OFFICE OF THE MAYOR
CITV OF CHICAGO
RAHM EMANUEL
MAYOR
May 23,2018
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request of the Commissioner of Fleet and Facility Management, I transmit herewith an ordinance authorizing the extension of a right-of-entry agreement with Family Rescue.
Your favorable consideration of this ordinance will be appreciated.
Very truly yours,
Mayor
ORDINANCE
WHEREAS, the City of Chicago (the "City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970, and as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, the City is the owner of real property located at 10 South Kedzie Avenue, Chicago, Illinois, PINs 16-14-203-012 / -013 / -014 / -032 / -033 / -034, that is improved with a building that houses the City's Department of Family and Support Services ("DFSS") Garfield Community Service Center (the "Garfield Community Service Center"); and
WHEREAS, the City is the lessee of real property located at 4300 West North Avenue, Chicago, Illinois, PINs 13-34-424-034 / -035, that is improved with a building that houses the DFSS Trina Davila Community Service Center (the "Trina Davila Community Service Center"); and
WHEREAS, the City is the owner of real property located at 845 West Wilson Avenue, Chicago, Illinois, PINs 14-17-221-001 through -004 / -013 through -015 / -034, that is improved with a building that houses the DFSS North Area Community Service Center (the "North Area Community Service Center"); and
WHEREAS, the City is the owner of real property located at 1140 West 79th Street, Chicago, Illinois, PINs 20-29-424-032 through -036, that is improved with a building that houses the DFSS Englewood Community Service Center (the "Englewood Community Service Center"); and
WHEREAS, the Garfield Community Service Center, the Trina Davila Community Service Center, the North Area Community Service Center, and the Englewood Community Service Center are referred to herein as the "DFSS Facilities"; and
WHEREAS, DFSS previously provided domestic violence services to area residents at the DFSS Facilities through a program funded by the Illinois Criminal Justice Information Authority ("ICJIA") but ICJIA has altered their service delivery model and, as a result, government agencies are no longer eligible to receive funding for the provision of domestic violence services; and
WHEREBY, DFSS wishes for domestic violence services to continue to be provided to area residents at the DFSS Facilities, and Family Rescue, an Illinois not-for-profit corporation (the "Licensee") wishes to provide domestic violence services to area residents at the DFSS Facilities; and
WHEREAS, pursuant to Section 2-51-050(1) of the Municipal Code of Chicago (the "MCC"), the Commissioner of the Department of Fleet and Facility Management (the "Commissioner") has the authority to enter into right of entry agreements for up to 180 days each; and
WHEREAS, the City and Licensee have entered into a right of entry agreement to allow Licensee access to the DFSS Facilities to provide domestic violence services (the ''Right of Entry Agreement"); and
WHEREAS, Licensee and DFSS wish for Licensee to continue to provide domestic violence services at the DFSS Facilities through December 31, 2024; and
WHEREAS, pursuant to Section 2-51-050(1) of the MCC, approval by the City Council of the City (the "City Council") is required to extend the Right of Entry Agreement beyond the initial 180 day term; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. The foregoing recitals are hereby adopted as the findings of the City Council.
SECTION 2. Notwithstanding any provision to the contrary in Section 2-51-050(1) of the MCC regarding the 180 day limit on extensions for right of entry agreements, the Commissioner is authorized to execute an amendment to the Right of Entry Agreement to extend the existing term through December 31, 2024; such amendment is to be approved by DFSS and approved as to form and legality by the Corporation Counsel in substantially the form attached hereto as Exhibit A.
SECTION 3. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.
SECTION 4. All ordinances, resolutions, motions or orders inconsistent with this ordinance are hereby repealed or amended to the extent of such conflict.
SECTION 5. This ordinance shall take effect immediately upon its passage and approval.
EXHIBIT A Amendment to Right of Entry Agreement
[Attached]
AMENDMENT TO RIGHT OF ENTRY AGREEMENT
THIS AMENDMENT TO RIGHT OF ENTRY AGREEMENT (the "Amendment") is
made and effective as of July 16, 2018, by and between CITY OF CHICAGO, an Illinois municipal corporation and home rule unit of government (the "City") and FAMILY RESCUE, an Illinois nonprofit corporation (the "Licensee"). Capitalized terms used in this Amendment but not defined herein shall have the meaning set forth in the Agreement ("Agreement" is defined below).
