¦^2 o m
Dec is-, ^°21
ORDINANCE
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICA GO:
SECTION 1. Title 17, ofthe Municipal Code of Chicago, the Chicago Zoning Ordinance be amended by changing all the RT4 Residential Two-Flat, Townhouse and Multi-Unit District symbols and indications as shown on Map No. 3-H in the area bounded by
The alley next north of and parallel to West Beach Avenue; a line 147.50 feet west of and parallel to North Paulina Street; West Beach Avenue; and a line 171.50 feet west of and parallel to North Nobel Street,
to those of a RM 4.5 Residential Multi-Unit District.
SECTION2. This ordinance shall be in force and effect from and after its passage and due publication.
Common Address of Property:
...I-. r^TRo J>rm Dec is; ^02 /
CITY OF CHICAGO APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE
ADDRESS of the property Applicant is seeking to rezone:
1714 W. Beach. Chicago, IL
Ward Number that property is located in: 2
APPLICANT: J. Cory Faulkner and Melissa Sweazy
ADDRESS: 1714 W. Beach CITY: Chicago
STATE: Illinois ZIP CODE: 60622 PHONE: 312-782-1983
EMAIL: nick@sambankslaw.com CONTACT PERSON: Nicholas J. Ftikas
Is the Applicant the owner of the property? YES X NO
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.
OWNER: Same as Above
ADDRESS: CITY:
STATE: ZIP CODE: PHONE:
EMAIL: nick@sambankslaw.com CONTACT PERSON: Nicholas J. Ftikas
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY: Law Offices of Samuel V.P. Banks. Nicholas Ftikas
ADDRESS: 221 N. LaSalle St 38th Floor
CITY: Chicago STATE: Illinois ZIP CODE: 60601
PHONE: (312) 782-1983 FAX: 312-782-2433 EMAIL: nick@sambankslaw.com
6. 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.
N/A
On what date did the owner acquire legal title to the subject property? 2013
Has the present owner previously rezoned this property? If Yes, when? No
Present Zoning District: RT-4 Proposed Zoning District: RM-4.5
Lot size in square feet (or dimensions): 24 ft. by 100 ft. - 2,400 square feet
Current Use of the Property: The subject property is improved with a two-and-one-half
story single family home
Reason for rezoning the property: To meet the bulk and density requirements of the RM-
4.5 Zoning District so the Applicants can permit a third floor addition, a rear addition, and
a new attached garage at the rear of the subject lot.
Describe the proposed use of the property after the rezoning. Indicate the number of
dwelling unit number of parking spaces; approximate square footage of any commercial
space; and height of the proposed building. (BE SPECIFIC): The Applicants are proposing
to construct a third floor addition, a rear addition, and a new attached garage at the rear of
the subject lot. The proposed third floor addition will increase the home's height dimension
to 31 feet-6'/2 inches. The single family home will be supported by the proposed, attached
two (2) car garage that will be accessed at the rear of the subject lot.
The Affordable Requirements Ordinance (ARO) requires on-site affordable housing units and/or a financial contribution for residential housing projects with ten or more units that receive a zoning change which, among other triggers, increases the allowable floor area, or, for existing Planned Developments, increases the number of units (see attached fact sheet or visit www.cityofchicago.org/ARO for more information). Is this project subject to the ARO?
YES NO X
COUNTY OF COOK STATE OF ILLINOIS
We, Melissa Sweazy and J. Cory Faulkner, being first duly sworn on oath, state that all the above statements and the statements contained in the documents submitted herewith are, to the best of our knowledge, true and correct.
Signature ofApnticant
S ignature^f App 1 icant
Subscribed and Sworn to before me this day of
Notary Public
,2021.
OFFICIAL SEAL
Nicholas Ftikas NOTARY PUBLIC, STATE OF ILLINOIS My Commission Expires September 28,2024
Date of Introduction:
File Number:
Ward:
EXACTA
Land Surveyors, LLC
www oxactaianci corn office 773 30S^i011
PROPERTY ADDRESS: 1714 W BEACH AVENUE, CHICAGO, ILLINOIS 60622
2109.6342
BOUNDARY SURVEY COOK COUNTY
:4 IK
FND CROS5 PC hi
r
-GAR. 0.20' E
-0.5'
GAR 0.30' E
LINE TABLE'. L1 24.00'(R)
S89*34,40,W 24.03' (M) L2 24 00' (R)
N wrww E 24.00' (M)
LOT 48 BLK7
•o ^ t
0 3'
^Ijtfc^' ON 147.50'(R) ,
5ET CROSS , ' . .• SET CR05S- ' ' c ""' ¦ 'fi ' - M- 1 i—n r —~
n O CONC CURE 4 GUTTER
W BEACH AVENUE (60' R/W)
30|9 9|15 30
GRAPHIC SCALE (In Feel) 1 inch = 30' ft.
STATE OF ILLINOIS COUNTY OF GRUNDY
POINTS OF INTEREST: NONE VISIBLE
THIS IS TO CERTIFY THAT THIS PROFESSIONAL SERVICE CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY SURVEY GIVEN UNDER MY HAND AND SEAL THIS DATE HEREON
ILLINOIS PROFESSIONAL LAND SURVEYOR No 3403 LICENSE EXPIRES 11/30/2022 EXACTA LAND SURVEYORS, LLC PROFESSIONAL DESIGN FIRM 184008359-0008
Exacta Und Surveyors, LLC
Land Surveyors. LLC f> 7733CS40';?
116 Eafl JdAsor. SllC'_'l j Mor-i,, IL 604ji)
Survey STARS
DATE OF SURVEY: 10/18/21 FIELD WORK DATE: 10/18/2021 REVISION DATEIS): (REVO 10/18/2021)
SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION PAGE 1 OF 2 - NOT VALID WITHOUT ALL PAGES
PROPERTY ADDRESS: 1711W BEACH AVENUE, CHICAGO, ILLINOIS 60622 SURVEY NUMBER: 2109 6342
JOB SPECIFIC SURVEYOR NOTES:
LEGAL DESCRIPTION:
LOT 47 IN BLOCK 7 IN MCREYNOLD'S SUBDIVISION IN THE EAST 1/2 OF THE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
GENERAL SURVEYOR NOTES:
1 The Legal Description used lo perform tins survey was
supplied by othen Thu survey doe-; not determine nm imply ownership o' i he lands or nny fences shown hereon Unless othe'wise noted, an examination of the abstract of t.tlc was NOT performed by the signing surveyor to determine which instruments, if any, are affecting this property
2. The purpose or" this survey is to est ealnh the boundary of the I ands described by the legal description provided and to depict the visible improvements tticreon for a pending financial transaction Underground footings, utililics, or other service lines, including roof rave overhangs were not located as part oflhis survey Unlets specifically stated otherwise the purpose aid intent of this survey is not for any construction activities or future planning
3 If there is * septic tank or dram field shown on this survey, the location depicted hereon was either shown to the surveyor by a third party or it was estimated by visual above ground Inspection. No excavation was performed to determine its location
4. This survey is exclusively for a pending fjnanclil transaction and only to be used b> thc parties to whom it is certified.
Alteration* to this survey map and report by other than the signing surveyor are prohibited
Dimensions fire m feet and decimals thereof
Any HIM A flood ^one data contained on this survey is for informational purposes only Research to ohtain said data was performed at www fem.i gov ,ind may net reflect ihe most recent information
Unless otherwise noted "SET* indicates a set iron rebar, S/fl inch in diameter and eighteen inches long
The symbols reflected in the legend and on th;s survey may have been enlarged or reduced for clarity 1 he symbols have been plotted at thc approximate cenrer of the field location and may not repiesen; the actual ttiape or size of the feature
Points of Interest tPOlY, are select above-ground improve merits, which may appeal in conflict with boundary, bulldmrj setback cr casement lines, as defined by the parameters of this survey Thi'ic POI's may no: represent
all items of Interest to thc viewer There may be additional POI's which are not shown or called-out as POi's. or which are otherwise unknown to the surveyor
Utilities shown on the subject property may cr may not indicate the existence of recorded or unrecorded utility easements
The information contained on this survey has been performed exclusively by and is thc sole: responsibility of Ex.icls Land Surveyors. LLC Additional logos or references io third party firms are for informational purposes on!,.
