St. INTRODUCTION DATE: September 24, 2015 REVISED / CPC DATE: February 18, 2016 1149.0001 Page 4 of 6 Subarea A building(s) shall obtain LEED, Energy Star, Chicago Green Homes, or Green Globes certification and will include a green roof for at least 50% of the net roof area. Notwithstanding the foregoing (and notwithstanding the Bulk Table), the Applicant may obtain LEED Silver certification in lieu of providing a green roof. 15. The Applicant acknowledges and agrees that the rezoning of the Property from RM5 Residential Multi-Unit District to RM6.5 Residential Multi-Unit District and then to Residential-Business Planned Development for construction of this Planned Development triggers the requirements of Section 2-45-110 ofthe Municipal Code (the "Affordable Housing Ordinance"). Any developer of a "residential housing project" within the meaning of the Affordable Housing Ordinance ("Residential Project") must: (i) develop affordable housing units as part ofthe Residential Project; (ii) pay a fee in lieu of the development of affordable housing units; or (iii) any combination of (i) and (ii). In accordance with these requirements and the Affordable Housing Profile Form attached hereto as Exhibit A, the Applicant has agreed to make a cash payment to the Affordable Housing Opportunity Fund in the amount of $100,000 per unit ("Cash Payment"). At the time of each Part II review for the Residential Project, Applicant may Update and resubmit the Affordable Housing Profile Form to the Department of Planning and Development ("DPD") for review and approval. If the Applicant subsequently reduces the number-of dwelling units in the Residential1 Project, DPD may adjust1 the requirements of this Statement 15 (i.e., number of Affordable Units and/or ambunt of Cash'Payment) accordingly without amending the Planned Development. Prior to the issuance of any building permits for the Residential Project, including, without limitation, excavation or foundation ' permits, the Applicant must either make the required Cash Payment,- or execute an Affordable Housing Agreement in accordance with Section 2-45-1 L0(i)(2). The terms of the Affordable Housing Agreement and any amendments. thereto are incorporated herein by this reference. The Applicant acknowledges and agrees that the Affordable Housing Agreement will be recorded against the Residential Project and will constitute a lien. The Commissioner of DPD may enforce remedies for breach of the Affordable Housing Agreement, and enter into settlement agreements with respect to any such breach, subject to the approval ofthe Corporation-Counsel, without amending the Planned Development. 16'. This Planned Development shall be governed by Section 17-13-0612 ofthe Zoning Ordinance. Should'this Planned Development ordinance lapse, the Commissioner of the Department of Planning and Development shall initiate a Zoning Map APPLICANT: ADDRESS: INTRODUCTION DATE: REVISED / CPC DATE: Lexington Dearborn L.L.C. 1010-1028 N. Dearborn St. September 24, 2015 February 18, 2016 Amendment to rezone the property to the pre-existing RM6.5 Residential Multi-Unit District. APPLICANT: Lexington Dearborn L.L.C. ADDRESS: 1010-1028 N. Dearborn St. INTRODUCTION DATE: September 24, 2015 REVISED / CPC DATE: February 18, 2016 1149.0001 Page 6 of 6 Residential-Business Planned Development No. Bulk Regulations and Data Table Gross Site Area: Area in Adjoining Right-of-Way: Net Site Area (By Subarea): Subarea A (Residential site): Subarea B (Ruth Page site): Subarea C (Palette & Chisel site): 11,281 sq.ft. 9,483 sq.ft. 9,105 sq.ft. 41,147 sq.ft. ( 0.94 acres) 11,278 sq.ft. ( 0.26 acres) ( 0.26 acres ) ( 0.22 acres ) ( 0.21 acres ) 29,869 sq.ft. ( 0.69 acres) Maximum Floor Area Ratio (FAR) (By Subarea): Subarea A: Subarea B: Subarea C: Maximum Floor Area Ratio (FAR) (PD): 15.79 3.19 4.20 8.25 Maximum Number of Dwelling Units (By Subarea): Subarea A: Subarea B: Subarea C: Maximum Number of Units (Entire PD): 50 0 0 50 Minimum Number of Off-Street Parking Spaces (By Subarea): Subarea A: . . Subarea B: Subarea C: 72 spaces (includes 22 spaces for the.us Subarea B) 0 spaces 0 spaces Minimum Number of Loading Berths (By Subarea): Subarea A: Subarea B: Subarea C: 1 berth(s) (10'x25') 0 berth(s) 0 berth(s) APPLICANT: ADDRESS: INTRODUCTION DATE: REVISED / CPC DATE: Lexington Dearborn L LC 1010-1028 N. Dearborn St. September 24, 2015 February 18. 2016 FINAL FOR PUBLICATION Minimum Setbacks from Property Lines (By Subarea): Subarea A: Subarea B: Subarea C: Per attached site plans. Per attached site plans. Per attached site plans. Maximum Building Height: Subarea A: Subarea B Subarea C 351 feet 56 feet (existing) 50 feet (existing) Green Roof (By Subarea): Subarea A: Subarea B Subarea C 50% of net roof area 0 % of net roof area 0 % of net roof area APPLICANT; Lexington Dearborn L.L.C ADDRESS: 1010-1028 N. Dearborn St. INTRODUCTION DATE: September 24, 2015 REVISED / CPC DATE: February 18,2016 1149.0001 Page 2 of 2 2007 ARO Affordable Housing Profile (For Sale) Submit this form to the Department of Planning & Development for projects that are subject to the 2007 ARO. Projects submitted after October 13, 2015 will be subject to the 2015 ARO. More information is online at www.cityofchicago.org/ARO .
This completed form should be returned to Kara Breems, Department of Planning & Development, 121 N. LaSalle Street, Chicago, IL 60602. E-mail: kara.breems@cityofchicago.org Telephone: (312) 744-6476
Date:
SECTION 1: DEVELOPMENT INFORMATION
Development Name: TPc
Development Address: io»o - ictPd rV £ag*^pcp4 Ward:cS'Jo
If you are working with a Planner at the City, what is his/her name? -j^Miiy-- fi-AieMU*—
Type of City involvement: Land write-down
(check all that apply) Financial Assistance (If receiving tif assistance, will tif funds be
used for housing construction? ")*if yes, please provide copy of the TIF Eligible Expenses X Zoning increase, PD, or City Land purchase
SECTION 2: DEVELOPER INFORMATION '
Developer Name: Lexit^+srV vete&c&A LUL,
Contact Person: K£HriC.jtt e*\«4£.«=» ' \ .
Address: ire>l A. \\M.c&t ^t. ;<=rticAcco(/«_ +
Email address:^ ^p^^^^i^^^A^c^o
Telephone Number -773,- .SECTION 3: DEVELOPMENT INFORMATION - All projects (oven paying fee-in-lieu) must complete
How many affordable units"are required? If this is an ARO project; . •. v
'S*^: x 1Q%* .= ... '.*5? . (note that we always round up)
Total units total affordable :units required
*20% if f IF assistance is provided,:
If this is a Density Bonus project: &sr /^(U
X 25% =
Bonus Square Footage* Amount of affordable square footage required
"Note that the-maximurn allowed bonus is 20% of base FAR in dash-5; 25% in dash-7 or -10; and 30% of base FAR in dash-12 or -16 (www.cityofchicago.org/hed for zoning info).
Is parking included in the price of: market rate unit? : Yes
affordable unit __; Yes
Is parking optional? Yes No
If parking is not included in the unit price, .what is the price to purchase parking?
Estimated date for the commencement of marketing
1 of 2
Estimated date for completion of construction of the affordable units:
Building Type: (condo, townhouse, etc):
*You must include an appraisal or CMA justifying projected market price for each unit type. SECTION 4: PAYMENT IN LIEU OF UNITS
For each unit configuration, fill out a separate row, as applicable (see example)
Unit Configuration Square feet/ Unit Number of affordable Units Proposed Number of Market-rate units proposed Total # Projected Assessments Proposed Affordable Price Proposed Level of Affordability (80, 90, or 100% AMI) Expected Market Price* Land Trust? (admin use only)
:'?Ex:-1it&rm;-; "' 2 bath ¦m iiDPD.Siaff ;$220,000
Building Total N/A N/A N/A N/A
onth/Year
When do you expect to make the payment -in-lieu?
