OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR
September 24, 2015
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request of the Commissioner of Planning and Development, I transmit herewith ordinances authorizing 2016 budgets and service provider agreements for various Special Service Areas.
Your favorable consideration of these ordinances will be appreciated.
Mayor
Very truly yours,
ORDINANCE
WHEREAS, special service areas may be established pursuant to Article VII, Sections 6(1) and 7(6) of the Constitution of the State of Illinois, and pursuant to the provisions of the Special Service Area Tax Law, 35 ILCS 200/27-5 et seq., as amended from time to time (the "Act") and pursuant to the Property Tax Code, 35 ILCS 200/1-1 et seq., as amended from time to time (the "Code"); and
WHEREAS, on December 2, 2009, the City Council of the City of Chicago (the "City Council") enacted an ordinance (the "Establishment Ordinance") which established an area known and designated as City of Chicago Special Service Area Number 45 (the "Area") and authorized the levy of an annual tax, for the period beginning in 2009 through and including 2018, not to exceed an annual rate of three percent (3%) of the equalized assessed value of the taxable property therein (the "Services Tax") to provide certain special services in and for the Area in addition to the services provided by and to the City of Chicago generally (the "Special Services"); and
WHEREAS, certain funds in Fund A75 ("Fund A75") in the amount of $25 are available for use in connection with the Area; and
WHEREAS, the Establishment Ordinance established the Area as that territory consisting approximately of the area on both sides of Halsted Street between the north side of 115th Street and the south side of 99th Street; both sides of 103rd Street between Morgan Avenue and Lowe Avenue; and along Vincennes Avenue between north 115th Street and 111th Street; and
WHEREAS, the Special Services authorized in the Establishment Ordinance include but are not limited to: recruitment of new businesses to the Area, rehabilitation activities, maintenance and beautification activities, security, coordination of promotional and advertising activities, strategic planning for the Area, and other technical assistance activities to promote commercial and economic development (which may include, but are not limited to, streetscape improvements, strategic transit/parking improvement including parking management studies, enhanced land use oversight and control initiatives); and
WHEREAS, the Establishment Ordinance provided for the appointment of the 103rd Halsted Special Service Area Commission (the "Commission") to advise the City Council regarding the amount of the Services Tax to be levied and for the purpose of recommending to the City Council: (1) a yearly budget based upon the cost of providing the Special Services; (2) an entity to serve as a service provider (the "Service Provider"); (3) an agreement between the City and the Service Provider for the provision of Special Services to the Area (the "Service Provider Agreement"); and (4) a budget to be included in the agreement between the City and the Service Provider (the "Budget") (the aforementioned items 1 through 4 shall be known collectively herein as the "Recommendations"); and
2015SSA45Ord v. 1.doc
WHEREAS, the Commission has been duly appointed and qualified and has heretofore prepared and transmitted to the Commissioner of the Department of Planning and Development (the "Commissioner") its Recommendations to the City Council, including the Budget attached hereto as Exhibit A and hereby made a part hereof; now, therefore
Be It Ordained by the City Council of the City of Chicago:
SECTION 1. Incorporation of Preambles. The preambles of this ordinance are hereby incorporated into this text as if set out herein in full.
SECTION 2. Appropriations. There is hereby appropriated the following sums in the amounts and for the purposes necessary to provide the Special Services in and for the Area, the estimated amounts of miscellaneous income and the amounts required to be raised by the levy of the Services Tax indicated as follows:
103rd HALSTED SPECIAL SERVICE AREA COMMISSION SPECIAL SERVICE AREA BUDGET
For the fiscal year commencing January 1, 2016 and ending December 31, 2016.
EXPENDITURES
Service Provider Agreement for the provision of Special
Services $699,138
TOTAL BUDGET REQUEST $699,138
SOURCE OF FUNDING Tax levy at an annual rate not to exceed three percent (3%) of the equalized assessed value, of the taxable property within
Special Service Area Number 45 $627,313
Fund A75 $25
Carryover funds currently available
from prior tax years $43,800
Late collections received by the City of Chicago attributable to the levy of the Services Tax in prior tax years, along with interest income
thereon, if any $28,000
SECTION 3. Levy of Taxes. There is hereby levied pursuant to the provisions of Article
2015SSA45Ord v. 1.doc
VII, Sections 6(a) and 6(l)(2) of the Constitution of the State of Illinois and pursuant to the provisions of the Act and pursuant to the provisions of the Establishment Ordinance, the sum of $627,313 as the amount of the Services Tax for the tax year 2015.