Due to varying construction standards, house dimensions are approximate and are not intended to be used for new construction or planning
Surveyor bearing* ne used for anguUr reference and are used to show angular relationships of lines only and are not related or ntientaicd lo Hue or magnetic north Rearing* are shown as surveyoi bearing:, and when shown as matching those on the subdivlMon plats on which this survey is based, they are to be deemed no more accurate as thc determination of a north oncnlalion nude on and for those oiigmal subdivision plats. North 00 degrees East is assumed and upon preparation or this plat, the resulting bearing hctween found points as shown on this survey a the basis of said surveyor bearings as defined and required to be noted by Illinois Administrative Code Title fifl. Chapter VII, Sub-Chapter B, Part 127fj, Suction 12/0 5b, Paragraph B, Sub-Paragraph 6, Item k
THIS SURVEY IS A PRO! ESSIONAL SERVICE IN COMPLIANCE WITH THE MINIMUM STANDARDS OF THE STATE OF ILLINOIS NO IMPROVEMENTS SHOULD BE MADE ON THE BASIS OF THIS PLAT ALONE PLEASE REFER ALSO TO YOUR DEED, TITLE POLICY AND LOCAL ORDINANCES COPYRIGHT BY EXACTA ILLINOIS SURVEYORS THIS DOCUMENT MAY ONLY BE USED BY THE PARTIES TO WHICH IT IS CERTIFIED PLEASE DIRECT QUESTIONS OR COMMENTS TO EXACTA ILLINOIS SURVEYORS, INC AT THE PHONE NUMBER SHOWN HEREON
SURVEYOR'S LEGEND
Chain Link or Wire
* Easement
*— EdgeofWatei
¦O—O—¦ Iron Fence
—OHL Overhead Lines
. Structure
¦ Vinyl Fence
» Wall or Party Wall
SURFACETYPES
'/ Asprrflt •/ BrickprTile
Concrete - Covered Area
^4
Wood_
SYMBOLS
^ ; Benchmark <£ Center Line
A
: Central Angle or Delta
= Common Ownership
I Elevatio
TCT FireHydrant
. Find or Set Monument
Guy wire or Anchor
O Manhole © *Tree
$ Utility or Light Pole
Well
ABBREVIATIONS
(Cl-Calculated
(D) - Deed
(F) - Field
(M) - Measured
(P) - Plat
(S)-Survey
A/C - Air Conditioning
A£ - Access Easement
ANE - Anchor Easement
ASBL - Accessory Setback Line
B/W- Bey/Box Window
DC - Block Corner
BFP - Backfiow Preventer
BLDG-Building
BLK - Block
BM - Benchmark
BR - Bearing Reference
BRL • Building Restriction Line
BSMT - Basement
C - Curve
C/L-Center Line
C/P - Covered Porch
C/S-Concrete Slab
CATV ¦ Cable TV Rissr
CB • Concrete Block
CH ¦ Chord Bearing
CH1M - Chimney
CLF ¦ Chain 1 ink Fence
CME - Canal Maintenance
Easement
CO-CleanOut
CONC-Concrete
COR - Corner
CS/W - Concrete Sidewalk
CUE - Control Utilriy Easement
CVG - Co-it rele Valley Gutter
D/TW - Driveway
DE - Drainage Easement
DF- Drain Field
OH - Drill Hole
DUE-Drainage & Utility
Easement
ELEV- Elevation
EM-Electric Meter
ENCL - Enclosure
ENT - entrance
EOP - Edge of Pavement
EOW-EdgcofWater
ESMT - Easement
ELIB - Electric Utility Box
F/DH - Found Drill Hole
FCM - found Concrete
Monument
FF- Finished Floor
FiP - Found iron Pipe
Ff PC - Found Iron Pipe ft Cap
FIR - Found Iron Rod
FIHC - found Iron Rod & Cap
FN ¦ Found Nail
FNIrD - F ound Nail ft Disc
FRRSPK - Found Rail Road
Spike
GAR-Garage
GM- Gar Meter
ID-identification
IE/EE - Ingress/Egress Easement
ILL - Illegible
INST - Instrument
INT - Intersection
IRRE - Irrigation Easement
L-Length
LAE - Limited Access Easement LB*-License No (Business) LBE- Limited Buffer Easement LE - Landscape Easement LME - Lake/Landscape Maintenance Easement LS* - License No (Surveyor) MB-Map Book ME - Maintenance Easement MES-Miteied End Section MF-Metal Fence MH - Manhole NR - Non-Radial NTS - Not to Scale NAVDS8 - North American Vertical Datum 19B8 NGVD29 - National Geodetic Vertical Ddtum 1929 OG-On Ground
ORB - Official Records Book ORV - Official Record Volume O/A-Overall O/S - Offset
OFF - Outside: Subjecl Property
OH'Overhang
OHL - Overhead Utility Lines
ON - Inside Subject Property
P/E - Pool Equipment
PB-Plat Book
PC - Point of Curvature
PCC - Point of Compound
Curvature
PCP - Permanent Control Point
PI ¦ Point of Intersection
PLS - Professional Land
Surveyor
PLT ¦ Plantei
POB - Pom', of Beginning
POC ¦ Point of Commencement
PHC-Point of Reverse
Curvature
PRH ¦ Pcrmancn: Reference Monument
PSM - Professional Surveyor & Mapper
PT - Point of Tangency PUE - Public Utility Easement n - Radius or Radial R/W- Right of Way RES-Residential RGE- Range
ROE - Roof Overhang Easement RP-Radius Point
S/W- Sidewalk
SBL-Setback. Lire
SCL - Survey Closure Line
SCR-Screen
SEC-Section
SEP-ScpticTanL
SEW - Sewer
SIRC - Set Iron Rod ft Cap
SMWE- Storm Water
Management Easemen;
SNftD- Set Nail and Disc
SQFT-Square Feet
STL-SurveyTie Line
STY - 5tory
SV-Sewer Valve
SWE- Sidewalk Easement
TBM - Temporary Bench Mark
TEL-Telephone Facilities
TOB-Top of Bank
TUE -Technological Utility
Easement
TWP - Township
TX - Transformer
TYP-Typical
UE- Utility Easement
UG-Underground
UP-Utility Pole
UR- Utility Ruer
VF - Vinyl Fence
W/C-Witness Cornei
WfF-Water Filter
WF - Wood Fence
WM - Water Meter/Valve Box
WV-Water valve
FLOOD ZONE INFORMATION:
DATE SIGNED: 10/18/21
LENDER:
TITLE COMPANY:
CLIENT FILE NO:
TITLE COMMITMENT:
SEE PAGE 1 OF 2 FOR MAP OF PROPERTY PAGE 2 OF 2 - NOT VALID WITHOUT ALL PAGES
^EXACTA
yt_f Land Survevore, LLC
Exacta Land Surveyors, LLC PiSf 1S100S0S9 a 772.305.4011 si Jackjor; Street I Morris IL 6M50
Written Notice, Form of Affidavit: Section 17-13-0107
December 15, 2021
Honorable Thomas Tunney
Acting Chairman, Committee on Zoning
121 North LaSalle Street
Room 304 - City Hall
Chicago, Illinois 60602
To Whom It May Concern:
The undersigned, Nicholas Ftikas, being first duly sworn on oath, deposes and says the following:
That the undersigned certifies that he has complied with the requirements of Section 17-13-0107 ofthe Zoning Code ofthe City of Chicago, by sending written notice to such property owners who appear to be the owners of the property within the subject area not solely owned by the Applicant, and on the owners of all property within 250 feet in each direction of the lot line of the subject property, exclusive of the public roads, streets, alleys and other public ways, or a total distance limited to 400 feet. That said written notice was sent by USPS First Class Mail no more than 30 days before filing the application.
That the undersigned certifies that the notice contained the address of the property sought to be rezoned as 1714 W. Beach, Chicago, Illinois; a statement of intended use of said property; the name and address of the Applicants and Owners; and a statement that the Applicants intend to file an application for a change in zoning on approximately December 15, 2021.
That the Applicants have made a bonafide effort to determine the addresses of the parties to be notified under Section 17-13-0107 of the Zoning Code of the City of Chicago and that the Applicants certify that the accompanying list of names and addresses of surrounding property owners within 250 feet is a complete list containing the names and last known addresses of the owners ofthe property required to be served.
Law Offices of Samuel V.P. Banks
, OFFICIAL SEAL ,
SARA K BARNES »
NOTARY PUBLIC, STATE OF ILLINOIS '
My Commission Expires 11/15/2024 >
m m *• "'"'*''' *
Via USPS First Class Mail
December 15, 2021
Dear Sir or Madam:
In accordance with the Amendment to the Chicago Zoning Code enacted by the City Council, Section 17-13-0107-A, please be informed that on or about December 15, 2021, I, the undersigned, intend to file an application for a change in zoning from a RT-4 Residential Two-Flat, Townhouse, and Multi-Unit District to a RM-4.5 Residential Multi-Unit District, on behalf ofthe Applicant Property Owners, J. Cory Faulkner and Melissa Sweazy, for the property located at 1714 W. Beach, Chicago, IL.
The Applicants are proposing to construct a third floor addition, a rear addition, and a new attached garage at the rear of the subject lot. The proposed third floor addition will increase the home's height dimension to 31 feet-6V2 inches. The single family home will be supported by the proposed, attached two (2) car garage that will be accessed at the rear of the subject lot.
The Applicant Property Owners, J. Cory Faulkner and Melissa Sweazy, are located at 1714 W. Beach, Chicago, IL 60622.
I am the attorney for the Applicants. I will serve as the contact person for this zoning application. My address is 221 N. LaSalle St., 38th Floor, Chicago, IL 60601. My telephone number is (312) 782-1983.
Sincerely,
Law Offices of Samuel V.P. Banks
Nicholas J. Ftikas Attorney for the Applicant
*Please note the Applicant is NOT seeking to purchase or rezone your property.
*The Applicant is required by Ordinance to send this notice to you because you are shown to own property located within 250 feet of the property subject to the proposed Zoning Amendment.
To whom it may concern:
We, Melissa Sweazy and J. Cory Faulkner, Owners of property located at 1714 W. Beach, Chicago, IL, authorize the Law Offices of Samuel V.P. Banks to file a Zoning Amendment Application with the City of Chicago for that property.
Melissa Sweazy
J. Cory Faulkner
FORM OF AFFIDAVIT
Chairman, Committee on Zoning Room 304 - City Hall Chicago, IL 60602
To Whom It May Concern:
We, Melissa Sweazy and J. Cory Faulkner, understand that the Law Offices of Samuel V.P. Banks has filed a sworn affidavit identifying us as Owners holding interest in land subject to the proposed zoning amendment for the property identified as 1714 W. Beach, Chicago, IL.
We, Melissa Sweazy and J. Cory Faulkner, being first duly sworn under oath, depose and say that we hold that interest for ourselves and no other person, association, or shareholder.
Melissa Sweazy
J. Cory Faulkner
Subscribed and Sworn to before me
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:
Melissa Sweazy
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[X] the Applicant
OR
[ ] a legal entity currently holding, or anticipated to hold within six months after City action on
the contract, transaction or other undertaking to which this EDS pertains (referred to below as the
"Matter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legal
name:
OR
[ ] a legal entity with a direct or indirect right of control of the Applicant (see Section 11(B)(1)) State the legal name ofthe entity in which the Disclosing Party holds a right of control:
Business address ofthe Disclosing Party: 1714 W. Beach
Chicago, IL 60622
Telephone: 312-782-1983 Fax: 312-782-2433 Email: nick@sambankslaw.com
Name of contact person: Nicholas Ftikas - Attorney
Federal Employer Identification No. (if you have one):
Brief description of the Matter to which this EDS pertains. (Include project number and location of property, if applicable):
Zoning Amendment concerning 1714 W. Beach, Chicago,
Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Ver.2018-1 Page 1 of 15
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
[X] Person
[ ] Publicly registered business corporation
[ ] Privately held business corporation
[ ] Sole proprietorship
[ ] General partnership
[ ] Limited partnership
[ ] Trust
[ ] Limited liability company
[ ] Limited liability partnership
[ ] Joint venture
[ ] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[ ] Yes [ ] No [ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
N/A
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 [ ] Organized in Illinois
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below the full names and titles, if applicable, of: (i) all executive officers and all directors of the entity; (ii) for not-for-profit corporations, all members, if any, which are legal entities (if there are no such members, write "no members which are legal entities"); (iii) for trusts, estates or other similar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general or limited partnerships, limited liability companies, limited liability partnerships or joint ventures, each general partner, managing member, manager or any other person or legal entity that directly or indirectly controls the day-to-day management ofthe Applicant.
NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
N/A - Individual
2. Please provide the following information concerning each person or legal entity having a direct or indirect, current or prospective (i.e. within 6 months after City action) beneficial interest (including ownership) in excess of 7.5% ofthe Applicant. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture, interest of a member or manager in a
Page 2 of 15
limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None."
NOTE: Each legal entity listed below may be required to submit an EDS on its own behalf.
Name Business Address Percentage Interest in the Applicant
N/A - Individual
SECTION in - INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTED OFFICIALS
Has the Disclosing Party provided any income or compensation to any City elected official during the
12-month period preceding the date of this EDS? [ ] Yes [X]No
Does the Disclosing Party reasonably expect to provide any income or compensation to any City
elected official during the 12-month period following the date of this EDS? [ ] Yes [X] No
If "yes" to either of the above, please identify below the name(s) of such City elected official(s) and describe such income or compensation:
N/A
Does any City elected official or, to the best of the Disclosing Party's knowledge after reasonable inquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined in Chapter 2-156 ofthe Municipal Code of Chicago ("MCC")) in the Disclosing Party? []Yes [xJNo
If "yes," please identify below the name(s) of such City elected official(s) and/or spouse(s)/domestic partner(s) and describe the financial interest(s).
N/A
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist (as defined in MCC Chapter 2-156), 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 ofthe 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. 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 IS
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.
Law Offices of Sam Banks
221 N. LaSalle St., 38th Floor Attorney Est. $2,500.00
Chicago, IL 60601
(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
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under MCC 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 (xl No [ ] No person directly or indirectly owns 10% or more ofthe 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
B. FURTHER CERTIFICATIONS
[This paragraph 1 applies only if the Matter is a contract being handled by the City's Department of Procurement Services.] In the 5-year period preceding the date of this EDS, neither the Disclosing Party nor any Affiliated Entity [see definition in (5) below] has engaged, in connection with the performance of any public contract, the services of an integrity monitor, independent private sector inspector general, or integrity compliance consultant (i.e., an individual or entity with legal, auditing, investigative, or other similar skills, designated by a public agency to help the agency monitor the activity of specified agency vendors as well as help the vendors reform their business practices so they can be considered for agency contracts in the future, or continue with a contract in progress).
The Disclosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee, tax or other source of indebtedness owed to the City of Chicago, including, but not limited to, water and sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the Disclosing Party delinquent in the payment of any tax administered by the Illinois Department of Revenue.
Page 4 of 15
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section 11(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, during the 5 years before 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 subparagraph (b) above;
have not, during the 5 years before the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, during the 5 years before 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 Disclosing Party understands and shall comply with the applicable requirements of MCC Chapters 2-56 (Inspector General) and 2-156 (Governmental Ethics).
Certifications (5), (6) and (7) 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 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 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 15
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 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 subparagraph (a) or (b) above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a Base Wage); (a)(5)(Debarment Regulations); or (a)(6)(Minimum Wage Ordinance).
Neither the Disclosing Party, nor any 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 LLCS 5/33E-3; (2) bid-rotating in violation of 720 LLCS 5/33E-4; or (3) any similar offense of any state or ofthe 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 a Sanctions List maintained by the United States Department of Commerce, State, or Treasury, or any successor federal agency.
[FOR APPLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [see MCC Chapter 1-23, Article I for applicability and defined terms] ofthe Applicant 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 of the 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 MCC Chapter 1-23, Article I applies to the Applicant, that Article's permanent compliance timeframe supersedes 5-year compliance timeframes in this Section V.
[FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed as having an active exclusion by the U.S. EPA on the federal System for Award Management ("SAM").
10. [FOR APPLICANT ONLY] The Applicant 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
Certifications (2) and (9) above and will not, without the prior written consent ofthe City, use any such
Vcr.2018-1 Page 6 of 15
contractor/subcontractor that does not provide such certifications or that the Applicant has reason to believe has not provided or cannot provide truthful certifications.
11. 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
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.
12. 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 the 12-month period preceding the date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none").
N/A
13. To the best ofthe 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 $25 per recipient, or (iii) a political contribution otherwise duly reported as required by law (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 MCC Section 2-32-455(b).
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 MCC Chapter 2-32. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in MCC Chapter 2-32. 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."
Page 7 of 15
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in MCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explain here (attach additional pages if necessary):
N/A
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 FINANCIAL INTEREST IN CITY BUSINESS
Any words or terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.
In accordance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledge after reasonable inquiry, 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 LxJNo
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), skip Items D(2) and D(3) and 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 rx]No
If you checked "Yes" to Item D(l), provide the names and business addresses ofthe City officials or employees having such financial interest and identify the nature ofthe financial interest:
Name Business Address Nature of Financial Interest
N/A
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
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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 (2). Failure to comply with 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 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.
X 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:
N/A - Individual N/A
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 VTI. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations ofthe 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 1995, as amended, who have made lobbying contacts on behalf ofthe Disclosing Party with respect to the Matter: (Add sheets if necessary):
N/A
(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, as amended, 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
Ver.2018-1 Page 9 of 15
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.
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 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," as that term is defined in the Lobbying Disclosure Act of 1995, as amended.
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. n/A . Not Federally Funded
Is the Disclosing Party the Applicant?
[ ]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 Cornmittee, 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 [ ] Reports not required
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:
N/A
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SECTION Vn - FURTHER ACKNOWLEDGMENTS AND CERTIFICATION
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 are material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of this ordinance 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 this ordinance.
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 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 City transactions. 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 in, and appended to, this EDS may be made publicly available 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.
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 MCC Chapter 1-23, Article I (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by MCC Chapter 1-23 and Section 2-154-020.
Page 11 of 15
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS, and all applicable Appendices, are true, accurate and complete as of the date furnished to the City.
Melissa B. Sweazy (Print or type exact legal name of Disclosing Party)
Bv: I'lrm
(Sign here^
Melissa B. Sweazy
(Print or type name of person signing)
(Print or type title of person signing)
Signed and sworn to before me on (date) 1 ° t-b ^-
County,
N,Ch?^TfoFS»LUNOIS ^
Wv Commte^ v
Page 12 of IS
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%. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under MCC 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, daughter-in-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 U.B.l.a., if the Disclosing Party is a corporation; all partners ofthe 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 ofthe 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% 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 MNo
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.
N/A
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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% (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to MCC Section 2-92-416?
[ ]Yes MNo
/
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 MCC Section 2-92-416?
[ ] Yes [ ] No D(] The Applicant is not publicly traded on any exchange.
If yes to (1) or (2) above, please identify below the name of each person or legal entity identified as a building code scofflaw or problem landlord and the address of each building or buildings to which the pertinent code violations apply.
N/A
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«
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX C
PROHIBITION ON WAGE & SALARY HISTORY SCREENING - CERTIFICATION
This Appendix is to be completed only by an Applicant that is completing this EDS as a "contractor" as defined in MCC Section 2-92-385. That section, which should be consulted (www.amlegal.com ), generally covers a party to any agreement pursuant to which they: (i) receive City of Chicago funds in consideration for services, work or goods provided (including for legal or other professional services), or (ii) pay the City money for a license, grant or concession allowing them to conduct a business on City premises.
On behalf of an Applicant that is a contractor pursuant to MCC Section 2-92-385,1 hereby certify that the Applicant is in compliance with MCC Section 2-92-3 85(b)(1) and (2), which prohibit: (i) screening job applicants based on their wage or salary history, or (ii) seeking job applicants' wage or salary history from current or former employers. I also certify that the Applicant has adopted a policy that includes those prohibitions.
[ ] Yes
[ ]No
rx] N/A -1 am not an Applicant that is a "contractor" as defined in MCC Section 2-92-385. This certification shall serve as the affidavit required by MCC Section 2-92-385(c)(l). If you checked "no" to the above, please explain.
N/A
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Joseph Cory Faulkner
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[XJ the Applicant
OR
[ ] a legal entity currently holding, or anticipated to hold within six months after City action on the contract, transaction or other undertaking to which this EDS pertains (referred to below as the "Matter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legal name:
OR
[ ] a legal entity with a direct or indirect right of control of the Applicant (see Section 11(B)(1)) State the legal name of the entity in which the Disclosing Party holds a right of control:
Business address ofthe Disclosing Party: 1714 W. Beach ¦¦¦
Chicago, IL 60622
Telephone: 312-782-1983 Fax: 312-782-2433 Email: nick@sambankslaw.com
Name of contact person: Nicholas Ftikas - Attorney
Federal Employer Identification No. (if you have one):
Brief description of the Matter to which this EDS pertains. (Include project number and location of property, if applicable):
Zoning Amendment concerning 1714 W. Beach, Chicago,
Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Ver.2018-1 Page 1 of 15
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
[X] Person
[ ] Publicly registered business corporation
[ ] Privately held business corporation
[ ] Sole proprietorship
[ ] General partnership
[ ] Limited partnership
[ ]Trust
[ ] Limited liability company
[ ] Limited liability partnership
[ ] Joint venture
[ ] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[ ]Yes [ ]No [ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
N/A
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 [ ] Organized in Illinois
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below the full names and titles, if applicable, of: (i) all executive officers and all directors of the entity; (ii) for not-for-profit corporations, all members, if any, which are legal entities (if there are no such members, write "no members which are legal entities"); (iii) for trusts, estates or other similar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general or limited partnerships, limited liability companies, limited liability partnerships or joint ventures, each general partner, managing member, manager or any other person or legal entity that directly or indirectly controls the day-to-day management ofthe Applicant.
NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
N/A - Individual
2. Please provide the following information concerning each person or legal entity having a direct or indirect, current or prospective (i.e. within 6 months after City action) beneficial interest (including ownership) in excess of 7.5% of the Applicant. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture, interest of a member or manager in a
Page 2 of 15
limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None."
NOTE: Each legal entity listed below may be required to submit an EDS on its own behalf.
Name Business Address Percentage Interest in the Applicant
N/A - Individual
SECTION m - INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTED OFFICIALS
Has the Disclosing Party provided any income or compensation to any City elected official during the
12-month period preceding the date of this EDS? [ ] Yes [X]No
Does the Disclosing Party reasonably expect to provide any income or compensation to any City
elected official during the 12-month period following the date of this EDS? [ ] Yes [X] No
If "yes" to either of the above, please identify below the name(s) of such City elected official(s) and describe such income or compensation:
N/A
Does any City elected official or, to the best ofthe Disclosing Party's knowledge after reasonable inquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined in Chapter 2-156 ofthe Municipal Code of Chicago ("MCC")) in the Disclosing Party? []Yes MNo
If "yes," please identify below the name(s) of such City elected official(s) and/or spouse(s)/domestic partner(s) and describe the financial interest(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 (as defined in MCC Chapter 2-156), 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 ofthe relationship, and the total amount ofthe 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. 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.