(typically corresponds with payment/issuance of building permits)
For ARO projects, use the following formula to calculate payment owed:
f^> X 10% = X $100,000 = $ ^C£>, ooo"
Number of total units (round up to nearest Amount owed
in development , whole number)
For Density Bonus projects, use the following formula to calculate payment owed: fler a-^lica«£—
= $_
x 80% x $_
Bonus Floor Area (sq ft) median price per base FAR foot Amount owed
Submarket (Table for use with the Density Bonus fees-in-lieu calculations) Median Land Price per Base FAR Foot
Loop: Chicago River on north/west; Conqress on south; Lake Shore Dr on east $31
North: Division on north; Chicago River on south/west; Lake Shore Dr. on east $43
South: Congress on north; Stevenson on south; Chicago River on west; Lake Shore Dr. on east $22
West: Lake on north; Congress on south; Chicago River on east; Racine on west $29
Authorization to Proceed (to be completed by Department of DPD)
D< veloper/Project Manager
C^^fcyi PB^fLPc^i. CLC-) pi| "f^j-WesrlV- $*£tec=,j (Y^ttZ-
Date cAfpr^ W 7AV/
L-DjJte
2 of 2
FINAL FOR PUBLICATION
PAPPAGEORGE HAYMES
Pappageorge Haymcs Partners
6-40 N LaSalle, Suite 400
Chicago. IL G0654
0 312 337 3344 F 204 0988
Applicant.
Introduction Date. Plan Commission Date
Lexington Dearborn LLC
1010 to 1028 N Dearborn St Chicago, tL 60610
September 24th, 2015 February 18, 2016
Existing Zoning Map
Scale NTS
West Maple Street
X. • ' >.:r;\Buildingy,;''';
EVisKfi'g 3tStoVy.
Oisting ^Stpry^; $lifjeadentialts:j:
iv^uildifig^^r
West Oak Street
Pappageorge Haymes Partners
640 N LaSalle, Suite 400
Chicago, IL 60654
0 312 33/ 3344 F 204 6988
Applicant
Introduction Date Plan Commission Date
Lexington Dearborn LLC
1010 to 1028 N Dearborn St. Chicago, IL 60610
September 24th, 2015 February 18, 2016
mm
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mm mm
< o
mm
XI 3 CL
IP*
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PAP PAG EO R0 E HAYMES
Project Site
(Sub-Area A)
16"-0" Public Alley
Applicant: Lexington Dearborn LLC
Address' 1010 to 1028 N Dearborn St.
Chicago. IL 60610
Introduction Date September 24th, 2015
Plan Commission Date February 18, 2016
Pappagcorge Haymes Partners
G40 N LaSalle, Suite -100
Chicago, IL 60654
O 312 337 3344 F. 204.8988
Applicant.
Introduction Date Plan Commission Date
Lexington Dearborn LLC
1010 to 1028 N Dearborn St. Chicago. IL 60610
September 24th, 2015 February 18, 2016
Sub Area Map
Scale 1" =50'
rvahL run ruDuw%hwv
13th Level Private Terrace
• ^;-::p«^iehtialA-:;-' ;/Y?'--'; v :**A^Yv
L» -J^- >Xs vl»- -U^
¦vL- vL-
i-Green Roof- 6tl>4_eveU-
28th Level Private Terrace
29th Level Mechanical Roof
27th Level Private Terrace
111
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>>
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26th Level Private Terrace|1010|o
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(0 0)
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16'-0" Public Alley
.v':;:;;.tu-5£->
PAPPAOEORSE HAYMES
Pappageorge Haymes Partners
640 N. LaSalle. Suite 400
Chicago, IL 60054
O 312 337 3344 F 204 8908
Applicant:
Introduction Date Plan Commission Date
Lexington Dearborn LLC
1010 to 1026 N Dearborn St. Chicago. IL 60610
September 24th, 2015 February 18, 2016
Site Plan
Scale 1" =30'
PAPPAGEOP.SE HAYMES
Pappageorge Haymes Partners
640 N LaSalle, Suile 400
Chicago. IL 60654
0 312 337.3344 l: 204 09(36
Lexington Dearborn LLC
1010 10 1028 N Dearborn St. Chicago, IL 60610
Introduction Date. September 24th, 2015
Plan Commission Date February 18, 2016
Site Plan - Sub Area A
Scale 1" = 20'
RN'AL FOR PUBLiCAiiO
13th Level Private Terrace
28th Level Private Terrace
^ ^t.- -i-
i-Green Roof- 6thi-eveli-
Roof
29th Level Mechanical Roof
26th Level Private Terrace
^ Green Roof ^
vL-- -X* "-^L-
27th Level Private Terrace
Celtis
Occidentalis
26th Level Private Terrace
6th Level Private Terrace
|1010|O
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Green Roof Calculations
Plant List
BOTANICAL NAME
Deciduous and Evergreen Shrubs
Junitenjs Chinensfs 'Kallays Compact'
Tumferus SafaTria 'Buffalo
"Buxu's Hacrophllla 'Koreana'Wintergree77
"Hionymus Aiatus 'Compactus'
TEuonymus 'Vegetus' l_
Taxus^TvWdia 'Densrformls'
Viburnum Dentatum 'Slue Muffin'"
Perennials and Grbundcover TjararhagrostisAcutiflora 'Raff Forester' "Nepeta X Faasseni 'Walkers Low' _
"Rudeoeckia Fulgida 'Goldsturm'
hiostaTFr ancee1- _ ~
Euonymus Fortunci 'Coioratus' _ Geranium Sanguineum 'Max~F~reir _ SaTwTX Supcrba"'Blue Hill" Vinca Minor
'Deciduous Shade "Celtis Occidentaiis "G yrnhodadus Gtoicus
COMMON NAME
Kaflay Juniper Buffalo Juniper
Wlntergrccn Boxwood
Compact Burnjng_Bush TBigleaf WTntercreeper J *~DcnseYe"w
"Blue Murf'th'VibiTnuni: -
"|"Feather Reefl Gfass _J I Walker's L"bw Catmint
"Black-eye3 'Susan ~
Francee flosta
Purpleleaf Wintercreeper Max FriTBloody Cranesb' BJue'Hill Salvia- " Periwinkle
Common Hackberry _
Kentucky Coffee ^_
Proposed Net Roof Green Roof Area (sf)* Area|10 10|2.916
Roor : Gross Root Area (sO
Typ. 1-S . | 0
3.913
1,634
2.286
0 .|10 10 10|1.094 : 0
0 ,.'|10 10 10|1.094
': 0
Typ. 14-25 j
26
27; ¦ '. [/'. 399 ¦. ¦.
1.094 . .2.324
2,091
Root -
Total 14,418 4,010
Green Roof Area Requirement: " .:. - 2,005 i
i Based upon 50% ol Net ¦:; Roof Area lor Market Rate - Residential > 4 Units .
Notes: Net Area excludes areas dedicated to Private Roof Decks, Mechanical Equipment, and Service Walkways/Clearances.