SECTION 4. Filing. The City Clerk of the City (the "City Clerk") is hereby ordered and directed to file in the Office of the County Clerk of Cook County, Illinois (the "County Clerk") a certified copy of this ordinance on or prior to December 29, 2015, and the County Clerk shall thereafter extend for collection together with all other taxes to be levied by the City of Chicago, the Services Tax herein provided for, said Services Tax to be extended for collection by the County Clerk for the tax year 2015 against all the taxable property within the Area, the amount of the Services Tax herein levied to be in addition to and in excess of all other taxes to be levied and extended against all taxable property within the Area.
SECTION 5. Service Provider Agreement. The Commissioner, or a designee of the Commissioner (each, an "Authorized Officer"), are each hereby authorized, subject to approval by the Corporation Counsel as to form and legality, to enter into, execute and deliver a Service Provider Agreement as authorized herein with Far South CDC, an Illinois not-for-profit corporation, as the Service Provider, for a one-year term in a form acceptable to such Authorized Officer, along with such other supporting documents, if any, as may be necessary to carry out and comply with the provisions of the Service Provider Agreement. The Budget shall be attached to the Service Provider Agreement as an exhibit. Upon the execution of the Service Provider Agreement and the receipt of proper documentation the Authorized Officer and the City Comptroller are each hereby authorized to disburse the sums appropriated in Section 2 above to the Service Provider in consideration for the provision of the Special Services described in the Budget. The Department of Planning and Development shall promptly make a copy of the executed Service Provider Agreement readily available for public inspection.
SECTION 6. Enforceability. If any section, paragraph or provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such section, paragraph or provision shall not affect any of the remaining provisions of this ordinance.
SECTION 7. Conflict. This ordinance shall control over any provision of any other ordinance, resolution, motion or order in conflict with this ordinance, to the extent of such conflict.
SECTION 8. Publication. This ordinance shall be published by the City Clerk, in special pamphlet form, and made available in her office for public inspection and distribution to members of the public who may wish to avail themselves of a copy of this ordinance.
SECTION 9. Effective Date. This ordinance shall take effect 10 days after its passage and publication.
2015SSA45Ord v. 1.doc
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CITY Of CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I — GENERAL INFORMATION
Legal name of'the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
fat"' fKU-VVu\KV
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
(ijr'tbe 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. f ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control:
Business address of the Disclosing Parly: ^\Q3^> fS liCxiMtcl 93. r i^u^ b
Telephoned -t-i3 \ Shi-*i£l>3 Fa,\:(nvM Out Email; 1 rtf* Q fCr^ctha.
Name of contact person: Y\ V)( O I-QWI ¦ L0.C i f
E. Fedeial 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)
Tt> &UOu> for SC„*vu<~ A StVi,;Ct. i\ty:L^ r-»c,y tu^n i
Which City agency or department is requesting this EDS?t>ey/ Fi/inm M CmrJ k^i-^iafi^ji*-
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification #
SECTION II -- I) ISC I. OS I RE OF ON NEKSHIP IN IKKKS I\S
A VAll.'UF Ol- DISCI OS I NO PAR
I. Indteato the milure ol'tlie Disclosing
[ ) Peisou
[ J Publu:l> rcgisleied business corporation
[ J Privately held business corporation
{ | Sole propilelorslup
| j General partnership
| ! Limited partnership
[ j Trust.
Party
[ | Limited liability company [ J Limited liability partnership [ ] Joint venture I U^T^ot-for-prot'it corporation (Is the not-for-profit corporation also n 501(e)(3)).'
fuK« [ 1 No
|' ] Other (please specify)
Fiji legal entities, the state ior foreign country) of incorporation or organization, if applicable:
^\W&&.
For legal eniities nol oigani/ed in the State of Illinois: Has the organization rcgisleied to do business in the Stale of Illinois as a foreign entity'.'
[ ] Yes [ j No I^A
B. IF THE DISCLOSING PAR FY IS A LfcOAI FN'ITTY:
1. List below the full names and titles of all executive officers and all directors of the entity. NOTE: For nuI-for-profit corporations, also list below all members, if any. which are legal entities, tf there are no such me miners, write "no members." For trusts, estates or other similai eniities, list below the legal titlchi>kler(s)
II the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or loint venture, list below the name and title of each general partner, managing memnei. manager or any other person oi entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal enii.y listeJ below must submit an FDS on its own behalf.