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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.
Law Offices of Sam Banks
221 N. LaSalle St., 38th Floor
Chicago, IL 60601
(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
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under MCC 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 Lx] No [ ] No person directly or indirectly owns 10% or more ofthe 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
B. FURTHER CERTIFICATIONS
[This paragraph 1 applies only if the Matter is a contract being handled by the City's Department of Procurement Services.] In the 5-year period preceding the date of this EDS, neither the Disclosing Party nor any Affiliated Entity [see definition in (5) below] has engaged, in connection with the performance of any public contract, the services of an integrity monitor, independent private sector inspector general, or integrity compliance consultant (i.e., an individual or entity with legal, auditing, investigative, or other similar skills, designated by a public agency to help the agency monitor the activity of specified agency vendors as well as help the vendors reform their business practices so they can be considered for agency contracts in the future, or continue with a contract in progress).
The Disclosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee, tax or other source of indebtedness owed to the City of Chicago, including, but not limited to, water and sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the Disclosing Party delinquent in the payment of any tax administered by the Illinois Department of Revenue.
Page 4 of 15
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section 11(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, during the 5 years before 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 ofthe offenses set forth in subparagraph (b) above;
have not, during the 5 years before the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, during the 5 years before 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 Disclosing Party understands and shall comply with the applicable requirements of MCC Chapters 2-56 (Inspector General) and 2-156 (Governmental Ethics).
Certifications (5), (6) and (7) 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 TV, "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 of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 15
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 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 subparagraph (a) or (b) above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a Base Wage); (a)(5)(Debarment Regulations); or (a)(6)(Minimum Wage Ordinance).
Neither the Disclosing Party, nor any 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 LLCS 5/33E-4; or (3) any similar offense of any state or ofthe 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 a Sanctions List maintained by the United States Department of Commerce, State, or Treasury, or any successor federal agency.
[FOR APPLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [see MCC Chapter 1-23, Article I for applicability and defined terms] ofthe Applicant 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 MCC Chapter 1-23, Article I applies to the Applicant, that Article's permanent compliance timeframe supersedes 5-year compliance timeframes in this Section V.
[FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed as having an active exclusion by the U.S. EPA on the federal System for Award Management ("SAM").
10. [FOR APPLICANT ONLY] The Applicant 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
Certifications (2) and (9) above and will not, without the prior written consent of the City, use any such
Ver.2018-1 Page 6 of 15
contractor/subcontractor that does not provide such certifications or that the Applicant has reason to believe has not provided or cannot provide truthful certifications.
11. 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
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.
12. 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 the 12-month period preceding the date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none").
N/A
13. To the best ofthe 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, 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 $25 per recipient, or (iii) a political contribution otherwise duly reported as required by law (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 MCC Section 2-32-455(b).
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 MCC Chapter 2-32. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in MCC Chapter 2-32. 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."
Page 7 of 15
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in MCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explain here (attach additional pages if necessary):
N/A
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 FINANCIAL INTEREST IN CITY BUSINESS
Any words or terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.
In accordance with MCC Section 2-156-110: To the best ofthe Disclosing Party's knowledge after reasonable inquiry, 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 LX]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), skip Items D(2) and D(3) and 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 Part D.
Does the Matter involve a City Property Sale?
[ ] Yes rx] No
If you checked "Yes" to Item D(l), provide the names and business addresses ofthe City officials or employees having such financial interest and identify the nature ofthe financial interest:
Name Business Address Nature of Financial Interest
N/A
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
Page 8 of15
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 (2). Failure to comply with 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 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.
X 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:
N/A - Individual N/A
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 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 1995, as amended, who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
N/A
(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, as amended, 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
Ver.2018-1 Page 9 of 15
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.
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 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," as that term is defined in the Lobbying Disclosure Act of 1995, as amended.
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 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. N/A . Not Federa||y Funded
Is the Disclosing Party the Applicant?
[ ] 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 Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[ ] Yes [ ] No [ ] Reports not required
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:
N/A
Page 10 of 15
SECTION VII - FURTHER ACKNOWLEDGMENTS AND CERTIFICATION
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 are material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of this ordinance 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 this ordinance.
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 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 City transactions. 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 in, and appended to, this EDS may be made publicly available 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.
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 MCC Chapter 1-23, Article I (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by MCC Chapter 1 -23 and Section 2-154-020.
Page 11 of 15
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS, and all applicable Appendices, are true, accurate and complete as ofthe date furnished to the City.
Joseph C Faulkner
Joseph C Faulkner
(Print or type name of person signing)
(Print or type title of person signing)
Signed and sworn to before me on (date)
Notary Public
Page 12 of 15
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%. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under MCC 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 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, daughter-in-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 U.B.l.a., if the Disclosing Party is a corporation; all partners ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members ofthe 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% 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.
N/A
Page 13 of 15
|1010|
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFLDAVIT
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% (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to MCC Section 2-92-416?
[]Yes &<] No (
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 MCC Section 2-92-416?
[. ] Yes [ ] No |x] The Applicant is not publicly traded on any exchange.
If yes to (1) or (2) above, please identify below the name of each person or legal entity identified as a building code scofflaw or problem landlord and the address of each building or buildings to which the pertinent code violations apply.
N/A
Page 14 of 15
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX C
PROHIBITION ON WAGE & SALARY HISTORY SCREENING - CERTIFICATION
This Appendix is to be completed only by an Applicant that is completing this EDS as a "contractor" as defined in MCC Section 2-92-385. That section, which should be consulted (www.amlegal.com ), generally covers a party to any agreement pursuant to which they: (i) receive City of Chicago funds in consideration for services, work or goods provided (including for legal or other professional services), or (ii) pay the City money for a license, grant or concession allowing them to conduct a business on City premises.
On behalf of an Applicant that is a contractor pursuant to MCC Section 2-92-385,1 hereby certify that the Applicant is in compliance with MCC Section 2-92-385(b)(l) and (2), which prohibit: (i) screening job applicants based on their wage or salary history, or (ii) seeking job applicants' wage or salary history from current or former employers. I also certify that the Applicant has adopted a policy that includes those prohibitions.
[ ]Yes []No
r/] N/A -1 am not an Applicant that is a "contractor" as defined in MCC Section 2-92-385. This certification shall serve as the affidavit required by MCC Section 2-92-385(c)(l). If you checked "no" to the above, please explain.
N/A
Page 15 of 15
EXACTA
Land Surveyors, LLC
www Gxactaland com office T73 305 4011
PROPERTY ADDRESS: 1714 W BEACH AVENUE, CHICAGO, ILLINOIS 60622
2109.6342
BOUNDARY SURVEY COOK COUNTY
ALLEY(W RIW)
FND CROSS CO' M
SET CROSS i" / o |-ND
nrr n »l ^ r-A-s-
O 2' ON
LOT 47
BLK7
2395 SQ FT.±
O I' ON-
LOT 46 BLK 7
I 2' OFr-*<
^—Oj
Ci s">
-GAR 0.20' E
-0.5'
^-GAR. O 30' E
LINE TABLE L1 24 00'(R)
S 89"34'40" W 24.03' (M) L2 24.00'(R)
N 89°39'39- E 24.00- (M)
LOT 48 BLK 7
0.3'
i^H^-i V ON 147SO'(R)
SET CROSS
O CONC CUP.B * GUTTER
W BEA CH A VENUE (60" RJW)
30|9 9|15 30
GRAPHIC SCALE (In Feet) 1 inch = 30' n.
STATE OF ILLINOIS COUNTY OF GRUNDY
POINTS OF INTEREST: NONE VISIBLE
THIS IS TO CERTIFY THAT THIS PROFESSIONAL SERVICE CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY SURVEY GIVEN UNDER MY HAND AND SEAL THIS DATE HEREON
ILLINOIS PROFESSIONAL LAND SURVEYOR No LICENSE EXPIRES 11/30/2022 EXACTA LAND SURVEYORS, LLC PROFESSIONAL DESIGN FIRM 164008359-0008
Exjcld Lund iurveyo's. LLC
<, 77", )C5 401' ilt.Lasl Jicksoi' i'.if.-! I .V.cr-i, iL (B430
< ?SurveySTARS
DATE OF SURVEY: 10/18/21 FIELD WORK DATE: 10/18/2021 REVISION DATE(S): (REVO 10/18/2021)
SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION PAGE 1 Or 2-NOT VALID WITHOUT ALL PAGES
PROPERTY ADDRESS: 1714 W BEACH AVENUE, CHICAGO, ILLINOIS 60622 SURVEY NUMBER: 2109 634?
JOB SPECIFIC SURVEYOR NOTES:
LEGAL DESCRIPTION:
LOT 47 IN BLOCK 7 IN MCREYNOLD'S SUBDIVISION IN THE EAST 1/2 OFTHE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
GENERAL SURVEYOR NOTES:
1. The Lerjil Description used lo perform tint survey
supplied by others Thu survey does no: determine noi imply ownership of ihe lands or any fences shown neuron Unless othe'wise noted, an examination of the abstract of utle wes NOT performed by the signing surveyor to determine winch instruments, if any, arc affecting this property
I Thc purpose of this survey is to establish the bounda-y of tne lands described by the legal description provided an:! to depict the visible improvements thereon for n pending financial trail taction Underground footing-;, utilities, ot other service lines, including roof cove overhang j were not located as part of this survey Unless specifically stated otherwise the purpose and intent of this survey is not for any construe'ion activities or future planning
If there is a septic tankc dram field shown on this turvey. the location depicted hereon was cither shown to tne surveyor by a third paty or n was eitimaied by visual above ground inspection No excavation was performed to determine its location
This survey is exclusively for a pending financial transaction and only to be used by the parties to whom it is certified
Alterations to tins survey map and report by othm than the signing surveyor arc prohibited
Dimensions arc in fect and decimals thereof
7 Any FEMA flood zone data contained on this survey <; for
informal icr.al purposes only Research to obtain said data wns performed.it wwv.-.forrirt gov ,ind nay not icfiect Ihe most recent information ?