PAPPAGEOP.GE HAYMES Pappageorge Haymes Partners 640 N. LaSalle, Suite 400 Chicaqo, IL 60654 0 31S.337.3344 F. 204.8988 Applicant- Lexington Dearborn LLC Address' 1010 to 1028 N Dearborn St Chicago, IL 60610 Introduction Date September 24th, 2015 Plan Commission Date February 18, 2016 Landscape / Green Roof Plan N Scale. 1" =30'
Sub-Area B
Pappageorge Haymes Partners
640 N LaSalle, Suite 400
Chicago, IL 60654
0 312 337 33-14 F 204 6988
Lexington Dearborn LLC
1010 to 1028 N Dearborn St. Chicago, IL 60610
Introduction Date September 24th, 2015
Plan Commission Date February 18, 2016
East Elevation
Scale 1" =40'
••VI..... [_,J = „ .^V J j; , j <
T/Buildmg
+351'
"¦"¦/Residential
'°°L/>|
+327'
_25th Floor +279'
13th Floor
+139'-4"
Pappageorge Haymes Partners
PAPPAOEOP.SE HAYMES
640 N LaSalle. Suite 400
Chicago, IL 60654
O 312 337.33-14 F 204.8980
'•" >, . App^oX."'-.; A Location of '¦•'
fe^feiTt^r^ ;-L/->Ewshng^/>.Jr--'-.
- -v-Buiidincfv7>,-r ;>ti'utH P,age;Bldg. -
Sub-Area A
- /////////// ///.-/.¦
South Elevation
Scale 1" =40'
N Dearborn
/Building /-L +351 ;-0" y
T/Residential A +327'-0" V
25th Floor
+279-4"
13th Floor
+139'-4"
6th Floor
+55'-8"
Palette & Chisel • Academy of Fine Arts Bldg.
Sub-Area B
Pappageorge Haymes Partners
WO N LaSalle, Suite 400
Chicago, IL 606S4
0 312.337 3344 F 204 8988
Applicant Address
Introduction Date Plan Commission Dale'
Lexington Dearborn LLC
1010 to 1028 N Dearborn SI. Chicago, IL 60610
September 24th, 2015 February 18, 2016
West Elevation
Scale 1" =40'
Architectural Louver
Painted Architectural Grade Finished Concrete
Profiled Alum. Slab Edges
Glass Window System
Spandrel Glass
Balcony & Glass Railing, Typical
Punched Operable Windows
Painted Architectural Grade Finished Concrete
Alley
RMALFGR pub* mm
Sub-Area A
PAPPA3E0P.GE HAVMES
Pappageorge Haymes Partners
640 N. LaSalle, Suile 400
Chicago, IL 60654
O 312.337.3344 F: 204 8086
Applicant'
Introduction Date Plan Commission Date
Lexington Dearborn LLC
1010 to 1028 N Dearborn St. Chicago. IL 60610
September 24th, 2015 February 16, 2016
North Elevation
Scale 1" =40'
DlPARTMENT OF PLANNING AND DEVELOPMENT
CITY OF CHICAGO
MEMORANDUM
Alderman Daniel S. Solis
Chairman, City Council Committee on
David L Reifman Secretary
Chicago Plan Commission
DATE: February 19, 2016
RE: Proposed Waterway Residential Business Planned Development for property generally located at 1010-1028 North Dearborn Street.
On February 18, 2016, the Chicago Plan Commission recommended approval ofthe proposed planned development submitted by Lexington Dearborn LLC. A copy ofthe . proposed planned development is attached. I would very much appreciate your assistance in having this introduced at the next possible City Council Committee on Zoning hearing.
Also enclosed is a copy of the staff report to the Plan Commission which includes the Department of Planning and Development, bureau of Planning and Zoning recommendation and a copy of the Resolution. If you have any questions in this regard, please do not hesitate to contact me at 744-5777.
cc: Steve Valenziano
PD Master File (Original PD, copy of memo)
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS .60602
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FINAL
REPORT to the
CHICAGO PLAN COMMISSION from the
DEPARTMENT OF PLANNING AND DEVELOPMENT FEBRUARY 18, 2016
FOR APPROVAL: PROPOSED RESIDENTIAL BUSINESS PLANNED DEVELOPMENT
APPLICANTS: LEXINGTON DEARBORN, LLC
LOCATION: 1010-1028 NORTH DEARBORN STREET
Pursuant to the provisions ofthe Chicago Zoning Ordinance, Title 17 of the Municipal Code of Chicago, the Department of Planning and Development hereby submits this report and recommendation regarding a proposed Residential Business Planned Development for your review and recommendation to the Chicago City Council. The application for the amendment to the Zoning Ordinance was introduced into the City Council on September 24, 2015. Proper legal notice of the public hearing on the application was published in the Chicago Sun-Times on February 3, 2016. The Applicants were separately notified of this hearing.
The Applicant, Lexington Dearborn, LLC, submits a proposed Residential Business Planned Development for the property generally located at 1010-1028 North Dearborn Street. The Applicant is proposing to construct a 351' residential building with approximately 50 dwelling units and accessory parking on the property located at approximately 1028 North Dearborn Street, currently used as a parking lot, and to be known as Subarea A. The properties located at approximately 1010 North Dearborn Street and 1016 North Dearborn Street are improved with the Palette and Chisel Academy and the Ruth Page Center for the Arts and will remain within the planned development boundary, to be known as Subareas C and B, respectively. The underlying zoning for the overall 29,869 square foot site is currently RM-5 (Residential Multi-Unit District) and is proposed to be rezoned to RM-6.5 (Residential Multi-Unit District) prior to establishing the proposed Residential Business Planned Development. Pursuant to Section 17-8-0512-A ofthe Chicago Zoning Ordinance, a planned development application is required because the proposed tower's height exceeds 140'.
PROJECT BACKGROUND
Lexington is the contract purchaser of an approximately 11,281 square foot site that is currently owned by the Ruth Page Foundation and is used as a surface parking lot (Subarea A). This property is located at approximately 1028 N. Dearborn Street and is the site of the proposed tower.
Ruth Page owns and operates a four-story performing arts studio and theater at
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approximately 1016 N. Dearborn (Subarea B). No alterations are contemplated to the Ruth Page facility as part of this planned development.
Palette and Chisel owns and operates a three-story visual arts studio at approximately 1010 N. Dearborn (Subarea C). This building is a City of Chicago Landmark property. No alterations are contemplated to the Palette and Chisel facility as part of this planned development.
SITE AND AREA DESCRIPTION
The site is located within the broader Near North Side Community Area of Chicago which encompasses some of the most economically vibrant as well as diverse neighborhoods and business districts in Chicago. The proposed planned development boundary is bounded by North Dearborn Street on the east, a public alley on the west and south and private property to the north. The total net site area of the planned development is approximately 29,869 square feet.
The entire site is currently zoned RM-5 (Residential Multi-Unit District). North Dearborn Street at this location is split between downtown zoning districts on the east side of the street and neighborhood zoning districts on the west side ofthe street. Surrounding zoning districts include RM-6.5 (Residential Multi-Unit District), RM-5 (Residential Multi-Unit District), DR-3 (Downtown Residential District) and various generally residential planned developments. North Dearborn Street is overwhelmingly residential in nature and land uses in the area consist of rowhomes and multi-unit residential towers of various heights and styles. Lastly, the site is not located within either the Lake Michigan and Chicago Lakefront Protection District or a tax increment financing area.
PROJECT DESCRIPTION .
The Applicant is proposing to construct a 28-story building (plus mechanicals) on an 11,281 square foot site (Subarea A). The new building wiil contain a minimum of 72 enclosed parking spaces and a maximum of 50 dwelling units on floors six thru 28. Additionally; the building will contain various amenities for residents including common indoor space and private decks for each unit. The dwelling units will average approximately 2,963 square feet.
DESIGN/LANDSCAPING
The footprint of the proposed tower building measures approximately 75 feet along North Dearborn Street by 150 feet deep. The first five floors of the tower are proposed to be built over the entire 11,281 square foot site with the exception of an 8' setback from North Dearborn Street at the lobby/entrance. The first floor will contain the lobby and minor amenity space and access drive/ramp to the enclosed parking area via North Dearborn Street. Floors two thru five will contain the parking garage levels. The parking garage base level of the building will be approximately 56' in height and will be clad with stone panels and a window wall system at the ground floor.
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Floors six thru 28 comprise the tower which is proposed to be setback on the south facade from the base at varying levels. These floors will include the residential units. Floor plates will contain three units at the lowest levels, two in the middle and one per floor at the uppermost levels. An indoor common amenity level on floor six will complement the private balcony space afforded to each dwelling unit. The balconies will be predominantly recessed into the facade.
