ORDINANCE
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. Title 17 ofthe Municipal Code of Chicago, the Chicago Zoning Ordinance, is hereby amended by changing all ofthe B3-3 Community Shopping District symbols and indications as shown on Map No. 2-H in the area bounded by
West Jackson Boulevard; South Wood Street; West Odgen Avenue; West Van Buren Street; a line approximately 228 feet west of West Odgen Avenue; a line 129.06 feet north of and parallel to West Van Buren Street; a line 516 feet west of and parallel to South Wood Street.
to those of an Institutional Planned Development District.
SECTION 2. This ordinance shall be in force and effect from and after its passage and.-due publication.
Common Address of Property: 1801-1853 W. Jackson Boulevard
4829-6353-6938.6
FINAL FOR PUBLICATION
ORDINANCE
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. Title 17 ofthe Municipal Code of Chicago, the Chicago Zoning Ordinance, is hereby amended by changing all of the B3-3 Community Shopping District symbols and indications as shown on Map No. 2-H in the area bounded by
West Jackson Boulevard; South Wood Street; West Ogden Avenue; West Van Buren Street; a line approximately 228 feet west of West Ogden Avenue; a line 129.06 feet north of and parallel to West Van Buren Street; a line 516 feet west of and parallel to South Wood Street.
to those of an Business Planned Development District.
SECTION 2. This ordinance shall be in force and effect from and after its passage and due publication.
Common Address of Property: 1801 W. Jackson Boulevard
FINAL FOR PUBLICATION
BUSINESS PLANNED DEVELOPMENT STATEMENTS NO.
The area delineated herein as Planned Development Number , ("Planned Development")
consists of approximately 174,240 square feel of property (4 acres) which is depicted on the attached Planned Development Boundary and Property Line Map ("Property"') and is owned or controlled by the Applicant, Blackhawk Community lee Rink, LLC.
The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns and, if different than the Applicant, .the legal title holders and any ground lessors. All rights granted hereunder to the Applicant shall inure to the benefit ofthe Applicant's successors and assigns and, if different than the Applicant, the legal title holder and any ground lessors. Furthermore, pursuant to the requirements of Section 17-8-0400 of the Chicago Zoning Ordinance, the Property, at the time of application for amendments, modifications or changes (administrative, legislative or otherwise) to this Planned Development are made, shall be under single ownership or designated control. Single designated control is defined in Section 17-8-0400 ofthe Zoning Ordinance.
All applicable official reviews, approvals or permits are required to be obtained by the Applicant or its successors, assignees or grantees. Any dedication or vacation of streets or alleys or grants of easements or any adjustment of the right-of-way shall require a separate submittal to the Department of Transportation on behalf of the Applicant or its successors, assigns or grantees.
Any requests for grants of privilege, or any items encroaching on the public way, shall be in compliance with the Plans.
Ingress or egress shall be pursuant to the Plans and may be subject to the review and approval of the Department of Planning and Development and Transportation. Closure of all or any public street or alley during demolition or construction shall be subject to the review and approval of the Department of Transportation.
All work proposed in the public way must be designed and constructed in accordance with the Department of Transportation Construction Standards for Work in the Public Way and in compliance with the Municipal Code of the City of Chicago. Prior lo the issuance of any Pari II approval, the submit led plans must be approved by the Department of Transportation.
4. This Plan of Development consists of 16 Statements: a Bulk Regulations Table; an Aerial
Map; an Existing Zoning Map; an Existing Land-Use Map; a'Generalized Land-Use Map; a
Planned Development Boundary and Property Line Map; Site Plan; Landscape Plan; a Green
Roof Plan; Building Elevations (North, South, East and West) prepared by HOK: and a
Signage Plan and Matrix, submitted herein and dated January 21, 2016. Full-sized copies of
the Site Plan, Landscape Plan and Building Elevations are on file with the Department of
Planning and Development. In any instance where a provision of this Planned Development
conflicts with the Chicago Building Code, the Building Code shall control. This Planned
Applicant: Blackhawk Community Ice Rink, LLC
Address: 1801-1853 West Jackson Blvd.
CC Introduced: December 9, 2015
CPCDate: January 21, 2016
rwmt tuk rubLIUATION
Development conforms to the intent and purpose of the Zoning Ordinance, 'and all requirements thereto, and satisfies the established criteria for approval as a Planned Development. In case of a conflict between the terms of this Planned Development Ordinance and the Zoning Ordinance, this Planned Development Ordinance shall control.
Permitted Uses for the Property shall include: Professional athletic team training/practice facility; Community Center, Recreation Building; Entertainment & Spectator Sports (small, medium, large venue); International youth sporting events; Sports and Recreation, Participant (indoor); Place of Public Amusement, including rental of space; Offices; Parking, Accessory; Medical Services, including rehabilitation, training, physical therapy, ancillary medical services, nutritional counseling, fitness; Retail Sales, General; Food and Beverage Retail Sales; Eating and Drinking Establishments, including restaurant and bar service; Indoor Special Event Class B, including incidental liquor sales; Communications Service Establishments, including audio and video communication facilities; and accessory uses, including but not limited to catering and banquet; outdoor activities and sales, including public entertainment events; ice rink-related activities; educational programs; and accessory and related uses.
On-Premise signs and temporary signs, such as construction and marketing signs, shall be permitted within the Planned Development, subject to the review and approval of the Department of Planning and Development. Signage may be fully video capable, dynamic display, and/or static sign formats, and may include: venue identification and promotion, promotion of teams, players and other personnel and team events, charitable, civic, and community-related events and causes, public service announcements, promotion of upcoming events such as sporting events, concerts, family shows, meetings, religious events and other performances (whether or not held on the Property), and sponsor commercials for branding or promotion of products and services.
Notwithstanding the foregoing, the Department shall approve all signs substantially conforming to the PD Signage Matrix. The PD Signage Matrix is incorporated herein and is hereby approved as an integral part of this Planned Development, and development of the Property as contemplated herein.
For the purposes of this Planned Development, any sign which identifies the name or sponsorship of any structure or designated area within the Property, or any sponsor of the professional team operating in the facility, shall be deemed an on-premises sign and may be located anywhere in the Planned Development.
Nothing in this Planned Development or the PD Signage Matrix shall be deemed to regulate or limit any other sign exempt from regulation under Section 17-12-0500 ofthe Chicago Zoning Ordinance, or incidental, temporary and special events signage.
Solely as applied to the Property, this Planned Development and the PD Signage Matrix shall supersede any provisions of Title 17 of the Chicago Municipal Code which are inconsistent or in conflict with or more restrictive than the PD Signage Matrix, including, without
Applicant: Blackhawk Community Ice Rink, LLC
Address: 1801-1853 West Jackson Blvd.
CC Introduced: December 9, 2015
CPCDate: January 21, 2016
FINAL FOR PUBLICATION
limitation, video and dynamic display and other provisions of Chapter 17-12 ofthe Zoning Ordinance.