S UHcss otherwise noted "SET* indicates a set iron rebai, 5/8 inch in diameter and eighteen inch"! King
Ttic symbol! reflected in the legend and on this surve> may have been enlarged or reduced for clarity.'1 he symbols have been plotted at the approximate center of the fuMd location and may not represent the actual shape or size of thc feature
Points of Interest (POI's¦ are select above-ground improvements, which may appear in conflict with boundary, building setback cr easement lines, as defined by the parameters of this survey Th<\se POI's may not represent
all items of interest to thc viewer There may be additional POI's winch are not shown or called-out POI's. or which are otherwise unknown to the surveyor. 11. Utilities shown on the subject property may or may not indicate tne existence of recorded or unrecorded utility easements
12 Thc information contained on this survey has been performed exclusively by and is the snlr rcspom.-biliLy of Exatia Land Surveyors LLC. Additional legos or references to thud party firms are for informational purposes only.
13 Due to varying construction standards, house dimensio-ns are approximate and are not intend«d to be used for new construction or planning
K Surveyor bearings are used for angular reference and arc usc-d to show anguiar relationships of lines only and are not related or orient,neri to I rut: or magnetic north Bearings are •.hawn as lurveyoi bearings, and when shown as matching those on the subdivision plats on which tins survey is based, they are to be deemed no more accurate as the determination of a north orientation made on and for those original subdivision plats North 00 degrees East is assumed and upon preparation or this plat, the resulting bearing between found points is shown on this survey is the basis of said surveyor bearings as denned and required to be noted by Illinois Administrative Code Title CH, Chaptei VII, Sub-Chapter B, Part 1270. Section 12/0 56, Paragraph B, Sub-Paragraph 6, Itemk
15 THIS SURVEY IS A PROFESSIONAL SfcRVICK IN COMPLIANCE WITH THE MINIMUM STANDARDS OF THE STATE OF ILLINOIS NO IMPROVEMENTS SHOULD 8E MADE ON THE BASIS OF THIS PL AT ALONE PLEASE REFER ALSO TO YOUR DEED, TITLE POLICY AND LOCAL ORDINANCES COPYRIGHT BY EXACTA ILLINOIS SURVEYORS THIS DOCUMENT MAY ONLY BE USED BY THE PARTIES TO WHICH IT 15 CERTIFIED PLEASE DIRLCT QUESTIONS OR COMMENTS TO EXACTA ILLINOIS SURVEYORS, INC AT THE PHONE NUMBER SHOWN HEREON
SURVEYOR'S LEGEND
Center Line
Chain Link or Wire
' Easement . Edge of Water
Iron Fence
Overhead Unes
Structure
-¦ Vinyl Fence
- Wall or Party Wall
SURFACETYPES
;/.',',' Asphalt
^,7-^ BrlckorTde Concrete j Covered Area
L^>:>;-. Water " iVV-V^Wood
SYMBOLS
A
Benchmark '• Center Une
Central Angle or
Delta
Common
Ownership
Elevatio
Flre Hydrant
Find or Set Monument
Guy wire or Anchor
9 Manhole © *Tree
Xjl Utility or Light Pole
© wcii ;
ABBREVIATIONS
-Calculated
-Deed (F) - Field
(M) - Measured
(PJ - Plat
(SJ - Survey
A/C - Air Conditioning
AE - At cess Easement
ANE - Anchor Easement
ASBL - Accessory Setback Line
B/W - Bay/Box Window.
BC ¦ Block Corner
BFP ¦ Backfiow Preventer
BLDG- Building
BLK • Block
BM - Benchmark
BR - Bearing Reference
BRL - Buildinci Restriction Line
BSMT - Basement
C - Curve
CIL- Center Line
C/P - Covered Porch
C/S - Concrete Slab
CATV-Cable TV Riser
CB ¦ Concrete Block
CH ¦ Chord 3eannq
CHIM-Chimney
CLF - Chain Link Fence
CME - Canal Maintenance
Easement
CO - Clean Out
CONC-Concrete
COH-Corner
CS/W - Concrete Sidewalk
CUE - Control Utility Easement
CVG - Concrete Valley Gutter
D/W - Driveway
DE - Drainage Easement
Dr-Dra;i-i Field
DH-Drill Hole
DUE • Drainage & Utility
Easement
ELEV-Elevation
EM-Electric Meter
ENCL-Enclosure
ENT - entrance
EOP - Edge of Pavement
EOW- Edge of Water
ESMT-Easement
EUB - Electric Utility Box
F.'DH-Found Drill Hole
FCM - Found Concrete
Monument
FF - Finished Floor
FIP-Found Iron Pipe
FIPC - Found Iron Pipe & Cap
FIR - Found Iron Rod
F1RC - Found Iron Rod & Cap
FN - Found Nail
FNfcD - Found Nail 6 Dec
FRRSPK - Found Kai! Road
Spike
GAR - Garage
GM-Gas Meter
t0- Identification
tE/EE - Inesresj/Egrcss Easement
ILL - Illegible
INST-lnstrument
INT - Intersection
IRRE - Irrigation Easement
L- Length
LAE - Limi'.cd Access Easement LB#-License No (Business) LBE - Limited Buffer Easement LE - Landscape Easement LME - Lake/Landscape Maintenance Easement LS* - License No (Surveyor; MB-Map Book ME - Maintenance Easement MES-Mitercd EndSsclion MF - Metal Fence MH - Manhole NR - Non-Radial NTS - Not tn Scale NAVD8S - North American Vertical Datum 1S>S6 NGVD29 - National Geodetic Verticil Datum 1929 OG - On Ground
ORB - Official Records Book ORV - Official Record Volume O/A - Overall O/S-Offset
OFF - Outside Subjecl Property
OH-Overhanr;
OHL- Overhead Utility Lines
ON - Inside Subject Property
P/E - Pool Equipment
PB-PLjl Book
PC-Point of Curvature
PCC - Point of Compound
Cuivature
PCP - Permanent Control Point
Pt - Point of Intersection
PLS - Professional Land
Surveyor
PLT - Planter
POB - Point of Beginning
POC - Point of Commencement
PRC - Point of Reverse
Curvature
PRM - Pei maneni Reference Monument
PSM - Professional Surveyor & Mapper
PT - Point of Tangency
PUE - Public Utility Easement
R- Radius or Radial
R/W-Righl of Way
RES - Residential
RGE- Range
ROE - Roof Overhang Easement RP-Radius Point
S/W-Sidswalk
SBL - Setback Line
SCL - Survey Closure Line
SCR-Screen
SEC - Section
SEP-Septic lank
SEW-Sewer
SIRC-Sel Iron Rod & Cap
SMWE- Storm Watei
Management Easemen;
SNftD-Set Nail and Disc
SQFT-Square Feet
STL - Survey Tic Line
STY - Story
SV-ScwcrVaivc
SWE-SidewalkEasf.ment
TBM - temporary Bench Mark
TEL-Telephone Facilities
TOB-Top of Bank
TUE-Technological Utility
Easement
TWP-Township
TX - Transformer
TYP-Typical
UE-Utility Easement
UG - Underground
UP - Utility Pole
UR- Utility Riser
VF - Vinyl Fence
W/C-Witness Coiner
W/F - Water Filter
WF - Wood Fence
WM - Water Meter/Valve Sox
WV-Water valve
FLOOD ZONE INFORMATION:
DATE SIGNED: 10/18/21
BUYER:
CLIENT FILE NO:
TITLE COMPANY:
TITLE COMMITMENT:
SEE PAGE 1 OF 2 FOR MAP OF PROPERTY PAGE 2 OF 2 - NOT VALID WITHOUT ALL PAGES
?
4EXACTA
Land Surveyors, LLC
Exacta Land Surveyors, LLC PLSr 1?*00$Q5? o. 771 305 40.1 316 EartJacicum Streel i Moms, IL 00*50
EXACTA
Land Surveyors, LLC
wwwoyactalanrtcom office "773 305-aon
PROPERTY ADDRESS: 1714 W BEACH AVENUE, CHICAGO, ILLINOIS 60622
2109.6342
BOUNDARY SURVEY COOK COUNTY
LOT 47 BLK 7
2395 SQ.FT.t
O. I' ON
I 2'OFF'
BLK 7
¦>-.!¦:¦: -» Sit:
gas
m cn ry ¦¦¦¦ cNi.y- CC'
LINE TABLE L1 24.00' (R)
S89-34'40-W 24.03'(M) L2 24.00' (R)
N B9"39'39- E 24.00' (M)
0.3'
Tl
i4ljk=L3' ON 147 WW ,
3ET CROSS
O CQHC CURB * GUTTEi
W BE A CH A VENUE (60' R/W)
GRAPHIC SCALE (In Feet) 1 inch = 30' ft.
j-SS
STATE OF ILLINOIS COUNTY OF GRUNDY
THIS IS TO CERT I FY THAT THIS PROFESSIONAL SERVICE CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY SURVEY GIVEN UNDER MY hAND AND SFAL THIS DATE HEREON
POINTS OF INTEREST: NONE VISIBLE
II I.INOIS PROFESSIONAL LAND SURVEYOR No 3403 LICENSE EXPIRES 11/30/2022 EXACTA LAND SURVEYORS, LLC PROFESSIONAL DESIGN FIRM 184008059-0006
b:;ict.aLr.nct Surveyors, LLC
Land Surveyors. LLC c, 77'iyiSiiV
iibtaii Jd'.ksor !il'et*t i Varti it K-Ysi
< ? SurveySTARS
DATE OF SURVEY: 10/18/21 FIELD WORK DATE: 10/18/2021 REVISION DATE(S): (REVO 10/18/2021)
SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION PAGE 1 OF 2 - NOT VALID WITHOUT ALL PAGES
PROPERTY ADDRESS: 1714 W BtACH AVENUE. CHICAGO, ILLINOIS 60622 SURVEY NUMBER: 2109 4342
JOB SPECIFIC SURVEYOR NOTES:
LEGAL DESCRIPTION:
LOT 47 IN BLOCK 7 IN MCREYNOLD'S SUBDIVISION IN THE EAST 1/2 OF THE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
GENERAL SURVEYOR NOTES:
The Legal Description used lo perform ih:i survey was Supplied by others. This survey docs not determine nor imply ownership of the lands or *ny ft-nces shown hereon Unless otherwise noted an examination ot the abstract of title was NO * performed by th? signing surveyo'to determine winch instruments, if any. air affecting this property
The purpose o* this survey is to establish inc boundary of (thc lands desciibeii by the legal d-icnutron provided and
to depict tiit visible improvement-, thc-teon lor a pandi'V) financial transaction Underground footings, utilities, oi other service lines, including roof eave ovcihangs were not located as part oflhis survey Unless specifically stated other wise the purpose and interit of this survey is not for any construction activities C future planning
If there is n septic tank or drain field shown on this su-vey. the location depicted hereon was either shown to the surveyor by a third party or it was estimated by visual above ground inspection No excavation was performed to determine its location
This survey is exclusively for a pendimj finaiicul transaction and only to be used by the parties to whom it is certified
Alteration**" th's survey man and report It, utnur thai. t*ie signing surveyo-are prohibited
Dimensions arc- in feet and decimal' thereof
7 Any FEMA flood /one data contained on this survey i; for
informational purposes only Rescaich to obtain said data was performed a; www t"cm«i gov ,irid may not reflect the most recent information
B Unless otherwise noted "SET* indicates a set iron rcbar, 5/8 mrh in diami'terand I'lgvcii inchiM long
The symbols reflected in tne legend and on th's survey may have been enlarged or reduced for clarity The symbols have been plotted at thc approximate center of the field location and may not represent thc actual shape or size of the feature
Points of Interest (POI's; are select above-ground improvements, which may appear in conllici with boundary, buildmg setback or easement lines, as defined by the parameters of this survey Trvse POI's may not represent
all items of interest to the viewer There may be additional POI's which are not shown or c.illud-out as POI's. or which nre Otherwise unknown to the surveyor
Utilities shown on the subject property may or may not indicate thc existence of recorded o- unrThe mfoimatior. contained on this survey his been performed exclusively by ;ind the solr responsibility o! Ex.icia Land Surveyors. LLC Additional logos or reference* to thud party firms are for informational purpose*; only.