The modernly designed building will contain a glass storefront system at the ground level including the main pedestrian access point to the residential tower. Materials on the upper floors on all of the elevations will include a glass window wall system, profiled aluminum slab edges, finished concrete and various louvers. The tower is planned to be 351' in height.
The sidewalk along North Dearborn Street at the subject property will be improved with new trees in compliance with the Chicago Landscape Ordinance.
ACCESS/CIRCULATION
The project will provide four levels of enclosed parking in the base of the building, comprising a minimum of 72 parking spaces. Twenty-two ofthe spaces will be reserved for the Ruth Page Foundation. The parking will be accessed via a curb cut from North Dearborn Street. The primary pedestrian access to the building will be from North Dearborn Street. Loading will be achieved in the alley.
SUSTAINABILITY
In accordance with the City of Chicago's Sustainability Policy, the Applicant will minimally provide a green roof equating to 50% of the net roof area and obtain LEED certification or similar building certification, or may in lieu of a green roof obtain LEED Silver certification. The project will also comply with the Storm Water Management Ordinance, implementing best practices in all storm water management.
BULK/USE/DENSITY
The underlying zoning for the site is currently RM-5 (Residential Multi-Unit District). Under this proposal, the underlying zoning would be changed to RM-6.5 (Residential Multi-Unit District) prior to establishing the proposed planned development. Per the proposed Bulk Table included as an exhibit to this report, the overall proposed maximum floor area ratio for this planned development will be 8.25. The following is the breakdown per Subarea: 15.79 (Subarea A); 3.19 (Subarea B); and, 4.20 (Subarea C).
This Residential Business Planned Development includes the following uses: residential, parking, dance studio, art education, performing arts venue and accessory uses.
The maximum number of dwelling units allowed for the proposed tower and throughout the
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planned development will be 50. The Minimum Lot Area (MLA) for the project will be 597, which is well in excess of the minimum requirement under the Chicago Zoning Code of 300. The project is not proposed to contain any efficiency units.
RECOMMENDATION
The Department of Planning and Development has reviewed the project materials submitted by the Applicant and compared this proposal to existing development in the community. The area around this project consists of a mix of downtown and neighborhood zoning districts along North Dearborn Street in Chicago's Near North Side Community Area.
Based on that analysis, the Department of Planning and Development has concluded the following:
1. The proposed rezoning of the subject property is appropriate under Chapter 17-13 of the Zoning Ordinance. Specifically, the proposed zoning classification is compatible with surrounding zoning districts (17-13-0308-D).
The project--meets the purpose and criteria set forth in Chapter 17-8 ofthe Zoning Ordinance and .its adoption .would not have any adverse impact on the public's health, safety or welfare. Specifically, thisiproject meets the following provisions of Chapter 17-8:
Provides that high rise buildings have a clearly defined vertical appearance, comprised of a base, midsection and top (per 17-8-0907-B), as evidenced by the.elevation exhibits associated with this project; and,
Promotes green design.by conserving non-renewable energy.and scarce materials (per 17-8-0908-A) as evidenced by the proposed green roof and bui!ding; certification; and,
All sides and areas of the buildings thaLare visible to the public are treated with materials, finishes and architectural details that are of high-quality and appropriate for use on primary street-facing facade (17-8-0907-A-4), as evidenced through the material callouts in this report and on the elevations.
The public infrastructure facilities and city services will be adequate to serve the proposed development at the time of occupancy. The proposed project has been reviewed by the Mayor's Office for People with Disabilities and the Departmentof Transportation and all requested changes have been made. Copies of this application have been circulated to other City departments and agencies and no comments have been received which have not been addressed in the application.
The project will comply with the requirements for access in case of fire and other emergencies.
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Based on the foregoing, it is the recommendation of the Department of Planning and Development that this application for a Residential Business Planned Development be approved and that the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be "Passage Recommended".
Bureau of Zoning and Land Use Department of Planning and Development
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DEPARTMENT OF PLANNING AND DEVELOPMENT CITY OF CHICAGO
RESIDENTIAL BUSINESS PLANNED DEVELOPMENT 1010-1028 NORTH DEARBORN STREET
RESOLUTION
WHEREAS, the Applicants, Lexington Dearborn, LLC, The Ruth Page Foundation and Palette and Chisel Academv of Fine Arts have submitted an aDDlication seeking approval for a Residential Business Planned Development on a 29,869 square foot property currently zoned RM-5 (Residential Multi-Unit District); and,
WHEREAS, the Applicants seek to first, rezone the subject property from RM-5 (Residential Multi-Unit District) to RM-6.5 (Residential Multi-Unit District), prior to establishing the proposed planned development; and,
WHEREAS, Lexington Dearborn, LLC, intends to construct a 351' mixed use building with approximately 50 dwelling units and accessory parking on the property located at approximately 1028 North Dearborn Street, to be known as Subarea A under the planned development; and,
WHEREAS, the Ruth Page Foundation plans to maintain a four-story facility for performing arts on the property located at approximately 1016 North Dearborn Street, to be known as Subarea B under the planned development; and.
WHEREAS, the Palette and Chisel Academy of Fine Arts plans to maintain a three-story facility for visual arts on the property located at approximately 1010 North Dearborn Street, to be known as Subarea C under the planned development; and,
WHEREAS, the Applicants request to rezone the property was introduced to the City Council on September 24, 2015; and,
lA/LJEZDCTAC rnn/^r r-» r*i~* r\f 4 l-i f-^ V-»/-».-»rI l-\ r\f r\ rr\ l\r\r\ Dion Prtmmicci^n i« #00 r\l irtlionQrl
«« ¦ piupci icyai i luui/C ui uic i ictcii 11 ly uciui c u ic i lan uuiim nooiwi i ivdb ^uunbi icu
in the Chicago Sun-Times on February 3, 2016. The Applicants were separately notified of this hearing and the proposed zoning application was
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
considered at a public hearing by this Plan Commission on February 18, 2016; and,
WHEREAS, the Plan Commission has reviewed the application with respect to the provisions of the Zoning Ordinance and finds that the proposal will be consistent with said provisions; and
WHEREAS, the Department of Planning and Development recommended approval ofthe application, with the recommendation and explanation contained in the written report dated February 18, 2016, a copy of which is attached hereto and made a part hereof; and,
WHEREAS, the Plan Commission has fully reviewed the application and all informational submissions associated with the proposed amendment, the report and recommendation of the Commissioner of the Department of Planning and Development and all other testimony presented at the public hearing held on
Pohmarv/ 1 ft 901 ft ni\/inn roncirlfiratirvn tn th<=> 7nninn OrHinanr-.e'
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
THAT the above-stated recitals to this resolution together with the report of the Commissioner of the Department of Planning and Development be adopted as the findings of fact of the Plan Commission regarding this zoning map amendment application.
THAT this Plan Commission recommends approval to the City Council Committee on Zoning,- Landmarks and Building Standards of the final zoning application dated February 18, 2016; and,
RBPD No.
AjjLiiuVeu. rSuiu
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
RECEIVED
SEP 2420b ^bp^.^^oi5"
. \ CITY OF CHICAGO
Initlali^^JW RECEIVED
inu APPLICATION FOR AN AMENDMENT TO
THE CHICAGO ZONING ORDINANCE FEB 1 8 201$
Initial: ^LdL&dJ-
ADDRESS of ihe property Applicant is seeking to rezone:
1010-1028 N. Dearborn St.