For purposes of height measurement, the definitions in the Zoning Ordinance shall apply. The height of any building shall also be subject to height limitations, if any, established by the Federal Aviation Administration.
The maximum permitted Floor Area Ratio ("FAR") for the site shall be in accordance with the attached Bulk Regulations Table. For the purposes of FAR calculations and measurements, the definitions in the Zoning Ordinance shall apply. The permitted FAR identified in the Bulk Regulations Table has been determined using a Net Site Area of approximately 174, 240 square feet.
Upon review and determination, "Part II Review", pursuant to Section 17-13-0610 ofthe Zoning Ordinance, a Part II Review Fee shall be assessed by the Department of Planning and Development. The fee, as determined by staff at the time, is final and binding on the Applicant and must be paid to the Department of Revenue prior to the issuance of any Part II approval.
The site and landscape plans referenced in Statement 4, approved by this Planned Development, shall be deemed to be in substantial conformance with the Landscape Ordinance and any other corresponding regulations and guidelines. Any revisions thereto shall be in substantial conformance with the Landscape Ordinance and any other corresponding regulations and guidelines in effect at the time of such revisions. Final landscape plan review and approval will be by the Department of Planning and Development. Any interim reviews associated with site plan review or Part II reviews, are conditional until final Part II approval.
Any future expansion would be conducted through Site Plan approval, as follows:
Prior to the Part II Approval (per Section 17-13-0610 of the Zoning Ordinance), the Applicant shall submit a site plan, landscape plan and building elevations for the proposed project for review and approval by the Department of Planning and Development. Review and approval by the Department of Planning and Development is intended to assure that specific development components substantially conform with the Planned Development and to assist the City in monitoring ongoing development. Site Plan Approval Submittals (per Section 17-13-0800) need only include that portion of the Property for which approval is being sought by the Applicant. The site plan provided shall include all dimensioned and planned street Rights-of-Way.
No Part II Approval for any portion of the Property shall be granted until Site Plan approval has been granted. Following approval by the Department of Planning and Development, the approved Site Plan Approval Submittals, supporting data and materials shall be made part of the main file and shall be deemed to be an integral part of the Planned Development.
Applicant: Blackhawk Community Ice Rink, LLC
Address: 1801 -1853 West Jackson Blvd.
CC Introduced: December 9, 2015
CPC Date: January 21, 2016
FINAL FOR PUBLICATION
After approval of the Site Plan, changes or modifications may be made pursuant to the provisions of Statement 13. In the event of any inconsistency between approved plans and the terms of the Planned Development, the terms of the Planned Development shall govern. Any Site Plan Approval Submittals shall, at a minimum, provide the following information:
fully-dimensioned site plan (including a footprint ofthe proposed improvements);
fully-dimensioned building elevations;
fully-dimensioned landscape plan(s); and,
statistical information applicable to the subject Property, including floor area, the applicable FAR, uses to be established, building heights and setbacks.
Site Plan Approval Submittals shall include all other information necessary to illustrate substantial conformance to the Planned Development.
The Applicant shall comply with Rules and Regulations for the Maintenance of Stockpiles promulgated by the Commissioners of the Departments of Streets and Sanitation, Fleet and Facility Management and Buildings, under Section 13-32-125 of the Municipal Code, or any other provision of that Code.
The terms and conditions of development under this Planned Development ordinance may be modified administratively, pursuant to section 17-13-0611-A ofthe Zoning Ordinance by the Zoning Administrator upon the application for such a modification by the Applicant, .its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors.
The Applicant acknowledges that it is in the public interest to design, construct and maintain the project in a manner which promotes, enables and maximizes universal access throughout the Property. Plans for all buildings and improvements oh the Property shall be reviewed and approved by the Mayor's Office for People with Disabilities lo ensure compliance with all applicable laws and regulations related to access for persons with disabilities and to promote Ihe highest standard of accessibility.
The Applicant acknowledges that it is in the public interest to design, construct, renovate and maintain all buildings in a manner that provides healthier indoor environments, reduces operating costs and conserves energy and natural resources. Applicant will construct the facility with a green roof, covering 25% of the Net Roof Area, and the project shall be designed, constructed and maintained to achieve LEED Certification (Version 3).
This Planned Development shall be governed by Section 17-13-0612 of the Zoning Ordinance. Should this Planned Development ordinance lapse, the Commissioner of the Department of Planning and Development shall initiate a Zoning Map Amendment to rezone the property to B3-3.
Applicant: Blackhawk Community Ice Rink, LLC
Address: 1801-1853 West Jackson Blvd.
CC Introduced: December 9, 2015
CPC Date: January 21, 2016
FINAL FOR PUBLICATION
BULK REGULATION TABLE
GROSS SITE AREA (PD BOUNDARY): PUBLIC RIGHT-OF-WAY SITE AREA: NET SITE AREA:
ALLOWABLE USES: MAXIMUM ALLOWED FA.R.: MINIMUM OFF STREET PARKING SPACES: MINIMUM OFF STREET LOADING SPACES: MINIMUM PERIPHERY SETBACKS:
MINIMUM DISTANCE BETWEEN BUILDINGS: MAXIMUM BUILDING HEIGHT:
5.02 ACRES (218,671 SF)
1.02 ACRES (44,431 SF)
4 ACRES (174,240 SF)
PER PLANNED DEVELOPMENT STATEMENT NUMBER 5
1.1
80 PARKING SPACES
1 LOADING DOCK (10' x 25')
0' - NORTH O'-WEST 0' - SOUTH 5' - EAST 15' - SOUTHEAST
(FROM OGDEN)
NOT APPLICABLE 52'-0"
26 BICYCLE SPACES
Applicant: Blackhawk Community Ice Rink, LLC
Address: 1801-1853 West Jackson Blvd.
CC Introduced: December 9, 2015
CPC Date: January 21, 2016
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DlPARTMENT OF PLANNING AND DEVELOPMENT CITY OF CHICAGO
MEMORANDUM
TO: Alderman Daniel S. Solis
Chairman, City Council Committee on Zoning
FROM:
David L. Reif Secretary
Chicago Plan Commission DATE: January 22, 2016
RE: Proposed Business Planned Development for property generally located at 1801-1853 West Jackson Boulevard.
On January 21, 2016, the Chicago Plan Commission recommended approval ofthe proposed planned development submitted by Blackhawks Community Ice Rink, LLC. A copy ofthe proposed planned development is attached. I would very much appreciate your assistance in having this introduced at the next possible City Council Committee on Zoning hearing.