RECITALS
WHEREAS, on January 17, 2018, City and Licensee executed that certain Right of Entry Agreement (the "Agreement") governing Licensee's access to the Property for the Activity; and
WHEREAS,-the Term of the Agreement expires July 15, 2018; and
WHEREAS, Licensee seeks continued access to the Property for the Activity; and
WHEREAS, by ordinance adopted on , 2018, the City Council of the City
authorized the extension of the Term of the Agreement.
NOW THEREFORE, in consideration of the above recitals, and the mutual covenants and agreements contained herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
The foregoing recitals are hereby incorporated into and made a part of this Amendment by this reference.
The Term of the Agreement is hereby extended to December 31, 2024.
If any term, provision or condition of this Amendment is found to be or is rendered invalid or unenforceable, it shall not affect the remaining terms, provisions and conditions of this Amendment, and each and every other term, provision and condition of this Amendment shall be valid and enforceable to the fullest extent permitted by law.
This Amendment shall be governed, construed, applied and enforced in accordance with the laws of the State of Illinois.
This Amendment may be executed in any number of counterparts, each of which shall be deemed to be an original, and all of such counterparts shall together constitute one Amendment.
City and Licensee further acknowledge and agree that, except to the extent hereinabove provided, the provisions of the Agreement remain unmodified and in full force and effect. This Amendment is hereby attached and made part of the Agreement and is specifically incorporated into the Agreement. To the extent any terms and provisions of this
|1010|
Amendment are inconsistent with the terms and provisions of the Agreement, the terms and provisions of this Amendment shall prevail.
IN WITNESS WHEREOF, the parties have executed this Amendment to the Agreement as of the day and year first above written.
CITY OF CHICAGO,
an Illinois municipal corporation and home rule unit of government
Commissioner
Department of Fleet and Facility Management
Commissioner
Department of Family and Support Services
FAMILY RESCUE,
an Illinois not-for-profit corporation
By:
Print Name:
Title:
Approved as to form and legality:
Chief Assistant Corporation Counsel Department of Law
|1010|
CERTIFICATE OF FILING FOR C1TY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT
EDS Number: 120877 Certificate Printed on: 12/18/2017
Date of This Filing: 12/1.8/2017 08:29 PM Original Filing Date: 12/18/2017 08:29 PM
Disclosing Party: Family Rescue
Titkv.C. E. O./Executive Director
Filed by: Mrs. Joyce Marie Coffee
Matter: Right of Entry Agreement for access
to City of Chicago Property located at 10 S.
Kedzie: 845 Wilson; 4300 W. North Ave.: and
1140 W. 79th Street
Applicant: Family Rescue
Specification
Contract #:
The Economic Disclosure Statement referenced above has been electronically filed with the City. Please provide a copy of this Certificate of Filing to your city contact with other required documents pertaining to the Matter. For additional guidance as to when to provide this Certificate and other required documents, please follow instructions provided to you about the Matter or consult with your City contact.
A copy of the EDS may be viewed and printed by visiting
http://\vebappsl .cttyofchicago.org/EDSWeb and entering the EDS number into the EDS Search Prior to contract award, the filing is accessible online only to the disclosing party and the City, but is still subject to the Illinois Freedom of Information Act. The filing is visible online to the public after contract award.
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT and AFFIDAVIT Related to Contract/Amendment/Solicitation EDS #120877
SECTION I -- GENERAL INFORMATION
Legal name of the Disclosing Party submitting the EDS: Family Rescue
Enter d/b/a if applicable:
The Disclosing Party submitting this EDS is:
the Applicant
Business address of the Disclosing Party: P.O. Box .17 52 8
9204 S. Commercial Ave., Suite 401 Chicago, IL 60617 United States
Telephone:
773-375-1918 Fax:
773-734-1245 Email:
administracion@familyrescueinc.org
Name of contact person:
Mrs. -Joyce Marie Coffee
1 of 12
Federal Employer Identification No. (if you have one):
r|910|Brief description of contract, transaction or other undertaking (referred to below the "Matter") to which this EDS pertains:
Right of Entry Agreement for access to City of Chicago Property located at 10 S. Kedzie; 845 Wilson; 4300 W. North Ave.; and 1140 W. 7 9th Street
Which City agency or department is requesting this EDS?
DEPT 0? FLEET AND FACILITY MANAGEMENT
Specification Number
Contract (PO) Number
Revision Number
Release Number
User Department Project Number
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
NATURE OF THE DISCLOSING PARTY 1. Indicate the nature of the Disclosing Party: Not-for-profit corporation
Is the Disclosing Party also a 501(c)(3) organization?