2. Ward Number that, property is located in: 2nd Ward
3. APPLICANT Lexington Dearborn LLC
ADDRESS 1731 N. Marcey St., Suite 2 00 CITY Chicago
STATE__IL ZIP CODE 60614 PHONE 773-629-4789
EMAIL kbttrnefleiexingtonchicago.coiaCONTACT PERSON Ken Barnes
also attorneys listed below
Is the applicant the owner of the property? YES __ _ NO X
If the applicant is not the owner of the property, please provide the following information
regarding,the owner and attach written authorization from the owner allowing the application to
proceed. . .,
(1) The Ruth Page Foundation
OWNER (2) Palette And Chisel Academy Of Fine Arts
(1) 1016 N. Dearborn St. (l) Chicago
ADDRESS (2) 1012 N Dearborn St. CITY Q.\ rhir.agn
(1) IL (1) 60610 (1) 312-337-6543
STATE (2) IL ZIP CODE. (2) 606i0 - PHQNE (2) 312-642-4149
(1) venetia@ruthpage.org (1) Venetia Stifler, Exec Dir
EMAIL (2) finaartiolaeebcgiobai.netCQNTACT PERSON (2) William J. Ewers, Exec Dir
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY Mara Georges, Daley and Georges, Ltd.
Richard Toth, Daley and Georges, Ltd.
ADDRESS 20 S. Clark St., Suite 400
CITY Chicago STATE _IL ZIP CODE 60603
PHONE 312-726-8797 FAX 312-726-8819 EMAIL mgeorgesOdaleygeorges.com
rtothOdaleygeorges.com
If the applicant is a legal entity (Corporation, LLC, Partnership, etc.) please provide the names
of all owners as disclosed on the Economic Disclosure Statements.
.For applicant Lexington Dearborn LLC:
_ Kenneth E. Barnes, Wayne Moretti, Ronald Benach
- collectively 100% '.
_Jhe two property owners are each not-for-profit corporations with
_no stockholders.
On what dale did the owner acquire legal title to the subject property? Various .
Has the present owner previously rezoned this property? If yes, when?
.No. .
RM6.5 and then to
Present Zoning District RM5 Proposed Zoning District Residential-Busines
Planned Development
Lot size in square feet (or dimensions^ Approximately 29, 869 s.f.
Current Use of the property Two existing buildings owned and operated by not-for-profit corporations, used for dance and artistic purposes. Reason for rezoning the property To allow a new 50 dwelling unit, 365* high
residential building. „
Describe the proposed use of the property after the rezoning. "Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building. (BE SPECIFIC)
The existing buildings aiid not-for-profit uses will remain.
The zoning change wili allow a new 50 dwelling unit, 365* high
residential building. ,
On May 14th. 2007, the Chicago City Council passed the Affordable Requirements Ordinance (ARO) that requires on-site affordable housing units or a Financial contribution if residential housing projects receive a zoning change under certain circumstances. Based on the lot size of the project in question and the proposed zoning classification, is this project subject to the Affordable Requirements Ordinance? (See Fact Sheet for more information)
YES X
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
Legal name ofthe Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
the Ruth Page Foundation
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[ ] the Applicant
OR property
[xj a legal entity holding a direct or indirect interest inthe Applicant. State'the legal name of the
Property Applicant in which the Disclosing Party holds an interest: 1016 N. Dearborn. St
OR
3. [ ] 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: . . .
Business address of the Disclosing Party: 1016 N. Dearborn St
Chicago, IL 60610
Telephone: 312-337-6543 Fax: Email: venetia-ruthpage.org
Name of contact person: Venetia Stifler, Ph.D. - Executive and Artistic Director
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):
Application for zoning map amendment for 1010-1028 N. Dearborn St.
"Which City agency or department is requesting this EDS? Department of Planning and Dev' t
If the Matter is a contract being handled by the City's Department'-of Procurement Services, please complete the following:
Specification # N/A and Contract # N/A
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
[ ] Person
[ ] Publicly registered business corporation
[ ] Privately held business corporation
[ ] Sole proprietorship
[ ] General partnership
[ ] Limited partnership
[ ] Trust
[] Limited liability company
[ ] Limited liability partnership
[ ] Joint venture
[x] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[x] Yes I ] No
[ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois.
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
[ ] Yes [ ] No [x] 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 all members, if any, which are 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 Parly. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
Verietia Stifler, Ph.D. Executive Director
See attached exhibit (next page).
2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% of the Disclosing Party. Examples of such an interest include shares in a corporalion, partnership interest in a partnership or joint venture.
Page 2 of 13
Officers and Board of Directors
Officers
Thea Flaum, Chairman & President
Venetia Stifler, Ph;D., Vice President
Thomas Chakos, Treasurer
Silvino da Silva, Secretary
Board of Directors
Kristin R. Beal
Vice President, Investments Wintrust Wealth Management
Thomas Chakos
President
Golf Construction
Thea'Flaum President
the Hill Foundation
Sasha Gerritson Opera Director
Northeastern Illinois, University
Salme Harju Steinberg, Ph.D.
President Emerita Northeastern Illinois University
o David S. Kravls
Sara S. Schumann, Esq.
Allison,- Slutsky & Kennedy, PC
Venetia Stifler, Ph.D.
Executive and Artistic Director Ruth Page Center for the Arts
Juliet SSorenson
Clinical Associate Professor of Law Northwestern University School of Law
o Gloria L. Wlaterre
Partner
Dinsmore & Shohl, LLP
Maria Duzon
Kellog Board Fellow
Kellogg School of Management
RUTH PAGE CENTER FOR THE ARTS Administrative and Artistic Staff
o Venetia Stifler, Ph.D., Executive and Artistic Director
Silvino da Silva, Director of Marketing & Communications
Victor Alexander, Director, Ruth Page School of Dance
Dolores Lipinski Long, Associate Director, Ruth Page School of Dance
Clintina Taylor, Finance & Program Manager
Brandon Piekarski, Manager, Ruth Page Theater
John Landeroz, Coordinator, Ruth Page School of Dance
Suzanne Robertson Administrator Ruth Page School of Dance
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to. Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest-in the
Disclosing Party
The Disclosing Party is a not-for-profit corporation and therefore has no stockholders or owners.
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the datc;fhis EDS is signed?
[ ] Yes [x] No
If yes, please identify below the riamc(s) of such City elected official(s) and describe such relationship(s):
SECTION IV -- 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 othe.r 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 are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Parly Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
None.
(Add sheets if necessary)
jxj Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more ofthe Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
(] Yes [ ] No |k] No person directly or indirectly owns 10% 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 that agreement?
[ ] Yes [ ] No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1 -23, Article I ("Article i")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as 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, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee ofthe City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B. 1. of this EDS:
are not presently debarred, suspended,, proposed, for debarment, declared ineligible or 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a. public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state 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 this ED'S, had one or more public 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, including actions concerning environmental violations, instituted,by the City or by the federal government, any state, or any other unit of local government.
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 the Matter, including but riot 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,...un'dfer. 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 of a business entity following the ineligibility of a business entity to do business with federai or state or local government, including the City, using substantially the' same management;ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity mieahs a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under-common control of another person or entity;
any responsible official of the Disclosing Party, any Contractor, Or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Parly, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Conlractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, 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 or 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 adjudged 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 provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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 in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department ofthe Treasury or the Bureau of Industry and Security ofthe 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 List.
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2r56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
N/A
Page 6 of 13
If the 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.
8. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during ihe 12-month period preceding the execution date of this ED'S, an employee, or elected or appointed official, ofthe City of Chicago (if none, indicate with "N/A" or ''none").
N/A
.9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that'fhe Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, ofthe City of Chicago. For purposes of this statement, a "gift" does not include: (i) 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 $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient. N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check One)
[ ] is [x] is not
a "financial institution" as defined in Section 2 ¦_ 2-45 5(b) of the 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 of the Municipal
Code. We further pledge that hone of bur affiliates none of them will become, a predatory
lender as defined in Chapter 2-32 of the Municipal Code. We understand that becominga predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing busihcss'w ith the Gity."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates, (as defined in Section 2-32-455(b) ofthe Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," (he 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 2-1 56 ofthe Municipal.Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 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?