.Also enclosed is a copy of the staff report to the Plan Commission which includes the Department of Planning and Development, bureau of Planning and Zoning recommendation and a copy of the Resolution. If you have any questions in this regard, please do not hesitate to contact me at 744-5777.
cc: Steve Valenziano
PD Master File (Original PD, copy of memo)
121 NORTH LASALLE STREET, ROOM 1000, CHI CAGO,¦ 1LLINOIS 60602
City of Chicago Plan Commission
January 21, 2016
Blackhawk Community Ice Rink. LLC 1801-1853 West Jackson Brvd Busncss Planned Development
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REPORT to the
CHICAGO PLAN COMMISSION from the
DEPARTMENT of PLANNING AND DEVELOPMENT
JANUARY 21, 2016
PROPOSED BUSINESS PLANNED DEVELOPMENT
BLACKHAWK COMMUNITY ICE RINK, LLC
1801-1853 WEST JACKSON BLVD.
Pursuant to the provisions of the Chicago Zoning Ordinance, Title 17 of the Municipal Code of Chicago, the Department of Planning and Development hereby submits this report and recommendation on a proposed Business Planned Development for your review and recommendation to the Chicago City Council. This application was introduced into the City Council on December 9, 2015. Proper legal notice of this public hearing on the application was published in the Chicago Sun-Times on January 6 2016. The applicant was separately notified of this hearing.
The applicant proposes to rezone the site from a B3-3 (Community Shopping District) to a Business Planned Development. The applicant proposes to establish a two-story professional hockey practice facility and a community ice rink, with ground floor retail, office space, accessory parking and accessory uses. The site is currently improved with a two story academic building more commonly known as the Malcom X Community College and an accessory parking lot.
This project has been submitted as a mandatory planned development, pursuant to Section 17-8-0510-B, due to the proposed large commercial development with a net site area of four (4) acres and Section 17-3-0207 as an Entertainment and Spectator Sports for Large venues (1,000 + capacity).
SITE AND AREA DESCRIPTION
The subject property is currently part of the Malcolm X College building but will soon be vacated. The site is surrounded on all sides by a mix of uses; to the north is the New Malcolm X College Campus currently zoned Institutional Planned Development No. 1217 and several smaller scaled buildings currently zoned RM-5, Residential Multi-Unit District and B3-1, Community Shopping District. Along its southern boundary is Interstate 290 (Eisenhower) Expressway
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The site is bounded on the north by Institutional Planned Development No. 1217 and West Jackson Boulevard; on the west by a future multi-story campus development by Rush University; on the south by West Van Buren Street and on the east by South Wood Street and West Ogden Avenue.
The site is located in the Central West Tax Increment Finance District but not located within the boundaries"of the Lake Michigan and Chicago Lakefront Protection District. In addition, it is not located within the boundaries of a Chicago Landmark District and does not contain any designated local or national landmark structures or sites.
The site is served by the Chicago Transit Authority's bus routes #50 (Damen), #126 (Jackson/ Van Buren) and #20 (Madison) bus lines. The CTA rail station at the Illinois Medical District on the Blue Line includes stops located approximately 600 feet from the site along West Ogden Avenue and one further west on West Ogden Avenue.
PROJECT DESCRIPTION
The site is currently improved with a two story educational building more commonly known as the Malcolm X Community College. In January 2016 the school moved across the street to the new campus building. The current building will be demolished, prepared for development and sold to the applicant. The applicant proposes to construct a two-story, 127,000 square foot Ice Rink with 122 accessory parking spaces and includes a full service community hockey training center.
The facility will include two regulation sized ice sheets with capacity for 300 spectators in each rink, locker rooms, fitness facility, food & beverage, and related space. The Project also includes training and fitness facilities to be used as a primary training facility for the Chicago Blackhawks Hockey Club. The Blackhawks will utilize the facility during its practice times.
The training facility will provide hockey and ice skating programs to a wide range of users, with a focus on youth development. Programs will include ice skating, figure skating, recreational skating, recreational and advanced hockey leagues, tournaments, high school and college teams, semi-professional teams, off-ice training-including fitness and nutritional programs, and group events.
DESIGN
The main pedestrian access and entrance to the campus is located along West Jackson Boulevard. The building is designed with a precast concrete panel system, aluminum window system, and metal canopies at the main entry points. The exterior design ofthe building incorporates an architectural aluminum curtain wall system primarily at the entrances and a corrugated insulated metal panel system; an insulated composite metal panel system further defines the vocabulary and architectural design ofthe building.
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LANDSCAPING
The perimeter of the project will contain both shrubbery and street tree plantings; the entire planned development, including the surface parking lot along South Wood Street, will meet or exceed the requirements of the Chicago Landscape Ordinance. The project will provide 42 new interior trees and 9,628 square feet of landscaped area.
Along the south edge and east of the property street trees are planted where space is available, while a widened sidewalk runs along the West Jackson Boulevard and South Wood Street to allow for an efficient pedestrian flow and experience.
SUSTAINABILITY
The project will satisfy the requirements for the City of Chicago's Sustainable Development Matrix by providing a 25% green roof over the net roof area and also required to achieve basic L.E.E.D Certification. The entire roof area of the building is 93,355 square feet and will provide a green roof totaling 23,339 square feet.
ACCESS/CIRCULATION
Access to the interior of this project site for pedestrians and bicyclists will be possible via West Jackson Boulevard. A secondary entrance for the Blackhawks team will be located south along the proposed parking lot. The parking lot will accommodate 122 parking spaces. Vehicles with passengers destined for the facility will be able to access the parking lot via two proposed curb cuts; the first curb cut is located along West Jackson Boulevard and second is located along West Van Buren Street.
Individuals arriving via public transportation can currently access the property via numerous CTA bus routes, with stops in the immediate vicinity of the site; or, via the Medical District station CTA Blue Line, located within approximately 600 feet ofthe site. In addition to the sites access to public transportation the building is designed to provide a minimum of 26 bike parking spaces. •
BULK/USE/DENSITY
The current maximum allowable Floor Area Ratio (FAR) for the proposed underlying zoning (B3-3) is 3.0, but the proposed project will have a maximum allowable overall FAR of 1.1. The project will include a total of approximately 127,000 square feet of space in the Training facility on a lot with a net site area of approximately 174,240 square feet. The additional F.A.R will allow for a future expansion ofthe building but will not increase the height of the building. The maximum allowable height for this planned development is 53 feet to the top of the parapet.
This planned development will require a minimum of 80 accessory parking spaces in the proposed on-site parking lot. The total proposed parking spaces are sufficient (per Section 17-10-0207) to accommodate the projected traffic.
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RECOMMENDATION
The Department of Planning and Development has reviewed the project materials submitted by the Applicant and have concluded that the proposed development would be appropriate for the site for the following reasons:
The project meets the criteria and objectives set forth in Section 17-8-0900 of the Zoning Ordinance and its adoption would not have any adverse impact on the public's health, safety, or welfare and Section 17-8-0102 encourage unified planning and development;
The proposed planned development meets the criteria and objectives set forth in Section 17-8-0901 by conforming to the proposed B3-3 Community Shopping District in terms of Use, Bulk, Scale, and by adhering to an F.A.R of 1.1. The B3-3 District permits an F.A.R of 3.0 but the agreed upon F.A.R of 1.1 will not be exceeded.