Yes
Is the Disclosing Party incorporated or organized in the State of Illinois?
y s s
DISCLOSING PARTY IS A LEGAL ENTITY:
2 of 12
1.a.1 Does the Disclosing Party have any directors?
Yes
1.a.3 List below the full names and titles of all executive officers and all directors, if any, of the entity. Do not include any directors who have no power to select the entity's officers.
Officer/Director: Mx. David Offenberg
Title: Architect
Role: Officer
Officer/Director: Mrs. Johnna Koso
Title: Dir., Chief Privacy Officer
Role: Officer-
Off icer/Director: Mrs. Barbara Taube
Title: Sr. Vice President, Finance
Role: Officer
Officer/Director: Mrs. Joyce Marie Coffee
Title: Executive Director/CEO
Role: Director
1.a.5 Are there any members of the not-for-profit Disclosing Party which are legal entities?
No
SECTION III -- INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTED OFFICIALS
Has the Disclosing Party provided any income or compensation to any City elected official during the 12-month period preceding the date of this EDS?
No
Does the Disclosing Party reasonably expect to provide any income or compensation to any City elected official during the 12-month period following the date of this EDS?
No
3 of 12
D. Does any City elected official or, to the best of the Disclosing Party's knowledge after reasonable inquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined in CJ].aRter.2-156 pf.the Municipal Code ("MCC")) in the Disclosing Party?
No !
SECTION IV -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist (as defined in MCC Chapter 2-156), accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount 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.
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.
Has the Disclosing Party retained or does it anticipate retaining any legal entities in connection with the Matter?
f
CaiKin Technology Inc Retained
19Q55 Center Ave.
Homewood, IL 60430 United States
Consultant
ci 9 n r» no.
•J .1. / £. v., \J . \J W
Estimated
Yes 1 List below the names of all legal entities which are retained parties.
Name:
Anticipated/ Retained:
Business Address
Relationship: Fees
(.$$ or %) : Estimated/Paid:
Has the Disclosing Party retained or does it anticipate retaining any persons in connection with the Matter?
Yes
'J of 12
4. List below the names of all persons who are retained parties.
Name: Mr. Calvin Harden
Anticipated/ Retained
Retained:
Business Address: 19055 Center Ave.
Komewood, IL 60430 United Srar.es
Relationship: Consultant
Fees 51,200.00
($$ or %):
Estimated/Paid: Estimated
SECTION V -- CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE !
Under MCC Section 2-92-415. substantial owners of business entities that contract with the City must remain in compliance with their child support obligations -' throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage of any child support obligations by any Illinois court of competent jurisdiction?
Not applicable because no person directly or indirectly owns 10% or more of the Disclosing Party
FURTHER CERTIFICATIONS
1. [This certification applies only if the Matter is a contract being handled by the City's Department of Procurement Services.] In the 5-year period preceding the date of this EDS, neither the Disclosing Party nor any Affiliated Entity has engaged, in connection with the performance of any public contract, the services of an integrity monitor, independent private sector inspector general, or integrity compliance consultant (i.e. an individual or entity with legal, auditing, investigative, or other similar skills, designated by a public agency to help the agency monitor the activity of specified agency vendors as well as help the vendors reform their business practices so they can be considered for agency contracts in the future, or continue with a contract in progress).
This matter is not a contract handled by the Department of Procurement Services
5 of 12
The Disclosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee, tax or other source of indebtedness owed to the City of Chicago, including, but not limited to, water and sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the Disclosing Party delinquent in the payment of any tax administered by the Illinois Department of Revenue.
I certify the above to be true
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section 11(B)(1) of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, during the 5 years before the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction;
a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property:
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in subparagraph (b) above;
have not, during the 5 years before the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, during the 5 years before the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
I certify the above to be true
The Disclosing Party understands and shall comply with the applicable requirements of MCC Chapter 2-56 (Inspector General) and Chapter 2-156 (Governmental Ethics).
1 certify the above to be true
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, with respect to a Contractor, an Affiliated Entity,
or an Affiliated Entity of a Contractor during the 5 years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
6 of 12
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in subparagraph (a) or (b) above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Regumng.j_Base Wage): (a)(5J.(Debarment Regulations): or (aH6)(Minimum Wage Ordinance)
I certify the above to be true
Neither the Disclosing Party, nor any Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of
bid-rigging in violation of 720 ILCS 5/33E-3;
bid-rotating in violation of 720 ILCS 5/33E-4; or
any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
I certify the above to be true
Neither the Disclosing Party nor any Affiliated. Entity is listed on a Sanctions List maintained by the United States Department of Commerce, State, or Treasury, or any successor federal agency.