[ ] Yes [x] No
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 (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit ofthe City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ ] No NOT APPLICABLE
If you checked "Yes" to Item D.l...provide the names and business addresses ofthe City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
1 4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
* 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of 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 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 above, the
Disclosing Parly 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 Matter is federally funded, complete this Section VI. If the Matter is riot federally funded, proceed to Section VII. For purposes 6f this Section 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 Lobbying Disclosure Act of 1.995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if nepessary);
NOT APPLICABLE - THE MATTER IS NOT FEDERALLY FUNDED.
(If no explanation appears or begins on the lines above, or if the letters "N A" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf ofthe Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A. 1. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an. employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9r of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy ofthe statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) ofthe 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 engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration ofthe Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the M atter 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 outset of negotiations.
Is the Disclosing Party the.Applicant?
NOT APPLICABLE - THE MATTER IS NOT FEDERALLY FUNDED.
[]Yes []No If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to 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 Federal Contract Compliance, Prpgrams. or the Equal Employment Opportunity Commission all reports 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 you checked "No" 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:
The certifications, disclostires, and acknowledgments contained in this EDS will become-part of any contract or other agreement between the Applicant and the Gity in connection withtheMatter, whether procurement. City assistance; or other City action, and are material inducements to the City's execution of any contracl or taking other action with respect to the Mailer. The Disclosing Party understands that it must comply with all statutes, ordinances, and'regulations on which this EDS is based.
The City's Governmental'Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-16.4 of the Municipal Code, impose certain duties and obligations on persons or entities seeking Gity contracts,' work, business, or transactions. The full text of these ordinances and a training program is available on line at www.citvofchicago.org/Ethics . and may also be obtained from the City's Board of Ethics, 740 N .
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate,-any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue anyremedies under the contract or agreement (if riot 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 statement of material fact may include incarceration and an award to the City of treble damages.
It-is the City's policy to":make ^ the public on itsTntdrhet site and/or upon
request. Some or all ofthe information provided on this EDS aridaiiy attachments to this EDS may be
made.available to the public oh the Internet, in response to a Freedom of Iriformation Act request, or
otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible
rights or claims which it may have against the Gity in connection with the public release^of information
contained in this EDS and also authorizes "the City to verify the accuracy of any information submitted
in this EDS.
The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement, this EDS up to the time 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 requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information pro%'ided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.1. Tlie Disclosing Party is not-delinquent in ihe 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.1. and F.2. above and will not, without the prior written consent ofthe 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.
The Ruth Page Foundation ,
(Print or type name of Disclosing Party)
(Sign here)
Venetia Stifler, Ph.D.
(Print or type name of person signing)
Executive and Artistic Director
(Print or type title of person signing)
Signed and sworn to before me on (date) August 5 , 2015,
at/ToGk x^Co^nty, Illinois (state).
Notary Public.
Paae 12 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS 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. Itis hot to be completed by any'legal entity which has only ah indirect ownership interest in the Applicant.
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 "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing.Party or any "Applicable Party" or any Spouse.or Domestic Partner thereof is related, to the mayor, any. alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law. son-in-law, daughlerrin-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (J) all executive officers of the Disclosing Party listed in Section ILB.l.a., if the
Disclosing Party is a corporation; all.partners ofthe DisclosingParty, if theDisclosing Party is a-general
partnership; all general pa'rth Disclosing Party is a limited
partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers ofthe Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the;president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or 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 [X] No
If yes, please identify below (1) the name and title of such person, (2) the.name ofthe legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship:
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
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 (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Seclion 2-92-416 of the Municipal
Code?
Yes
?
If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of the Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 ofthe Municipal Code?
| | Yes f~]No [/) Not Applicable
3. If yes to (1) or (2) above, please identify below the name of the person or legal entity
identified as a building code scofflaw or problem landlord and the address of the building or buildings to which the pertinent code violations apply.
Not applicable.
FILLING OUT THIS 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.
Page 14 of 14
(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.
Application for zoning map amendment (PD) This recertification is being submitted in connection with for 1010-1028 n. Dearborn st. [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 that all 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.
The Ruth Paae Foundation Date: January 3\ . 2016
(Print or type legal name of Disclosing Party)
(sign here) ' Print or type name of signatory:
Venetia Stifler
Title of signatory:
Executive and Artistic Director
Signed and sworn to before me on [date] January 3\ . 2 016 , by
Vepefcia Stifle*'"') , at Cook County, Illinois [state].
Notary Public.
Commission expires:
CLINTINA TAYLOR OFFICIAL SEAL Notary Public. Slate of Illinois
My Commission Expires June 14, 2016
Vcr. 11-01-05
CITY OF CHICAGO ECONOMICDISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Lcgul name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: The Palette And Chisel Academy Of Fine. Arts
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[ ] the Applicant "
OR
property
[X] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
property Applicant in which the Disclosing Party holds an interest: 1012 N. Dearborn St.
OR
3. [ ] 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: 1012 N. Dearborn St.
Chicago, IL 60610
Telephone: 312-642-4400 pax: 312-642-4317 Email:, fineart1012esbcglobal.net
Name of contact person: William J." Ewers.
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, (lnclude-project number and location of property, if applicable):
Application for zoning map amendment for 1010-1028 N. Dearborn-St.
Which Gity agency or department is requesting this EDS? Department of Planning and Dev't
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification U N/A and Contract U N/A
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
I. Indicate the nature of the Disclosing Party.
I J Person [ J Limited liability company
[ ] Publicly registered business corporation [ ] Limited liability partnership
| J Privately held business corporation ( ] Joint venture
( J Sole proprietorship fx] Not-for-profit corporation
[ ] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
[J Limited partnership [Xj Yes I. J No
|J Trust [J Other (please specify)
2. For legal entities, the state (Or foreign country) ofincorporation or organization, if applicable: Illinois.
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
[ ] Yes [ ] No [x] 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 ofthe entity. NOTE: For not-for-profit corporations, also list below all members, if any, which arc legal entities. If there arc 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
William J. Ewers Executive Director
See attached exhibit (next page).
2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7-5% ofthe Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
The Board of Directors at the Palette and Chisel
Palette & Chisel
AC.»UEMY Of FINF AT.t*
Pliant-: 312 6424-tOG Fix: 312 612-=1317
101 ? N.Oo»rbotn Chicago. IL {>06I0 Office Hours: Mon-fr:. 10:30am -6:30pm
Board of Directors
Officers
President Val Yachik
Sharon Williams Lenin Delsol
Vice President Jack Beckstrom
Treasurer Secretary
Director*
Clayton J. Beck III Stuart Fullerton Pam Gibson
James Hajleek
Errol Jacobson Lenore Murphy Mary Qian
Executive Director
William J. Ewers
CONTACT US
1012 H. Dearborn ChlOBO IL 60G10 | Phone: (312)G42-440O Fax: (312)642-1317 Email: l© Palette & Chisel | Powered by Irnpcrisolt | Site Map
httpyAvww.paletteandchisel.org/boardinembers/Doard^Tiembers/cms.aspx
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other .similar entity. If none, stale ''None." NOTE: Pursuant to Section 2-1 54-030 ofthe Municipal Code of Chicago ("Municipal Code7'}, the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
The Disclosing Party is a not-for-profit corporation and therefore has no stockholders or owners.
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Parry had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
t ] Yes Ix] No
If yes, please identify below the namc(s) of such City elected officials) and describe such relationship(s):
SECTION IV -- DISCLOSURE QF 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 are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any pari of whose duties as an employee of another includes undertaking to influence any legislative or administrative.action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney. paid or estimated.) NOTE':
lo be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response. Robbins, Salomon & Patt, LTD. 380 N. LaSalle St., Suite 3300, Chicago, IL 60601
Attorney: Michael Castellino
$2,500 (Estimated)
(Add sheets if necessary)
|x] Check here if the Disclosing Party has hot retained, nor expects to retain, any such persons or entities. SECTION V -- CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business cntities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the D isclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ J Yes [ 1 No fc] No person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes:j" has the person entered into a court-approved agreement for payment of'all support owed and is the person in compliance with that agreement?