The Central West Tax Increment Financing District Plan Amendment 3 was approved by the Plan Commission on December 17, 2015 and was recently introduced to the Chicago City Council on January 13, 2016, with approval expected in February 10, 2016. The revised Land Use map ofthe Plan identifies this parcel as "Mixed Use." The proposed project uses for this property would conform to the revised Land Use map in the plan."
The public infrastructure facilities and city services will be adequate to serve the proposed development at the time of occupancy. The proposed Planned Development has been reviewed by the Chicago Department of Transportation and all requested changes have been made.
Copies of this application have been circulated to other City departments and agencies and all comments received have been addressed in the revised application. The project will comply with the requirements for access in case of fire and other emergencies.
Based on the foregoing, it is the recommendation of the Department of Planning and Development that this application for a proposed Business Planned Development for, Blackhawk Community Ice Rink, LLC, the applicant be approved and that the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be "Passage Recommended".
Bureau of Zoning and Land Use Planning Department of Planning and Development
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Department of Planning and Development CITY OF CHICAGO
1801-1853 WEST JACKSON BLVD. RESOLUTION
WHEREAS, the applicant, BLACKHAWK COMMUNITY ICE RINK, LLC, proposes to rezone the site from a B3-3 (Community Shopping District) to a Business Planned Development. The applicant proposes to establish a two-story professional hockey practice facility and a community ice rink, with ground floor retail, office space, accessory parking and accessory uses; and
WHEREAS, the applicant filed the application as a mandatory planned development, pursuant to Section 17-8-0510-B, due to the proposed large commercial development with a net site area of four (4) acres and Section 17-3-0207 as an Entertainment and Spectator Sports for Large venues; and
WHEREAS, proper legal notice of the hearing before the Chicago Plan Commission was published in the Chicago Sun-Times on January 6, 2016. The Applicant was separately notified of this hearing and the proposed zoning application was considered at a public hearing by this Plan Commission on January 21, 2016; and
WHEREAS, the Plan Commission has reviewed the application with respect to the provisions of the Chicago Zoning Ordinance and finds that the proposal will be consistent with said provisions; and
WHEREAS, the Department of Planning and Development recommended approval of the application, with the recommendation and explanation contained in the written report dated January 21, 2016, a copy of which is attached hereto and made a part hereof; and
WHEREAS, the Chicago Plan Commission has fully reviewed the application and all informational submissions associated with the proposed amendment, the report and recommendation of the Commissioner of the Department of Planning and Development, and all other testimony presented at the public hearing held on January 21, 2016 giving due and proper consideration to the Chicago Zoning Ordinance; and
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO ILLINOIS 60602
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
Approved: January 21, 2016 BPD No. .
THAT the final application dated January 21, 2016 be approved as being in conformance with the provisions, terms and conditions of the corresponding zoning application; and
THAT this Plan Commission recommends approval to the City Council Committee on Zoning, Landmarks and Building Standards of the final zoning application dated January 21, 2016; and
THAT the above-stated recitals to this resolution together with the report of the Commissioner of the Department of Planning and Development be adopted as the findings of fact of the Chicago Plan Commission regarding the zoning map amendment and planned development application.
RECEIVED JAN 21 2016
APPLICATION l'OR. AN AMENDMF,Nt TO J) r\ .
THE CHICAGO ZONING ORDINANCE Imtial^SUfeS^^^
AMENDED
ADDRESS ofthe property Applicant is seeking to rezone: 1801 - 1853 W.Jackson Blvd.
Ward Number that property is located in: 27th
APPLICANT Blackhawk Community ice Rink, LLC
ADDRESS 680 N. Lake Shore Drive, Suite 1900 CITY Chicago
STATE IL ZIP CODE 60611 PHONE (3)2)943-7000
EMAIL don.vitek@wirtziealty.com CONTACT PERSON Don Vitek
Is the applicant the owner ofthe property? YES NO X
Ifthe 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 Board of Trustees of Community College District No. 50S
ADDRESS 226 W. Jackson Blvd. CITY Chicago
STATE IL ZIP CODE 60606 PHONE 312-553-2538
EMAIL emunin@ccc.edu CONTACT PERSON Eugene Munin
5. Ifthe Applicant/Owner ofthe property has obtained a lawyer as their representative for the
rezoning, please provide the following information:
ATTORNEY Donna J. Pugh, Foley & Lardner LLP
ADDRESS 321 North Clark Street, Suite 2800
CITY Chicago STATE IL ZIP CODE 60654
PHONE (312) 832-4596 FAX (312) 832-4700 EMAIL djpugh@foley.com
Ifthe applicant is a legal entity (Corporation LLC, Partnership, etc.) please provide the names of all owners as disclosed on the Economic Disclosure Statements.
Blackhawk Community Ice Rink, LLC
Chicago Stadium Corporation
Vv'irtz Corporation
On what date did the owner acquire legal title to the subject property? N/A
Has the present owner previously rezoned this property? If yes when? No
Business Planned
Present Zoning District B3-3 Proposed Zoning District Development
Lot size in square feet (or dimensions) Approximately 174,240 sq. ft.
Current Use of the property Academic/Institutional
Reason for rezoning the property To develop a professional hockey team practice facility
and community ice rink.
Describe the proposed use of the property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building.
127,535 sq ft hockey practice facility/community ice rink (with a 92,890 sq. ft. building footprint);
122 parking spaces; 26 bicycle spaces; building height: 52 feet
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?
NO X
Planned Development - Blackhawk Community Ice Rink, LLC
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION 1 - GENERAL INFORMATION
A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Blackhawk Community Ice Rink,,LLC
Check ONE ofthe following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[X] the Applicant
OR
[] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest:,-,
OR
3. [] a legal entity with a right of control (see Section II.B.1.) State the legal name of the entity in
which the Disclosing Party holds a right of control^ ^
Business address of the Disclosing Party: 680 N. Lake.Shore Drive 1.9th,Floor .
ffiticaKo;TL\60611. . . ... s.. .: ¦
Telephone: (312)475-6327 ._ .Fax: Mit)MW§17 .•Email>Nadine'.%1dijfch^wirty£oipxom
Name of contact person: .Nadine^Heidrifch
Federal Employer Identification No. (if you have one);,^ '
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
l PJanned Development approval far 18(]Jyl853 W. Jagkgon Blvd. •¦ —¦¦¦ ¦¦- - , „ ¦- .—
G. Which City agency or department is requesting this EDS? Depar^ftient_of-J^lfpping ^
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification U , and Contract # ,. ,
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
[ j Person
[ j Publicly registered business corporation
f ] Privately held business corporation
[ ] Sole proprietorship
[ ] General partnership
[ ] Limited partnership
[ ] Trust
DO Limited liability company
[] Limited liability partnership
[ ] Joint venture
f ] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[JYes []No [] Other (please specify)
For legal entities, the state (or foreign country) of incorporation or organization, if applicable:-
Illinois , .- - - —- _ .