Due to varymcj construction standards, house dimensions are approximate and arc not intended to be used for new construction or planning
Surveyor bearings are used for angular reference and are used to show angular relationships of lines only and arc net related or orientated to Iruir or rnaqnciir north Bearings ate shown as surveyo! bearings, and wlien shown as matching ttiuse on thc subdivision plats on which this survey is bjsed. [he/ are to be deemed no (T.ore accurate as the tie termination of a north orientation made on and for those original subdivision plats. North 00 degrees East is assumed and upon preparation of tins plat, thc resulting bearing between found points as shown on this survey is the basis of said surveyor bearings as denned and required to be noted by Illinois Administrative Code Title £18, Chapter VII, Sub-Chapter B, Part 1270. Section 1270 56. Paragraph B, Sub-Paragraph 6, Item k
I HIS SURVeYIS A PROFESSIONAL SERVICE IN COMPLIANCE WITH THE MINIMUM STANOARDS OF THE STATC OF ILLINOIS NO IMPROVEMENTS SHOULD Sc. MADE ON THE BASIS OF THIS PLAT ALONE PLEASE REFER ALSO TO YOUR DEED, TITLE POLICY AND LOCAL ORDINANCES COPYRIGHT BY F.XAC1A ILLINOIS SURVEfORS THIS DOCUMENT MAY ONLY Bh U5LD BY THE PARTIES TO WHICH IT IS CERTIFIFD PLEASE DIRECT QUESTIONS OR COMMENTS TO EXACTA ILLINOIS S'JRVLYDUS, INC. AT THC PHONE NUMBER SHOWN HEREON
SURVEYOR'S LEGEND
LINETVPES
Boundary Line
Center Line
Cham Link orWirc
, r£alernent
- EdgeofWater
-O O— Iron Fence
—OHL Overhead Lines
Structure SurveyTieLir Vinyl Fence Wall or Party Wall Wood Fence SURFACETYPES //////A A*Ph*h
{ S-"7*A BrickorTile
.y T.. _
Concrete Covered Area
* sty
SYMBOLS ^ Benchmark ([ Center Line A 1 Central Angle or Z-i _: Delta
Comrfion *^ Ownership
S_ Control Point Ii] . Catch Basin
^t^j Elevation
X]f Fire Hydra
Find or Set Monument
€ Cuywirt
<3 Manhole
© Tree
$ Utility or Light Pole © Well j
ABBREVIATIONS
(O-Calculated
(D) - Deed
tO - Field
(Ml - Measured
(PJ - Plat
(SI - Survey
A/C - Air Conditioning
AE - Access Easement
ANE-Anchor Easement
ASBL - Accessory Setback Line
B/W-Bey/3oi-Window
BC-Block Corner
BFP - BackHov.' Preventer
BLDG - Building
BLK-Block
BM - Benchmark
BR - Bearing Reference
BRL ¦ Uuildmri Restriction Line
B5MT - Basement
C - Curve
C/L-Center Line
C/P - Cohered Porch
C/S - Concrete Slab
CATV-CableTV fcsei
CB-Concrete Block
CH - Chord Bearing
CHIM - Chimney
CLF-Cham Link Fence
CME - Canal Maintenance
Easement
CO - Clean Out
CONC - Concrete
COR - Comer
CS/W-Concrete Sidswalk
CUE - Control Uliiitv Easement
CVG - Concrete valley Gutter
D/W - Driveway
DE- Drainage Easement
DF-Drain Field
OH ¦ Drill Hole
DUE - Drainage & Utility
Easement
ELF.V-Elevation
EM-Electric Meter
ENCL - Enclosure
ENT-f.ntrance
EOP - Edge of Pavement
EOW- EdgeofWater
ESMT • Easement
EUB - Electric Utility Box
F/DH-Found Drill Hole
TCM - Found Concrete
Monument
FF - Finished Floor
FIP - Found Iron Pipe
FtPC - Found Iron Pipe «r Cap
FIR - Found Iron Rod
FIRC - Found Iron Rod & Cap
FN - Found Nail
FNIrD - Four.d Nail & Disc
FRRSPK - Found Rail Road
Spike
GAR-Garage
GM-Gas Meter
ID - Identification
IE/EE - Ingress/Egress fasement
ILL-Illegible
INST-Instrument
INT-Intersection
inRE- Irrigation Easement
L- Length
LAE - Limited Access Easement LB*-License No (Business) LBE - Limited Buffer Easement LE - Landscape Easement LME - Lake/Landscape Maintenance casement LSI - License No (Surveyor) MB- Map Book ME - Maintenance Lasenient MES - Miteied End Section MF - Metal Fence MH-Manhole NR - Non-Radial NTS-Not to Scale NAVD88 - North American Vertical Datum 1988 NGVD29 - National Geodetic Vertical Datum 1929 OG - On Ground
ORB - Official Records Book ORV - Official Record Volume O/A - Overall O/S - Offsel
OFF - Outside Subject Property
OH - Overhang
OHL - Overhead Utility Lines
ON - Inside Sub;cct Property
P/E - Pool equipment
P8 - Plat Book
PC - Point«' Cu-vature
PCC - Point o' Compound
Curvature
PCP - Permanent Conttol Point
PI - Point o' Intersection
PLS - Professional Land
Surveyor
PLT • Planter
POB - Point of Beginning
POC - Point of Commencement
PRC - Point of Rcvc'se
Curvature
PRM - Permancnr Reference Monument
PSM - Professional Surveyor & Mapper
PT-Point ofTangcncy PUE - Public Utility Easement R - Radius or Radial R/W-'tight of Way RES-Residential RGB-Range
ROE - Roof Overhang Easement RP - Radius Point
S/W- Sidewalk'
SBL-Setback Line
SCL - Survey CloiU'e Line
SCR - Screen
SEC-Section
SEP - Septic Tank
SEW-Sewer
SIRC-Soi Iron Rod & Cap
SMWE - Storm Water
Management Easement
SNAD-Set Nail and Disc
SQFT- Square Feet
STL - Survey Tie Line
STY-Slory
SV-Sewer Valve
S WE - Sidewalk Easement
TBM - Tempora-'y Bench Mark
TEL - Telephone Facilities
TOB-Topof Bank
THE - Technological Utility
Easement
TWP-Township
TX -Tiansformcr
TTP-Typical
UE-Utility Easement
UG - Undergrounc
UP-Utility Pole
UR-U;ility Riser
VF -Vmyl Fence
W/C- Witness Cornei
W/F - Water Tiller
WF - Wood Fence
WM - Water Meter/Valve 6o>
WV-Waiei valve
FLOOD ZONE INFORMATION:
DATE SIGNED: 10/18/21
TITLE COMPANY:
CLIENT FILE NO:
TITLE COMMITMENT:
SEE PAGE 1 OF 2 FOR MAP OF PROPERTY PAGE 2 OF 2 - NOT VALID WITHOUT ALL PAGES
^EXACTA
^» Land Surveyors. LLC
Exacta Land Surveyors. LLC
' o 77J3C3 '.0;i 316 EibtJackion Street {Worm, 1150*50
XACTA
Land Surveyors, LLC
vjvm exact-danci-com omce. "773 30s ^JOn
PROPERTY ADDRESS: 1714 W BEACH AVENUE. CHICAGO. ILLINOIS 60622
2109.6342
BOUNDARY SURVEY COOK COUNTY
ALLEY (W WW) O SET CROSS 1""
D3 I"
FND CROSS ' 3.00'M
0 2' ON
LOT 47 ^
BLK 7
-J
2395 SQ.FT.±
0.1'ON-
I 2'OFF
9f?
;'-¦>- ¦ 5-".
.;.gs4;:Bj-
GAR O 20' E
GAR 0 30' E
LINE TABLE L1 24.00'(R)
S89*34WW 24.03'(M) L2 24.00' (R)
N 89"39'39" E 24 00' (M)
LOT 48 BLK 7
-O 3'
-y on U750'(R)
sirr cross .