I certify r.he above to be true
[FOR APPLICANT ONLY]
Neither the Applicant nor any "controlling person" [see MCC .Chapter .1.-2.3, Article I for applicability and defined terms] of the Applicant is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any "sister agency"; and
the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City.
7 of 12
NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, that Article's permanent compliance timeframe supersedes 5-year compliance timeframes in this Section V.
I certify the above co be true
9. [FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor
permit their subcontractors to use, any facility listed as having an active exclusion by
the U.S. EPA on the federal System for Award Management ("SAM")
I certify the above to be true
[FOR APPLICANT ONLY] The Applicant will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in Certifications (2) and (9) above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Applicant has reason to believe has not provided or cannot provide truthful certifications.
I certify the above to be true
To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the date of this EDS, an employee, or elected or appointed official, of the City of Chicago.
None
12 To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than $25 per recipient, or (iii) a political contribution otherwise duly reported as required by law.
None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies, as defined in MCC Section 2-32-455(b), the Disclosing Party
Ira nO'_ a ii.ic.:Ci.ai. ...j4^ wi ^ jlIO:.
8 Of 12
D. CERTIFICATION REGARDING FINANCIAL INTEREST IN CITY BUSINESS
Any words or terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.
1. In accordance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledge after reasonable inquiry, does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter?
No
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
If the Disclosing Party cannot make this verification, the Disclosing Party must disclose all required information in the space provided below or in an attachment in the "Additional Info" tab. Failure to comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City. ''
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.
I can make the above verification
SECTION VI -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
Is the Matter federally funded? For the purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City are not federal funding.
No
SECTION VII - FURTHER ACKNOWLEDGMENTS AND CERTIFICATION
The Disclosing Party understands and agrees that:
A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and
9 of 12
the City in connection with the Matter, whether procurement, City assistance, or other City action, and are material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of this ordinance and a training
¦¦ program is available on line at www.cityofchicaqo.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with this ordinance.
I acknowledge and consent to the above The Disclosing Party understands and agrees that:
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other City transactions. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided in, and appended to. this EDS may be made publicly available on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires NOTE: With respect to Matters subject to MCC Article I of Chapter 1_-23 (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by MCC Chapter 1-23 and Section 2-154-020.
I ackncv/ledge and consent to the above
10 of 12
APPENDIX A - FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5%. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under MCC Section 2-154-015. the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, .grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all corporate officers of the Disclosing Party, if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5% 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?
No
APPENDIX B - BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5% (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
11 Of 12
Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to MCC Section 2-92-416??
No
ADDITIONAL INFO
Please add any additional explanatory information here. If explanation is longer than 1000 characters, you may add an attachment below. Please note that your EDS, including all attachments, becomes available for public viewing upon contract award. Your attachments will be viewable "as is" without manual redaction by the City. You are responsible for redacting any non-public information from your documents before uploading.
This EDS is being updated for a Right of Entry Application to four Chicago Department of Family and Support Service Centers.
List of vendor attachments uploaded by City staff None.
List of attachments uploaded by vendor Nor.e.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS, and Appendices A and B (if applicable), on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS, and Appendices A and B (if applicable), are true, accurate and complete as of the date furnished to the City. Submission of this form constitutes making the oath associated with notarization.
/s/12/18/2017 Mrs. Joyce Marie Coffee C. E. O./Executive Director Family Rescue
This is a printed copy of the Economic Disclosure Statement, the original of which is filed electronically with the City of Chicago. Any alterations must be made electronically, alterations on this printed copy are void and of no effect.
12 of 12
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested.
Right of Entry Agreement for access to City property, located at This recertification is being submitted in connection with 10 s Kedzie, 845 w Wilson, 4300 w North Ave, and ii40W79th [identify the Matter]. Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS recertification on behalf of the Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as of the date furnished to the City and continue to be true, accurate and complete as of the date of this recertification. and (3) reaffirms its acknowledgments.
Family Rescue Date: 5/9/2018
Print or type name of signatory:
Quadrella Mayfield
Title of signatory:
Chief Financial Officer
Vlt. 11-01-05
(Print or type legal name of Disclosing Party)