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 []N.o , []N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY?
.1. ; . List,below.the full names and titles of all executive officers and all directors of the entity.
NOTE: For not-for-profit corporations, also list below all members, if any, which/are legal entities. If
there are no such members, write "no members." For trusts, estates or other similar entities, list below
the legal titleholder(s). ' .
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management ofthe Disclosing Party NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
Chicago Stadium Corporation ^ . .r„ . .,, lyjan^ '
2. Please provide the following ihformatioiTcon'cerhing each person or entity having a director indirect beneficial interest (including ownership) in excess of 7.:5% ofthe Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
Chicago Stadium Corporation 680 N. Lake Shore Drive- . lOOP/o :
... 19th Floor. ., ...
Chicago, IL 606:11 , ^ ^
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the dale this EDS is signed?
[]Yes WNo
If yes, please identify, below the name(s) of such City elected official(s) and describe such relationship(s):
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d," is
not an acceptable response.
Foley La rdncr r Retained Attorney 125;000 estimated .
HOK - To be retained ... _. .. , Architect 1.00,000 estimated
.JSam,S.chwar.t-z Engineering,- To be retained Traffic Consultant 1 Q.,000 estimated
Cj^istyj-Wcbbeii.bandsc.a^e§y-r:^02j^Fctamed. Landscape Arch itecl 25,000 estimated
(Add sheets if necessary)
[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.;-,. SECTION V- CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10%'or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes p(]No [] No person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?
[ j Yes ["] No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article l")(which the Applicant should consult for defined terms (e.g.,'"doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant arid is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or lias ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article 1 is a continuing requirement for doing business with the City. NOTE: If Article I applies lo the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities enlified in Section II.B.1. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, within a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving-stolen property;
c.-. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal,
state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding the date of this EDS, had one,or more public transactions (federal, state or local) terminated for cause or default; and
have not,.within.a five-year period preceding the date of this EDS, been convicted, adjudged
. guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal.government, any state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Dis.closing 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 ofthe 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 13
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 five years before (he date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
a. - 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 ofthe federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
b. 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
prbspective bidders, ih'restfaiht Trcedbm of competlfioii"by" a|frc^mWtTt6"b"idTfixWpTice"nor
otherwise; or
c. . made an admission of such conduct described in a. or b. above that>isa'matter of record, but
have not been prosecuted for such conduct; or
'dV violated'the provisions' of Municipal Code Sectibri"2*92*61 O^Livin'g Wage Ordinance),
4. ' Neither the Disclosing Party, Affiliated Entity or Contractor/or any;of their employees, officials, agents or partners, is barred from contracting with any unit of-state or local government as-a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state ot of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
5 Ne'ither'the' Disclosing Party nor any Affiliated EhtitjMS listcdion any of the following lists maintained by the Office of Foreign Assets Control of the U:S: Department'of the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated N ationals List, the Denied Person's List, the Unverified List, th.e'Entity List'and the Debarred ListJ
6. "The Disclosing Party understands and shall comply with the applicable Requirements of Chapters
2-55 (Legislative Inspector General), 2-56(Inspector General) and;2-l 56' (Governmental Ethics) of the
Municipal Code.
7. If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further
Certifications); the Disclosing Parly must explain below:
Page 6 of 13
If the letters "NA." the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of ail current employees ofthe Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, ofthe City of Chicago (if none, indicate with "N/A" or "none").
None . ... . . ¦ . —.
9. To the best of the Disclosing Parly's knowledge after reasonable inquiry, the following is a
complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the
12-month period preceding the execution date of this EDS, to an employee, or elected or appointed
official, ofthe City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything
made generally available to City employees or to the general public, or (ii) food or drink provided in the
course of official City business and having a retail value of less than $20 per recipient (if none, indicate
with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
Tjlone. , .. .... _ . ' _ L:;. _ ,-. _
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is M is not
a "financial institution" as defined in Section 2-32-455(b) ofthe Municipal Code.
Ifthe Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory, lender within the meaning of Chapter 2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 of '. }
Ifthe letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified lo Ihe above statements.
D. GERTIFICATJON REGARDING INTEREST IN CITY BUSINESS
Any words or terms that arc defined in Chapter 2-! 56 of the Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156'-110 of the Municipal Code: Does any official or employee of the .City .havc a financial interest in his or her own name or in the name of any other person or
--entity-in-the.Matter? _ . ..: _. .... _ *.
• [ J Yes. M No
NOTE: If you.ciicckcd "Yes" to Item D. 1'., proceed' to Tterns'D.2." and D~3. "Ifybu 'checked "No"'to ' Item D. l .,.prpceed 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 bf any other person or entity in the purchase of any properly 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 docs not constitute a financial interest within the meaning of this PartD.
Does the Matter involve a City Property Sale?
[ J Yes [ ] No
If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees haying.such interest and identify the nature of such interest:
Name . { Business Address Nature of Interest
4. The Disclosing Party further certifies.thai no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment lo (his EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
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.
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 Parly verifies thai the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
' * : '""—'" - ' ". " ' '—- >¦ - - .-—~—¦¦— ~ . '^.«—~ • ' —:—. ..... 1 .. :— •'
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: Ifthe 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 of the City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or ifthe letters "NA" or ifthe word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.], 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 1 986; or (ii) it is an organization described in section-
501 (c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A. 1. 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 ~CftyupoTTrequcsrr
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal-regulations require thcApplicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
[ ] 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.)
[]Ycs []No
Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[ ] Yes [ ] No
Have you participated in any previous contracts or subcontracts subject lo the equal opportunity clause?
[ ] Yes [ ] No
. If you checked "No" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII-- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, 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 and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.citvofchicatio.or^yi^thi&s ,. and may also be obtained from the City's Board of Ethics, 740 N.Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
Ifthe 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 transactions with the City. Remedies al law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It 'is-the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. .By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims 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. Ifthe Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1 -23 and Section 2-1 54-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor arc the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, lax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party" is the Applicant, the Disclosing Party airdits Affiliated Entities'will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System.("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subconlraclors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.'l.'and F.2. above and will not, without the prior written consent ofthe City, use any such" contiactor/subcoritracfor that does not provide such "certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthfurccrtificatiohs.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.L, F.2. or F.3. above, an explanatory statement must be attached to this EDS. '
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrant's that he/she is'authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, arid (2) warrants that all certifications arid statements contained iri this EDS and Appendix A (if-applicablc) are true, accurate and complete as of the date furnished to the City.