CONC CURB t GUTTER
W BEACH AVENUE (60' R/W)
GRAPHIC SCALE (In Feet) 1 inch = 30' ft
STATE OF ILLINOIS COUNTY OF GRUNDY
POINTS OF INTEREST: NONE VISIBLE
THIS IS TO CERTIFY THAT THIS PROFESSIONAL SERVICE CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY SURVEY GIVEN UNDER MY HAND AND SEAL THIS DATE HEREON
ILLINOIS PROFESSIONAL LAND SURVEYOR Nc 3403 LICENSE EXPIRES 11/30/2022 EXACTA uAND SURVEYORS, LLC PROFESSIONAL DESIGN FIRM 184003059-0008
LxjcU Land Surveyors. Ll£
Land Surveyors. LLC o 77i3CS-»0'i
1 i f. Edit Jdikw! Sl'Kl I Vorrri IL K450
-< ?SurveySTARS
DATE OF SURVEY: 10/18/21 FIELD WORK DATE: 10/18/2021 REVISION DATE(S): (REVO 10/18/2021)
SEE PAGE ?. OF 2 FOR LEGAL DESCRIPTION PAGE 1 OF 2 - NOT VALID WITHOUT ALL PAGES
PROPERTY ADDRESS. '714 W BEACr1 AViZNUli. CHICAGO, LUNOIS 60622 SURVEY NUMBER: 210? 63-C2
JOB SPECIFIC SURVEYOR NOTES:
LEGAL DESCRIPTION:
LOT 47 IN BLOCK 7 IN MCREYNOLD'S SUBDIVISION IN THE EAST 1/2 OF THE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS
GENERAL SURVEYOR NOTES:
The Lec-al Description used lo perform tins survey was supplied by other'* This survey doe* no! determine nor imply ownc-shipo' ir:e lands or any fi.-nors shown hereon Unless otherwise noted, an examination ofthe abstract of title was NO* performed by lh? signing surveyor to deiprmine winch instruments, if anv. anVrting this property
The purpose or" it us survey si to establish r.hn boundary of tne buds descnyed by the legal description p-ovided and to depict tne v. isit>Ie> improvements thereon for a pending financial transaction Underground footings, utilities orothei service lines, including roof eave overhangs were nor located as pari of this sunf-y. Unless specifically stateo otherwise the purpose and intent of tms survey is not for any construction activities or future planning
If there is a septic tank or drain field shown on this survey, the location depicted hereon was either shown to the surveyor by a third party or il was estimated by visual above ground inspection No excavation was performed to determine its location
This survey is exclusively for a pending financial transaction and only to be used by the parties to whom it is certified
Alterations to thi? survey man and report by otner than the signing surveyo- are prohioited
Dimensions arc- in feet and decimals thereof
Any F-LMA Hood zone d Jla contained on tins survey ii (or Informational purposes only Research to obtain said data was performed a: www fen-m gov and may not reflect Ihe most recent information
Unless otherwise noted 'SET" indicates a set iron rebsr. 5/8 inrh in diamrtiirand (rrghlr-.'ii inches long The synods reflected in thc iegend and on this survey may have been enlarged or reduced for clarity I he symbols have been plotted at thc approximate center of the field location and may not represent the actual shape or size of thc feature Points of Interest iPOI's! arc select above -ground improvements, which may appear in contlici with boundary, building setback ci easement lines, as defined by the parameters of this survey These POI's may not represent all items of interest to the viewer There may bt additional POI's which aie not shown or caMed-out .:s POI's or which are otherwise unknown to the surveyor Utilities shown on the subject property may or may not indicate the existence of recorded or unrecorded utiliiy easements
The information contained on this survey has been performed exclusively by and is the sole responsibility of Exiicta Land Surveyors LLC Additional logos o; references to third party firms aie for informational purposes only-
Due to varying construction standards, house dimensions arc approximate and are not intended to be used for new constiuct-on or pl.mmng
Surveyor bearings are used lor angular reference and arc usea to show angular i elations'nips of lines only and are no' related or orientated to trui! or magnetic r.orth Bccninijs art shown as surveyor bearings, and v.-hen jhowr. as matching those on the MJudiviMon plats on which tins, survey is b jsed. they are to be deemed no more accurate as the cctermmation of a north orientation made on and for Ihosc original subdivision plats North 00 degrees East is assumed and upon preparation of this plat, thc resulting bearing between found points as shown on this survey is the basis of said surveyor bearings as defined and required to be noted by Illinois Administrative Code Title C,B, Chapter VII, Sub-Chaplur B, Part 127S, Section 1270 56, Paragraph B. Sub-Paragraph 6, Item k THIS SUFlVeY IS A PROFESSIONAL SbRVICfc IN COMPLIANCE WITH THE MINIMUM STANDARDS OI THE STATE OF ILLINOIS NO IMPROVEMENTS SHOULD BE MADE ON TUT BASIS OF THIS PLAT ALONE PLEASE REFER ALSO TO YOUR DEED, TITLE POLICY AND 1 OCAl. ORDIN/-NCCS COPYRIGHT BY EXACTA ILLINOIS SURVEYORS THIS DOCUMENT MAY ONLY BE USED BYTHE PARTIES TO WHICH IT IS CERTRFD PLEASE DiRECT QUESTIONS Oil COMMENTS TO cXACTA ILLINOIS SURVEYORS, INC AT THE PHONL NUMBER SHOWN HEREON
SURVEYOR'S LEGEND
¦ Center Line
« Chain Link or Wire Fence
—, Easement
- EdgeofW.iter
—O O—¦ Iron Fence
'—OHl . Overhead Lines
¦ Structure
Survey Tic Line
¦ Vinyl Fence - Wall or Party Wall
SURFACE TYPES
//// Asphalt
¦' BrickorTile '. Concrete Covered Area
'~\.'C'Cs Water
SYMBOLS Ben clou ark Center Line
A
Central Angle or
Delta
Common
" Ownership
Elevation *Qf Fire Hydrant
: t GuywneorAnchoi
O Manhole
© Tree
ijl Utility or Light Poll
© Well
ABBREVIATIONS
- Calculate!
- Deed (F) - Field
{MJ - Measured
(P)-Pla!
IS) - Survey
A/C - Air Conditioning
AE - Access Easement
ANE - Ancho' Easement
ASBL - Accesscrv Setback Lin!
B/W - Bay/Bo^ Window
BC - Block Corner
BFP - Backfiow Preveniet
BLDG - Building
BLK - Block
BM - Benchmark
BR - Bearing Reference
BRL - Building Restriction Lini
BSMT - Basement
C - Curve
C/L-Center Line
C/P-Covered Porch
C/5-Concrete Slab
CATV-Cable TVR-ser
CB - Concrete Block
CH - Chord Bearing
CHIM-Chimney
CLF-Cham Link Fence
CME - Canal Maintenance
casement
CO-Clean Out
CONC-Concrete
COR - Corner
CS/W - Concrete Sidewalk
CUE-Control Utility Easement
CVG - Concrete valley Gutter
D/W - Driveway
DE - Drainage Easement
DF- Drain Field
DH - Drill Hole
DUE - Drainage & Utility
Easement
ELEV - Elevation
EM-Electric Meter
ENCL • Enclosure
ENT - Entrance
EOP - Edge of Pavement
EOW-Edge of Water
ESMT ¦ Easement
EUB - Electric Utility Box
F/DH-Found Drillhole
FCM - Found Concrete
Monument
FF* Finished Floor
FIP-Found Iron Pipe
FtPC - Found Iron Pipe I Cap
FIR - Found Iron Rod
FlflC - Found Iron Rod L CaD
FN • FcunG Nail
FNIrD - Found Nail £ Disc
FRRSPK-round Rail Road
Spike
GAP-Garage
GM-Gas Meter
ID -Identification
IE/EE - Ingress/Egress Easement
ILL-lllegihle
INST - Instrument
INT - Intersection
[RRE - Intuition Easement
L - Length
LAE - Limited Access Easement LB* - License No (Business) LBE- Limited Buffet Easement LE - Landscape Easement LME - Lake/Landscape Maintenance f.asement LSf - License No (Surveyor', MB - Map Book ME - Maintenance Easement MES - Miteied End Section MF - Metal Fence MH- Manhole NR-Non-Radial NTS - Not to Scale NAVD8B - North American Vertical Datum 1936 NGVD29-National Geodetic Vertical Datum 1929 OG - On Ground
ORB -Official Records Book ORV - Official Record Volume O/A • Overall O/S - Offsel
OFF - Outside Suoj-irl Property
OH - Overhang
OHl. - Overhead Utility Lines
ON - Inside Subject Property
P/E-Pool Equipment
PB- Plal Book
PC-Po-ntofCu-ve.turi:
PCC - Point of ComDOund
Curvature
PCP - Permanent Control Point
PI - Point of Intersection
PLS - Professional Land
Surveyor
PLT-Planter
POB * Point of Beginning
POC - Point of Commencement
PRC - Point of Revcse
Curvature
PRM - Pctmanen: Reference Monument
PSM - Professional Surveyor & Mapper
PT - Point of Tangenty
PUE - Public Utility Easement
R - Radius or Radial
R/W-Right of Way
RES - Residential
RGE - Range
ROE - Roof Overhang Easement RP- Radius Point
S.'W- Sidewalk SBL - Setback Line 5CL- Survey Closure Line SCR - Screen SEC-Section SEP-StpticlanV SEYf - Sewer
S1RC-Setlrcr Rod £ Cap SMWE-Storm Water Management Ea*=emcnt SN&D-Sft Nail and D:sc SOFT-Square Feet STL-SurvcyTie Line STY - Story SV- Sewer Valve SWE - Sidewalk Easement TBM - Tempoiary Bench Mar* TEL - Telephone Facilities TOB * Top of Bank TUE - Technological Utility . Easement TWP-Township TX - Transformer; TYP-Typital UE - Utility Easement UG - Underground UP-Utility Pole UR-Utility Riser VF-V-nyl Fence W/C- WitnessCornsr W/F-Water Filter WF-Wood Fence WM - Water Meter/Valve Bo* WV-Water valve
FLOOD ZONE INFORMATION:
DATE SIGNED: 10/18/21
TITLE COMPANY:
CLIENT FILE NO:
TITLE COMMITMENT:
SEE PAGE 1 OF 2 FOR MAP OF PROPERTY PAGE 2 OF 2 - NOT VALID WITHOUT ALL PAGES
^EXACTA
Land Surveyor-*;, l_LC
Exacta Land Surveyors, LLC
c 77i305<*i0:i Edit Jdcxsor: St met i Morris, IL OO-1'SO
-^EXACTA
Land Surveyors, LLC
v/v/wt?xacrstana com offico: 773 305 -4011
PROPERTY ADDRESS: 1714 W BEACH AVENUE. CHICAGO, ILLINOIS 60622
2109.6342
BOUNDARY SURVEY COOK COUNTY
o o