[) Yes []No
FURTHER CERTIFICATIONS
1. Pursuant tO'Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined'terrhs (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted1 Or charged with, or has admitted guilt of; or has ever been convicted Of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against' an officer or employee of the City or any sister agency; and "(ii) the Applicant understands and acknowledges that compliance with Article 1 is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:
arc not presently debarred, suspended, proposed for debarment, declared ineligible or 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes: fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making,false statements: or receiving stolen properly;
arc 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 Section V;
have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
c. have not, within a fivcrycar 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.
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 the Matter, including but" not limited to all persons or legal entities disclosed tinder 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, 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 of a business entity following 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 ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
any responsible Official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an A ff ilia ted Hni ity, or an A ffiliaied Entity of a ('out met or during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, 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.or of any state or-local government in'thc 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 adjudged guilty of agreement or collusion among bidders oi-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, bin have not been prosecuted for such conduct; or
violatcdthc provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Entity br-Contractbr, pr'any of their employees, officials, agents or partners, is barred from contracting with any unit Of state'dr local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury Or the Bureau of Industry and Security ofthe 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 List.
The Disclosing Party understands and shall Comply with the applicable requirement's of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the MunicipafCode.
If the Disclosing Party is uhable'to certify to any of'the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
N/A
Page 6 of 13
If the 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.
H. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees ofthe Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS. an employee, or elected or appointed official, ofthe City of Chicago (if none, indicate with "N/A" or "none"). N/A
9. To the best of the Disclosing Party'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 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: (i) 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 any gift listed below, please also list the name ofthe City recipient.
N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is (x] is not
a "financial institution" as defined in Section 2-32-455(b) of the 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 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a 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 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the 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 arc defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Pari D.
In accordance with Section 2-156-1 10 of the Municipal Code: Does any official or employee ofthe City have a financial interest in his or her own name or in the.name of any other person or entity in the Matter?
[]Ycs [po
NOTE: If you checked "Yes" to Item D.l., proceed to Items D.2. and D.3. If you checked "No" to Item D. 1., 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 (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to thcCity's'eminent domain power docs not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ ] No NOT APPLICABLE
If you checked "Yes" to Item D. 1., 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 of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter 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 Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply wiih these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
x _1. The Disclosing Party verifies lhat the Disclosing Party has searched any and all records of ihe Disclosing Party and any and all predecessor entities regarding records of 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 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 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 Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations Ofthe City arc not federal funding.
A. CERTIFICATION REGARDING LOBBYING
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 Party with respect to the Matter: (Add sheets if necessary):
NOT APPLICABLE - TEE MATTER IS NOT FEDERALLY FUNDED.
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act-of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Parly certifies that cither: (i) it is not an organization described in section 501(c)(4) ofthe Internal Revenue-Code of 1986; or (ii) if is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has.not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration of the Matter and must make 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 and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
NOT APPLICABLE - THE MATTER IS NOT FEDERALLY FUNDED.
[ ] Yes [ J No
If "Yes," answer the three questions below:
Have y6;ii developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (Sec 41 CFR Part 6.0-2.)
I ] Yes I ] No
Have you filed with the Joint 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?
[]Yes []No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes [ ] No
If you checked "No" to question I. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII -- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLI ANCE, PENALT1ES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, disclosures, and acknowledgments contained in this EDS. will.become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and arc material inducements to the City's execution of any contract or taking other action with respect lo the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this HDS is based.
The City's Governmental Ethics and Campaign 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. The full text of these ordinances and a training,program is available on line at www.cityofchicago.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable; arid: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 statement of material fact may include incarceration and an award to the City of treble damages.
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 the information provided on this EDS and any attachments tp 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 EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing
Party must supplement this EDS up to the time 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 requires. NOTE: With respect to Matters subject to Article I of
Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified
offenses), the information provided herein regarding eligibility must be kept current for a longer period,
as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.I. The Disclosing Party is hot delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor arc the Disclosing Parly or its Affiliated Entities dclinquentin paying any iine, 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 ihe 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 frorivany contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance-to those in;F.I. and l\2. above: and will not, without the prior written-consent of the City, use any such contractor/subcontractor that docs not provide such certifications or that the Disclosing Party has reason to believe has not providedor cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.1F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of peVjury, the;'p'e>sb'ri'si,gning''b'el6w:XiTwarranfs'that he/she is authorized to execute this EDS arid Appendix A (if applicable) on behalf ofthe Disclosing Party; arid (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as ofthe date furnished to the City.
The Palette And Chisel Academy Of Fine Arts (Print or type name of Disclosingjiarty)
(Sign here)
William J. Ewers
(Print or type name of person signing)
Executive Director
(Print or type title of person signing)
Signed and sworn to before mc oh (date) August b ,. 2015 ,
at Cook ^County; Illinois (state);
Page 12 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS 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 disclose whether such Disclosing Party or any "AppIicableParty" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship1' exists if, as ofthe date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department.head as spouse or domestic partner or as any ofthe following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, .grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughtcr-iri-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l .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 Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7,5 percent ownership interest in the Disclosing Party. "Principal officers" means the president; chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Docs 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?
I J Yes [X] No
If yes, please identify below (1) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDA VIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
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 (an "Owner"). It is not,to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-010, is the.Applicant or an>' Owner identified as a' building code scofflaw or problem landlord pursuant to Section 2-92-416 ofthe Municipal Code?
Yes
?
If the Applicant is a legal entity publicly traded on any exchange, is anyofficer or director of the Applicant identified as a buildihg code scofflaw ofproblem landlord pursuant to Section 2-92-416 of the Municipal Code?
[~| Yes |~~|No [/] Not Applicable
If yes to 1) or (2) above, please identify' below the name of the person.or legal ehtity identified asabuildirigxode scofflaw of problem landlbfd'and the address of the buildingor buildings; to which the pertinent code violations apply .
Not applicable.
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDK B IS INCORPORATED BY REFERENCE INTO, AND. MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATiON MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Page. 14 of 14
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to Cily Council or on ihe dale 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 Cit> Council matters. Not for City procurements unless requested.
Application for zoning map amendment (PD) This recertification is being submitted in connection with for 1010-1028 n. Dearborn st. [ident ify the Matter]. Under penalty of perjury, the person signing below: (I) warrants that he/she is authorized to execute this EDS recertification on behalf of the Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS' arc 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.
The Palette And Chisel Academy Of Fine Arts (Print or type legal name of Disclosing Party)
^N*y_
(sign here)
Print or type name of signatory:
William J. Ewers
Title of signatory:
Executive Director
Signed and sworn to before mc on [date]
_, at Cook_
CLINT1NA TAYLOR OFFICIAL SEAL I Notary Public. Slate of Illinois My Commission Expires June 14. 2016
Vcr. 11-01-05
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:
Lexington Dearborn L.L.C.
Check ONE ofthe following three boxes:
Indicate whether the Disclosing Party submittingnhis EDS is:
[xj the Applicant
OR
[ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest: '_
OR
3. [ ] a legal entity with a right of control (sec Section II.B.l.) State the legal,name ofthe entity in
which the Disclosing Party holds a right of control:
B. Business address of the Disclosing Party: 1731 N. Marcey St., Suite. 200 ¦
Chicago, IL 60614
Telephone: 773-829-4789 Fax: 773-360-0301 Email: xbarneselexingtonchic'ago.com
Name of contact person: Ken Barnes, Member
Federal Employer Identification No. (if you have one): none
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):
Application for zoning map amendment for 1010-^1028 N. Dearborn St.