Blackhawk Community Ice Rink, LLC
(Print or type name of Disclosing Party)
B^vfe%g^^^
(Sign here)
.(Nadine_Heidrich , - -
(Print or type name of person signing)
jAuthorizcd Repieschtative
(Print or .type title of person signing)
Signed and sworn to before me on (date) t ^3." 3^3?~ ^^f at ILPP yC. . County, J cU pOlS , (state).
Notary Public.
Commission expires: %~ !b " ii
Page 12 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership Interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "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 Parly" 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 II.B.1 .a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Parly. "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 naturc.of such familial'relationship.
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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'percent (ah "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal
': "Code?
. ' [ ] Yes ' [X] 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 Section 2-92-416 of the Municipal Code?
[ ] Yes [ ] No .[Xj:Not Applicable
3'. If yes to (1) or (2) above, please identify below the name of the person or legal entity
Identified as a buiiding;code scofflaw or prbblem landlord and the address ofthe building or buildings to which the pertinent code violations apply.
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO, AND MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Planned Development - Wirtz Corporation
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Legal name ofthe Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Wirtz Corporation r
Chech ONE of the following three boxes;
Indicate whether the Disclosing Party submitting this EDS is:
[ ] the Applicant
OR
£(] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest:? Blackhawk Community Ice RinkLLC
OR
3. [] a legal entity with a right of control (see Section II.B.1.) State the legal name of the entity in
which the Disclosing Party holds a right of controls a
Business address of the Disclosing Party: 680_N. Lake Shore Drive 19th Floor ' .
Chicago. IL 60611 .
Telephone: :(312)'47:5-6327 ... Fax: Iai2>9.43:9.017 Fanail:Nadine.Heidrichg&\yirt?:torp.com
Name of contact person: Nadiirc.Hcidrlch ,
Federal Employer Identification No. (if you have one)' ,
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Planned Development approval, for 1801 - 1 «53 W.Jackson Blvd. = „
G. Which City agency or department is requesting this EDS? Depariment-iof^lannipg
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract // _^ ._
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SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
[ ] Person
[ ] Publicly registered business corporation fXJ 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:
Delaware .. ,. - .
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?
M Yes . []No [ ] N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:"
.1, List below the full names and titles of all executive officers and all directors ofthe entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below
the legal titleholdcr(s). • •
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of bach general partner, managing member, manager or any other person or entity that controls the day-to-day management ofthe Disclosing Party. NOTE: Each legal entity listed below must'submit an EDS on its own behalf.
Name Title
See attached list. . —.' -— ¦ . - ¦— = _: „
2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% of Ihe Disclosing Paily. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-1 54-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
W. Rockwell Wirtz ; 680 N: Lake .Shore Drive 80% r
19th,Floor . . .
Chicago, IL 60611 =
Other Owners , . . 20%.(cach less than 7.5%) _
SECTION III — BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
MYes MNo
If yes, please identify below the name(s) of such City elected official(s) and describe such rclationship(s):
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney; lobbyist, accountant, consultant and any 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 lo disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
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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.
(Add sheets if necessary)
Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities¦>
SECTION V — CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person" who directly or indirectly owns 10% or more ofthe Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes p(]No [ ] No person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes," has the person entered into a court-approved agfecmentforpayment ofall support-owed and is the person in compliance with that agreement?
[ j Yes ['] No ' •
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article l")(which the Applicant should consult for defined terms (e.g.,'"doing business") arid legal requirements),,if the Disclosing Party submitting this EDS is the Applicant and is doing business with Ih'e City; then the Disclosing Party certifies as follows: (i) neither the Applicant n'or'any controllirig person is currently indicted or charged with, or has admitted guilt of, of has ever been convicted of, or placed under supervision for. any criminal offense involving actual, attempted, or conspiracy lo 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 Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
2. The Disclosing Parry and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.1. of this EDS:
a. , arc not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from any transactions by any federal, stale or local unit of government;
b. have not, wiihin a five-year period preceding the date of this EDS, been convicted of a criminal
offense, adjudged guilty, or had a civil judgment rendered against them in connection with:
obtaining, attempting lo 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; ihcft; forgery; bribery; falsification or destruction of records; making false
statements; or receiving, stolen property;
•c. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding the dale of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, within.a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
3. The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
¦ any."Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with 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 cntily 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 ofthe 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 13
Neither the Disclosing Parly, nor any Contractor, nor any Affiliated Entity of either the Disclosing Pat ty or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or. with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
a. - 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 ofiAmcrica, 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 prospectivebidders, in restraint oT'frcedom ofcdnYp'etitiW by "agreement- lo'bldlTfix^'^icTfbT otherwise; or
made an admission of such conduct described'in' a. or b. above that is a matter of record, but
have not been prosecuted for such conduct; or ; '¦ : ¦ ¦¦
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance):
Neither the Disclosing Party,- Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit oflstate or local governmentas a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any slatc orof the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed:on'-any'ofthe following lists maintained by the Office of Foreign Assets1 Cohlrbl ofthe U.SI department'bf the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or th'cirsuccessors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List'arid the Debarred'List.' '••'•'
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and;-2-156 (Governmental Ethics) of the Municipal Code.
Ifthe Disclosing Parly is unable to'certify to any ofthe above statements in this Part B (Further
Certification's), the Disclosing Party must explain below: . _ . . .
Page 6 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all current employees ofthe Disclosing Party who were, at any time during the 12-
month period preceding the execution date of this EDS, an employee, or elected or appointed official,
of the City of Chicago (if none, indicate with "N/A" or "none").
None . ¦¦ . . -. ...
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all gifts that the Disclosing Party has given or caused to be given, al any time during the
12-month period preceding the execution date of this EDS, to an employee, or elected or appointed
official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything
made generally available to City employees or to the general public, or (ii) food or drink provided in the
course of official .City business and having a retail value of less than $20 per recipient (if none, indicate
with "N/A" or "none"). As to any gift listed below, please also list the name ofthe City recipient.
. None. , _ , : , -
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
? is &d is not
a "financial institution" as defined in Section 2-32-455(b) ofthe Municipal Code,
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 ofthe Municipal Code. Wc further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in Ihe loss of the privilege of doing business with the City."
Ifthe Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 ol" J 3
Jf the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terms that are defined in Chapter 2-156 ofthe Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name, of any other person or
-entity.in.the Mattcr? ..; ..... _ '
f ] Yes M No
NOTE: l.f you checked'"Y"es" to Itemcheck"edT"No"'td' Item D.l., proceed to Part E.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any properly 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 properly taken pursuant to the City's eminent.domain power docs not constitute a financial interest within the meaning of Ibis Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ ] No
If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Parly further ccrlifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither I. or 2. below. If the Disclosing Party checks 2., the Disclosing Parly must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure lo
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
„X__i- The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and al; predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI - CERTIFICATIONS FOR FEDERALLY" FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City arc not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1. List bel.ow the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf ofthe Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or ifthe letters "NA" or ifthe word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded giant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Parly will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Parly certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage-in "Lobbying Activities".