SETtROSS"P "
FND CROSS
* g OQ'm
O 2' ON
LOT 47 „
BLK 7
2395 SQ.FT.t
o.roN-
2' OF'
LOT 46 'BLK 7
LOT 48 BLK 7
LINE TABLE: L1 24 00'(R)
S 89"34'40" W 24 03' (M) L2 24.00' (R)
N 89"39'39" E 24.00' (M)
-O 3'
3.5' ON-
5ET CROSS •
O CONC CURB * GUTfER
W BE A CH A VENUE (60' R/W)
,.H >™»l
GRAPHIC SCALE (In Feet) 1 inch = 30' ft
STATE OF ILLINOIS ")__<. COUNTY OF GRUNDYj"
THIS IS TO CERTIFY THAI' THIS PROFESSIONAL SERVICE CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY SURVEY GIVEN UNDER MY HAND AND SEAL THIS DATE HEREON
POINTS OF INTEREST: NONE VISIBLE
ILLINOIS PROFESSIONAL LAND SURVEYOR No 3403 LICENSE EXPIRES 11/30.'2022 EXACTA LAND SURVEYORS, LLC PROFESSIONAL DESIGN FIRM 1B4008059-0008
hxacU' Land Survcycs, LLC
u 77».3CS-4i')r JlofcAit Jdckitir Street | Uwk ILfi'j450
< ?SurveySTARS
DATE OF SURVEY: 10/18/21 FIELD WORK DATE: 10/18/2021 REVISION DATEvSh (REVO 10/18/2021)
SEE PAGE 2 OF2 FOR LEGAL DESCRIPTION PAGE 1 OF 2 - NOT VALID WITHOUT ALL PAGES
PROPERTY ADDRESS: 171-'. W SilACH AVENUE., ChlCAGO. ILLINOIS 60622 SURVEY NUMBER: 2109 0342
JOB SPECIFIC SURVEYOR NOTES:
LEGAL DESCRIPTION:
LOT 47 IN BLOCK 7 IN MCREYNOLD'S SUBDIVISION IN THE EAST 1/2 OF THE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
GENERAL SURVEYOR NOTES:
Thc Legal Description used to peilcm tins survey was supplied by others Thu survey docs not determine noi imply ownership of [tie lands or any fences shown hrreon Unless otherwise noted, an examination of tho abstract of title was NOT performed by the signing survey or to dclerm.ne v/lnch instruments, if an*, fire directing this property
The purpose of this survey is to csinbl sh !_;;¦_• boundary of the lands described by the leg.il description provided and to depict tne visible improvements thereon for a pending financial transaction Underground fooling;, utilities, or other service lines, including roof eave overhangs .vere not located as part o'tnis survey. Unless specifically stated otherwise thc purpose and intent of this survey is not fo- any cons;: uoon activities ot future planning
If there K a septic tank o' drain field sMown on this survey, the location depicted hereon was either shown to the surveyor by a third party or it was estimated by visual above ground inspection No excavation was performec to determine its location
This survey is exclusively for a pending financial transaction and only to be used by the parties to whom it is certified
Alterations to th:< survvy man and ;r*poir b> other than tie signing surveyor are p-ohiblted
Dimension* a'i- m feet and decimal; thereof
Any FEMA flood zone data contained on this su*veyi> (or informational purposes only Research to obtain said data was " performed .it www fcina gov ;ind m.iy not reflect the most recent information
Unless otherwise noted 'SET* indicates a set iion rebar, S/B m::h in diamntcr .i.id cighid'H inches long
The symbols reflected in the legend and on this survey may have been enlarged or reduced for clarity. I ne syr^boli have been plotted at thc approximate center of the field locution and may not represent the actual shape or sire of thc feature
Points of Interest (POl's) are select above-ground improvements, which may appear in conflict with boundary, building setback ot casement l-.net , at defined by the parameters of this survey These PO! s nay not represent
all Items of interest to thc viewer. There may be additional POI's which are not shown or called-uut a> POI's. ot which are otherwise unknown to the su'veyor il. Utilities shown on the subject property mayor may not indicate tne existence of recorded or unrecorded utility easements
12 The information contained on this survey has been performed exclusively by and is the «>lu responsibility of Exacia Land Surveyn's, LLC Additional logos or references to third party firms are for informational purposes onl.
Due to varying construction standards, house dimensions arc approximate and arc not intended to be used for new cnnstiuctionor planning
Surveyor bearings are used for angular reference <^d ere used to show angular relationships of lines only and are not related or orientated to irue or magnetic north Bcitnrgt .nr. shewn as surveyor bearing;, and when shown as matching those on the subdivision pla;s on which this survey is bused, ;hey cire to be deemed no more »ccurate as the determination of a north orientation made on and for (hose original subdivision plats North 00 degrees East Is assumed and upon preparation or this plat, thc resulting bearing between found points as shown or. this survey is the basis of said surveyor bearings as defined and required to be noted by Illinois Administrative Code Title 63, Chaptci VII, Sub-Chapter 6, Part 1270. Suction 1270.56. Paragraph fc. Sub-farograph 6. Item k.
I HIS SURVEY IS A PROKSSIONAL SERVICE IN COMPLIANCE WITH THE MINIMUM STANDARDS OF THE STATE OF ILLINOIS NO IMPROVEMENTS SHOULD BE MADE ON THE BASIS OF THIS PLAT ALONt PLEASE REFER ALSO TO YOUR DEED, TITLE POLICY AND LOCH. ORDINANCES COPYRIGHT BY EXACTA ILLINOIS SURVE fORS' THIS DOCUMENT MAY ONLY 0l USED BY THE PARTIES TO WHICH IT 13 CERTIFIED PLEASE DIRECT QUESTION OR COMMENTS TO EXACTA ILLINOIS SURVEYORS, INC AT THE PHONE NUMBER SHOWN HEREON
SURVEYOR'S LEGEND
—— Center Line
Chain Link or Wire Fence
1 Easement
. • EdgeofWater
O—O— Iron Fence
-OHL Overhead Lines
Structure
Survey Tie Line
Vinyl Fence - WallorPartyWall
SURFACETYPES
1 Concrete Covered Area
^Ajfj Wood
SYMBOLS Benchmark (7 Center Line A Central Atigltroi
Delta Common
Elcvatio
\f Fire Hydrant
Find or Set Monument
Guywire or Anchor
Q Manhole
$ Utility or Light Pole © Well
ABBREVIATIONS
(0 - Calculated
(D) - Deed
(F) - Field
(M)-Measured
(P)-Plai
(S) - Survey
A/C - Air Conditioning
AE - Access Easement
ANE - Anchor Easement
ASDL - Accessory Setback Line
B/W - Bey/Box Window
BC-Block Comer
BFP ¦ Backflow Preventet
BLDG- Building
BLK-Block
BM-Benchmark
BR - Beariiic Reference
BRL ¦ Building Restriction Line
BSMT- Basement
C - Cm ve
C/L-Center Line,
C/P -Covered Porch
C/S - Concrete Slab
CATV-Cable TV Ris-r
CB • Concrete Block
CH - Chord Bearing
CHIM -Chimniry
CLF-Cham link Fence
CtAE - Canal Maintenance
Easement
CO-CleanOut
CONC-Concrete
COR - Corner
CS/W - Concrete Sidewalk
CUE - Control Utility Easement
CVG - Concrete Valiey Gutter
D/W - Driveway
DE - Drainage Easement
DF-Drain Field
DH- Drill Hole
DUE-D.-ainageiUblity
Eesement
ELEV-Elevation
EM - Electric Meter
ENCL-Enclosure
ENT - entrance
EOP - Edge of Pavement
EOW-L-dgeofWatcr
ESMT - Easement
EUB-Electric Utility Bov
F.'DH - Found Dilll Hole
FCM - Found Concrete
Monument
FF - Finished Floor
FIP-Found Iron Pipe
FIPC- Found lion Pint: & Cap
FIR-found Iron Rod
FIRC - Found Iron Rod & Cap
FN - Found Nail
FN&D-Found Nail & Disc
FRRSPK - Found Rail Road
Spike
GAR-Garage
GM-Gas Meter
ID-Identification
IE/EE - Ingress/Egress Easement
ILL- Illegible
INST - Instrument
INT - Intersection
IRRE - irrigation Easement
L- length
LAE - Limited Access Easement LB# - License No (Business} LBE - Limited Buffer Easement LE - Landscape Easement LME - Lake/landscape Maintenance Easement LSt- License No (Surveyor; MB-Map Book ME - Maintenance Casement MES - MItcied End Section MF-Metal Fence MH- Manhole NR-Non-Radial NTS - Not to Scale NAVDBB - North American Vertical Datum 198B . NGVD29 - National Geodetic Vertical Datum 1929 OG- On Ground
ORB - Official Records Book ORV - Official Record Volume O/A - Overall O/S - Offset
OFF - Outside Subjecl Property
OH -Overhang
OHL - Oveihead Utility Lines
ON - Inside Subject Property
P/E - Pool Equipment
PB-Plat Book
PC-Pomto'Cu.-vdtiire
PCC - Point o'Camoound
Curvature
PCP - Ptrm.rni'nt Contiol Point
PI - Point of Intersection
PLS - Professional land
Surveyor
PLT-Planter
POB - Point of Beginning
POC - Point of Commencement
PRC - Point of Reverse
Curvature
PRM - Permanent Reference Monument
PSM - Professional Surveyor & Mapper
PT - Point of Tangency
PUE - Public Utility basement
R - Radius or Radial
R/W-liight of Way
RES - Residential
RGE-Range
ROE- Roof Overhang Easement RP - Radius Point
SAV-Sidewalk
SBL-Setback Line
SCL - Survey Closure Line
SCR-Screen
SEC - Section
SEP-Septic r«mk
SEW - Sev#er
SIRC-Set Iron Rod&Cup
SMWE-Storm Water
Management Easement
SNSrD - Set Nail and Disc
SQFT-Sqmre Feet
STL - Survey Tie Line
STY - Story
SV-Sewer Valve
SWE-Sidewalk Easement
TBM - Temporary Bench Mark
TEL-Teiephonc facilities
TOB-Top of Bank
TUE-Technological Utility
Easement
TWP- Township
TX -Transformer
TYP-Typical
UE-Utility Easement
UG- Undeiground
UP - Utility Pole
UF1 - Utility Riser
VF-Vmy! Fence
W/C-Witness Corner
W/F-Water Filter
WF - Wood Fence
WM - Water Meter/Valve Box
WV - Water valv«
FLOOD ZONE INFORMATION:
DATE SIGNED: 10/18/21
TITLE COMPANY:
CLIENT FILE NO:
TITLE COMMITMENT:
SEE PAGE 1 OF 2 FOR MAP OF PROPERTY PAGE 2 OF 2 - NOT VALID WITHOUT ALL PAGES
^EXACTA
^BF Land Surveyors. LLC
Exacts Land Surveyors. LLC
o- 773 305 40', 1 316 t«»>l Jackson St reel | Morris, IL 60*50