G. Which City agency or department is requesting this EDS? Department of Planning and Dev't
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A and Contract # N/A;
Page 1 of 13
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing
] Person
J Publicly registered business corporation
J Privately held business corporation
] Sole proprietorship
] General partnership
] Limited partnership
] Trust
arty:
[x] Limited liability company
[ ] Limited liability partnership
[] Joint venture
[] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[ ] Yes [ ] No
[] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
Illinois
3. For legal entities not organized.in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
&c] 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 all members, if any, which are 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
Wayne Moretti Manager
2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% ofthe Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of .13
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, slate "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
Kenneth E. Barnes See section I.B. above ;25%
Ronald Benach See section I.B. above 50%
Wayne Horetti See section I.B. above 25%;
SECTION III — BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
[ ] Yes M No
If yes, please identify below the namc(s) of such City elected official(s) and describe such relationship(s):
SECTION IV -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and. business address of each subcontractor, attorncyi lobbyistj.accountant,.consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with-ihe-Matterj 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 are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself; "Lobbyist" also means any person Or entity any part of whose duties-as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney. paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
Daley and Georges, Ltd. 20 S. Clark St., Suite 400 Attorneys $7,500.00 - estimated
Chicago, IL 60603 (at hourly rate)
Pappageorge Haymes Partners 640 N. LaSalle St. #400 Architects $15,000.00 - estimatec
Chicago, IL 60654 (at hourly rate)
(Add sheets if necessary)
[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes W'No [] No person directly or indirectly owns 10% 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 that agreement?
[]Yes []No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article i")(which the Applicant should consult.for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as 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, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee ofthe City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13.
The Disclosing Party and. if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection'with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public.transaction; a violation of federal Or state antitrust;statules;,fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
are not presently indicted for, Or criminally or civilly charged by, a governmental entity (federal, state 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 this EDS. had one or more public 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, including.actipns concerning,environmental violations, instituted .by the City or by the federal government, any state, or any other unit of local government.
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 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, 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 of a business entity following, the ineligibility of. a business entity todovbusincss with federal or state or local government, including the City, using substantially the same management, ownership, or principals as, the. ineligible entity); with respect to Contractors, the .term .Affiliated Entity means a person or entity that directly or. indirectly controls the Contractor, is controlled by it, or, with the Contractor, is.under common control of another person,or entity;
any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity, or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting-pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Conlractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer.or employee ofthe City, the State of Illinois, or any agency ofthe federal government or of any state or local government in the United Stales 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 adjudged 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 provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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 in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the.following lists maintained by the Office of Foreign Assets Control ofthe U.S. Department of the Treasury or the ' Bureau of Industry and Security ofthe 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 List.
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) ofthe Municipal Code.
If the Disclosing Party is unable to certify to any ofthe above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
N/A
Page 6 of 13
If the 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.
8. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees ofthe Disclosing Party who were, at any time during the 12-montb period preceding the execution date of this EDS, an employee, or elected or appointed official, ofthe City of Chicago (if none, indicate with "N/A" or "none"). N/A
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list Of all gifts that the Disclosing Party lias given or caused to be given, at any time during the 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: (i) 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 $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name ofthe City recipient.
N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
1. The Disclosing Party certifies that the Disclosing Party (check.ohe)
[ ] is [x] is'hot
a "financial institution" as defined in Section 2-32-455(b) ofthe' Municipal Code.
2, If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We arS'npC,aod':will hot become a preda'tofy lerider as defined ift Chapter 2;-32 of the Municipal Code. We furtherpledgc that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe 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 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "N A," 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 2-1 56-110 ofthe Municipal Code; Docs 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?
[ ] Yes [x] No
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 (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal,process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this PartD.
Does the Matter involve a City Property Sale?
[ ] YCS [] N0 NOT APPLICABLE
If you checked "Yes" to Item D.l., 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 of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter 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 Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
K 1 ¦ The Disclosing Party verifies that the Disclosing Party has searched any .and all records of the Disclosing Party and any and all predecessor entities regarding records of 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 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 above, the
DisclosingiP.arty has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes ful l 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 ihc.M after is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII; For purposes of this Section VT, 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 Lobbying Diselosure Act of 1995 who have made lobbying contacts on behalf of the "Disclosing Party with respect to the M atter : (Add sheets if necessary):
NOT APPLICABLE - THE MATTER IS NOT FEDERALLY FUNDED.
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter:)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy ofthe statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.I. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration of the Matter and must make sueh 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 and-all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
NOT APPLICABLE - THE MATTER IS NOT FEDERALLY FUNDED.
[]Yes f]No If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes [ ] N o
Have you filed with .the Joint 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?
[]Yes [JNo.
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[]Ycs []No
If you checked "No" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII -- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Parly understands and agrees thai:
The certifications, disclosures, and;acknowIedgmcnts contained in this EDS will becornc:part of any contract or other agreement between the Applicant and the City in connection"with the Matter,-whether procurement, City assistance, or other City action, and arc material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that il must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, imposc ccrtain duties and obligations on persons or entities seeking City cohtracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cilyofchicago.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate;, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contractor agreement (if notTescinded 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 statement of material fact may include incarceration and an award to the City of treble damages.
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 ofthe 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 EDS, the Disclosing Party waives and releases any possible rights or claims- whichMt,may:Jia;ve.^againstvthe.'Oity.!i^n connection with the publicxelcase.of information contained in this EDS and also authorizes the City to vcrify the accuracy of any information submitted in this EDS.
E. The information provided in this EDS must be kept current. In. the event of changes, the Disclosing
Party must supplement.this EDS up to the time the City takes action on the Matter. If fheMatter is a
contract being handled by the City's Department of Procurement Services, the Disclosing Party must
update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of
Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified
offenses), the information provided herein regarding eligibility must be .kept current for a longer period,
as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that.:.
Page .11 of 13
F.1. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor arc 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 Parly 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.1. and F.2. above and will not, without the prior written consent ofthe 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.I., F.2. of 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) arc true, accurate and complete as ofthe date furnished to the City.
Kenneth E. Barnes
(Print or type name of person signing)
Member
(Print or type title of person signing)
Signed and sworn to before me on (date) August fj , 2015,
at Cook County, Illinois (state).
Commission expires: /£
CITY OF CHICAGO-ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS 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. If is not to be completed by any legal entity which lias only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party mustdisclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has-a "familial relationship-with any elected ci ty official or department head. A "familial relationship" exists if, as of the date this EDS is signed, theiDisclosingParty or any "Applicable Party" or any Spouse or Domestic Partner;thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city dcparlmeht)head as spouse Or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" hibahs (T) all execufive^officers"-of.the'Disclosing P^ Section EB.].a., if the
Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general parmersh'ip; all general partners' ahd4iniite^
partnership; all managers, managing members and members of theDisclosing Party, if the.Disclosihg'Partyis^a limited liability company;.(2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 perfcent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or-secretary: of a legal, entity or any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner diereof currenily have a "familial relationship" with an elected city official or department head?
[]Yes [x]No
If yes, please identify below (1) the name-arid title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city officiaLor department head to whom such person has a familial relationship, and (4) the. precise nature of such familial relationship.
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX li
BUILDING CODE SCOFFLAVV/PROBLEM LANDLORD CERTIFICATION
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 (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
I I Yes
If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of the Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
J Not Applicable
3. If yes to (1) or (2) above, please identify below the name of the person or legal entity
identified as a building code scofflaw or problem landlord and the address ofthe building or buildings to which the pertinent code violations apply.
Not applicable.
FILLING OUT THIS 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.
Page 14 of 14
(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.
Application for zoning map amendment (PD) This recertification is being submitted in connection with for 1010-1028 n. Dearborn st. [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 that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as ofthe date furnished to the City and continue to be true, accurate and complete as ofthe date of this recertification, and (3) reaffirms its acknowledgments.
Lexington Dearborn LLC
(Print or type legal name of Disclosing Party)
Print or type name of signatory:
Kenneth E. Barnes
Title of signatory: Authorized Member
Signed and swom to before me on [date] January , 2016 , by
Kenneth E. Barnes _, at Cook County, Illinois [state].
Notary Public.
j** in
Jo
JAY WENDT. OFFICIAL SEAL . Noiaiy Public. Siato ol Illinois My Commission Expires Match 25, 2017
Commission expires: Z2)
Vcr. 11-01-05
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