Ifthe Disclosing Parly 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 subcoritractors'"certifications for the duration of the Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally.funded, federal-regulations -require the Applicant and,all proposed
subcontractors to submit the following information with their bids or in writing at the outset of
negotiations.: ... ; -:
Is the Disclosing Party the Applicant?
[ ] 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.)
[JYes [JNo
Have you filed with the Joinl Reporting Committee, the Director ofthe Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements? '
[ ] Yes ["]' No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[JYes [JNo
If you checked "No" to question 1. or 2. above, please provide an explanation:.
Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, 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 and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions,, The full text of these ordinances and a training program is available on line at www.citvtSfchica^o.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The. Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in:connection with, which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void),-at law, or in equity, including terminating the Disclosing Party's.participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims 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 Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kepi current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party is the; Applicant, the" Disc losing Party and its Affiliated Entities will not use, nor permit their subcontractors lo use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matler certifications equal in form and substance to those in'Fil. arid F.2. above and will riot, without the prior written consent ofthe City, use any such contractor/subcontractor thatdbes'hot provide such certifications or that "the Disclosing Par'ty 'has reason to'belicve has not provided or cannot provide truthful certifications.
NOTE: Ifthe Disclosing Party cannot certify as to any ofthe items in F.L, F.2. or F.3. above, an explanatory statement must be attached to this EDS: ' ' '
CERTIFICATION
Under.pena'lty of perjury, the person signing below:(l) warrants that-he/she is authorized to execute this EDS. and Appendix A (if applicable) on behalf ofthe Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS arid Appendix A- (if applicable).arc;true, accurate and complete as of the date furnished to the City.
_Wirtz Coiporation
(Print or lype name of Disclosing Party)
(Sign'here)
...Nadine Heidrich . . .
(Print or type name of person signing)
Vice President, CFO & Treasurer (Print or type title of person signing)
Signed and sworn to before mc on (date) 1 A
at tOO j _ County, lQ^i^r^uS^ $L I^W-iL/ .__ Notary Public;
Commission expires:
Page 12 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to he completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership Interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "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 (I) all executive officers ofthe Disclosing Party listed in Section II.B.1.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, ifthe 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 of the Disclosing Party; and (3) any person having more than a 7.5'percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
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 of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship:
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owiicr"). It is not to be completed by any legal entity which has only ah indirect ownership interest iii the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or prbblem landlord pursuant to Section 2-92-416 ofthe Municipal
Code?"
[ ] Yes [Xj No
If the Applicant is a legal entity publicly traded bri any excharige.-is'any officer or director-of the Applicant identified'as a building code s'cofflawor problem landlordpursuant loiSection 2-92-416 ofthe Municipal Code?
[ J Yes [ ]N6 [X] Not Applicable
¦ 3; Ifyes to (1) or (2) above, please identify below the name of the person or legal entity
identified as a building code scofflaw pnproblem landlord and die address of the building or buildings to which the pertinent code violations apply.
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO, AND MADE A PART OF, THE ASSOCIATED EDS, AND-THAT THEiREPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Wirtz Corporation Officers and Directors
Name
President
Vice President
Secretary
CFO & Treasurer
Assistant Secretary & Treasurer
Assistant Treasurer
Directors
W. Rockwell Wirtz Nadine Heidrich Wade Wacholz Nadine Heidrich Cynthia E. Krch Linda S. Boskelly W. Rockwell Wirtz Wade Wacholz Bruce W. MacArthur Daniel R. Wirtz Edwin H. Callison, Jr. Jeffrey Vender John Miller Arthur M. Wirtz, III
Planned Development - Chicago Stadium Corporation
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Legal name ofthe Disclosing Party submitting this EDS. Include d/b/a/ if applicable ; Chicago Stadium Corporation
Check ONE ofthe following three boxes :.
Indicate whether the Disclosing Party submitting this EDS is:
[ ] the Applicant
OR
|X] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest -.Blackhavyk Community Ice Rink, LLC
OR
3. [ ] a legal entity with a right of control (see Section II.B.1.) State the legal name of the entity in
which the Disclosing Party holds a right of control < ^ ^
B. Business address of the Disclosing Party: 680 N. Lake Shore Drive, 19th Floor
Chicago, IL 60611 ...^
Telephone, .(312)475-63.27 _". Fax : ,(3J2) 943-9017 Email y Nadine:'Hcidrich(ai.wirtzcorp.com
Name of contact person: Nadine Heidrich
Federal Employer Identification No. (if you have one)>; _t
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Planned Development approval for 1801 - 1853 W. Jackson Blvd.- - - ¦ ^
G. Which City agency or department is requesting this EDS? .Dgpartment,.of"Planning
Ifthe Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # , and Contract U .
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY I. Indicate the nature ofthe Disclosing Party:
| ] Person [ ]
[ ] Publicly registered business corporation f ]
(Xj Privately held business corporation [ ]
.[ ] Sole proprietorship [ ]
[ ] General partnership (Is
[ ] Limited partnership
f 1 Trust [ ]
Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation
the not-for-profit corporation also a 501(c)(3))?
[]Yes I] No
Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
Delaware . • . ._ „
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?
IX] Yes []No [ ]N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below, the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list: below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a genera) partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list'below the name and title of each general partner, managing-member, manager or any other person or entity that controls the day-to-day management ofthe Disclosing Party. NOTE: Each legal entity listed below must submit an EDS oh its own behalf.
Name Title
See attached list.-; ..... . . . ....... ... . ,
2. Please provide the followirig'informatiori concerning each person or entity having a .director indirect beneficial interest (including ownership) in excess of 7.5% ofthe Disclosing Parly. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, stale "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"'), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
.Wirtz£orporatibn 680 N. Lake Shore Drive 100% ¦ _
. „ 19th Floor „ . , ^
Chicmio.-IL 60611' _ _ . . . . .: . .. . .
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has ihe Disclosing Parly had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
[ 1 Yes M No
If yes, please identify below the namc(s) of such City elected official(s) and describe such relationship(s):
SECTION IV DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature ofthe relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
(Add sheets if necessary)
IX] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities, SECTION V--CERTIFICATIONS
COURT ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes |Xl No [] No person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all suppo'rt owed arid is the person in compliance with that agreement?
[ ] Yes [ ]'Nd
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1.-23, Article I ("Article i")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee ofthe City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City NOTE: If Article 1 applies lo the Applicant, the permanent compliance _ timeframe in Article I. supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.1. of this EDS:
a. , arc not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from any transactions by any federal, stale or local unit of government;
b. have not, within a five-year period preceding the date of this EDS, been convicted of a criminal
offense, adjudged guilty, or had a civil judgment rendered against them in connection with:
obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or
contract under a public transaction; a violation of federal or state antitrust statutes; fraud;
embezzlement; theft; forgery; bribery; falsification or destruction of records; making false
statements; or receiving stolen property;
c- are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any ofthe offenses set forth in clause B.2.b. o f this Section V;
d. have not, within a five-year period preceding the dale of this EDS, had one or more public
transactions (federal, state or local) terminated for cause or default; and
e, have not, within a five-year period preceding the date of this EDS, been, convicted, adjudged
guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions
concerning environmental violations, instituted by the City or by the federal government, any
state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but 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 ofthe Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
a-,-, bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attcmpting 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;
b. 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 FestrainFoflrce~doW
otherwise; or
c.:, made an admission of such conduct described in a. or b. above that is a matter of record, but
have not been prosecuted for such conduct; or '
d. viojated the provisions bf Municipal' Code Section 2^92-610 (Living Wage'0'rdin'aiice),
4. Neither the Disclosing'Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense'of any state or of the United States bf America that contains the same elements as the offense of bid-rigging or bid-rotating.
. 5., Neither the 'Disclosing Party nor any Affiliated'Entity is listed:on any of the following lists maintained by the Office of Foreign Assets Control ofthe U.S: Departmenfof the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
6. ' The Disclosing Party understands and 'shaJl comply with the applicable requirements of Chapters
2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) ofthe
Municipal Code.
7. If the Disclosing Party is unable to certify to any ofthe above statements in this Part B (Further
Certifications), the Disclosing Party must explain below:
Page 6 of 13
Ifthe letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all current employees of the Disclosing Parly who were, at any lime during the 12-
month period preceding Ihe execution date of this EDS, an employee, or elected or appointed official,
ofthe City of Chicago (if none, indicate with "N/A" or "none").
None , - .
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all gifts that the Disclosing Party has given or caused to be given, al any time during the
12-month period preceding the execution date of this EDS, to an employee, or elected or appointed
official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything
made generally available to City employees or to the general public, or (ii) food or drink provided in the
course of official City business and having a retail value of less than $20 per recipient (if none, indicate
with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
None . ¦ ... .- ¦ -
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is |xl is not !
a "financial institution" as defined in Section 2-32-455(b) ofthe Municipal Code. i
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 ofthe Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. Wc understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA,".the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Parly certified lo Ihe above statements.
D. CERTIPICATI O.N. REG AR. DIN G INTER EST IN CITY BUSINESS
Any words or terms that are defined in Chapter 2-1 56 ofthe Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 of the Municipal Code: Docs any official or employee
ofthe City have a.financial interest in his or her own name or in the name of any other person or
enti ty i n-the Matter?.— • ¦-. - - — - - - - .
[] Yes ixlNo
NOTE: I.f you checked "Yes" to Item D.l., proceed lo Items' 'D.2Tand"p".3.' If you dhecked''"'^"©'' to ltem;D.,l, procecd.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 nanieof 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 docs not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ ] No
If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing.Party further certifies lhat no prohibited financial interest in the Matter will be acquired by any City official or-employee.
E CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure lo
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
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.
2. The Disclosing Party verifies that, as a result of conducting the search in step i above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VIE 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 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or ifthe word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf ofthe Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or lo extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
T'lie 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) of the Internal Revenue Code of I 986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in."Lobbying Activities".
5. ' If the Disclosing Party is the Applicant,.the Disclosing-Party must obtain certifications equal in
form arid substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any
subcontract and the Disclosing' Paxty.musjt'maintain all such subcontractors' certifications for the , ¦
duration of the Matter and must make such certifications promptly available to the City upon request.
13. 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 it'the outset of" negotiations. .; / . ¦, .,
Is the Disclosing Party the Applicant?
f ] Yes [ ] No
If "Yes," answer the three questions below;:
Have you developed and do you have on file affirmative action programs pursuarit 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 [ J No
Have you participated in any previous contracts or subcontracts subject lo the equal opportunity clause?
I J Yes ['] No
If you checked "No" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other. City action, and arc material inducements to the City's execution of any contract or taking other action with respect 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 and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cilyofch i fca lib.orp/Eth icst and may also be obtained from the City's Board of Ethics, 740 N.Sedgwick St., Suite 500. Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
Ifthe 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 transactions with the City. Remedies al law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims 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. Ifthe Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 of Ihe Municipal Code (imposing PERMANENT.INELIGIBILITY for certain specified offenses), the. information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 ofthe Municipal Code.
The Disclosing Parly represents and warrants that:
Page 1.1 of 13
F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party is the"Applicahtj'the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2: above arid'will not, without theTprior written consent of the City, use any siic'li conU'abtbr/subcbnt'ractbr'that does riot pfovide's'uch certifications or that the ' Disclosing Party lias reason to b'elievchas riot provided or canriot provide truthful certifications.
NOTE: If the Disclosing .Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) arc true, accurate and complete as of the date furnished to the City.
Chicago StadiumiGorpQration
(Print or type name of Disclosing Party)
By^f^^,^^^,,; ,„„r;;
(Sign here)'
nJ>JadipeFJeidnch— _ ' ". _
(Print or type name of person signing)
.CF^fc^asUrer
(Print or type title of person signing)
Signed and sworn to before me on (date)_
at, CjDDt- _ County, I fc-V-i t6^iV ^ (state);
kA^pfs^k, QU \^~A^S Notary Public.
Commission expires: ^ *" ^?, " aL P ^
Pa:ic 12 of" 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) (he Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "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 Parly" 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 die 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 halfVsister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.1 .a., ifthe 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, ifthe Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
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 arid title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such farhilial relationship.
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAVV/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owner"). It is hot to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
I. Pursuant to Municipal Code Section 2-154-010- is the Applicantorariy Owrieridentifiedasa ' building code scofflaw orp'roblem landlord pursuant to Section 2-92-416 of the Municipal Code?
[ ] Yes : ' ' ' |X] No
2' If the Applicaht-is a legalcntity publicly traded oh, any exchange, isan.y officer or director of the A'ppiicanfidentififed as'abuilding code scofflaw or problem landlord pursuant lo.Section 2-92-416 of the Municipal Code?
[ ] Yes [ ] No [X] Not Applicable
?>t. If yes to (d)'.or (2>) above, please identify below the name of the person or legal entity
identified'as a building.code scofflaw or problem .landlord and the address ofthe building or buildings to which the pertinent code violations apply.
FILLING OtJT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND,AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE,INTO, AND.MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Chicago Stadium Corporation Officers and Directors
Name
President
Vice President
Secretary
CFO & Treasurer
Assistant Secretary & Treasurer
Directors
W. Rockwell Wirtz Bruce W. MacArthur Wade Wacholz Nadine Heidrich Cynthia E. Krch W. Rockwell Wirtz Donald Hunter Bruce W. MacArthur