Name Tide
/HA a Back* V l&fc <%?
2 Please pun ide the follow mu tnlormation concerning each person or entity ha\ \wi a direct or indirect beneficial interest (including owneislupi m excess of 7.5".i of the Disclosing Paity I" \ am pies of such an mteiesi include shares in a eorpoi ation parineiship mtciest in a partnership or |oim \einure
Chairman
Leon Walker
Preside of
LeRov Chalmers
Secretary
John Chenier
Treasurer
Dennis 0">VIaJle>
Director
Jackie Johnson-Sample Director
Major Da\ id I lnrve\ Director
Rev. Leonardo Gil ben
Director
Phillip Snordt-n
Abraham D. Lac> Executive Director
- 5 s "aisled Street. Suite I); Chien»o. IL (S0628 ! 0. <7"i) 04I-4K3J F sU lo252 i h.
inl.<,HHMHUlicdi. oi^ ' v\ w y,_t';iis.H,tlK<.leJ(ii w_\\w .panneisp,mt.U ore
lilt civs i ofmcmhoi i-r nunajier in 1 Im.iled luhihtv company. i>r inlciesi ofa beneficial \ ol a nust. estate m oi'iei simiiai entity (I'r.nn-. >i;it.; "NniK NO 1 V. Pmsuani to -S^c'-ion—:--1 >4-n *n o| the Municipal Cone or Chicago i "Municipal Code"), the Litv may ict|iiue any such additional m forma:ion Fioni any r.pptieani v. Lk.1i is reasonably inteinleil to achieve Full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
.AJoa^A- : __.
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has1 the Disclosing Paity had a "business relationship." as defined in Chapter 2-156 of the Municipal ("ode, with any City elected official in the 12 months before the date this FDS is signed0
I I Yes Ivr-tfo
II y es. please identify below the nanie(s) of such City elected official! s) and describe such relatiunshipls)
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Paris- must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Patty has retained or expeels to retain in connection with the Matter. a> well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid The Disclosing Parly is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means nnv person or entity w ho undertakes to influence any legislative or adminislialive action on behalf of any person or entity other than (I) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobby i.st" ciLo means any person or entity any part of w hose duties as an employee of another includes uiulerukmg lu influence any legislative or administrative action
If the Disclosing Pai y is uncertain whetbei a disclosure is icmnred inulei this Section, tne Disclosing Party must cither ask the City w lethei disclosure is required or make the dist loMire.
Page of I s
Name tuv-.'.u. ale w iiclh i Business Relationship lo D'sdosmg l\i'.:.y r ocs i :r,ilicuic w bether
re la in e i.l antic tp.ilod Address i subcontractor. Mo>. nev. paid oresimiaicu ) NO IT:
to he retained) lobbyist, etc.) "hoiniy ia;e ' oi "I h d "
not an acceptable response.
.^fiL-_A^at>i!WL^ -ll^fcr -
(Add shoots if necessary)
[ J Cheek here if the Disclosing Parly has nol retained, nor expects to retain, any such persons or entities SECTION V ~ CERTIFICATIONS
A. COOK r-ORDHRED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415. substantia) owners of business eniities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Mas any person who directly or indirectly owns 10% or more of the Disclosing Party been declaied in arrearage on any child support obligations by any Illinois court of competent jurisdiction'.'
{ ] Yes j ] No [vH^> person directly or indirectly owns 10% or more of Ihe
Disclosing Party.
If "Yes." has ihe person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement'.'
f J Yes f | No
B FURTHER CERTIFICATIONS
I Pursuant to Municipal Code Chapter 1-23. Article 1 ("Article l")(which Ihe Applicant should consult for defined tein:s (e g . "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business uith 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 con1- ictcd of. oi placed under super\ i.sion for. any criminal offense involving aelual. attempted, or conspiracy io commit bribery, then, fraud, foigery, perjury, dishonesty or deceit against an officer or employee of the City oi any sister agency: and Mi) the Applicanl understands and acknowledges thai compliance with Article I is a continuing re I applies to ihe -Ypplicunt. (he permanent compliance limel'rame in Article I supersedes some fi\e-yeai compliance timeframes m cerlillcaiion- 2 .uu! » hclou
FARSOUTM
Community Development Corporation
SSA#45 List of Retained Parties - 2016
RETAINED PARTIES - PROPOSED BUSINESS ADDRESS RELATIONSHIP ESTIMATED NOTES
WsGB'INVESTIGATIVE SERVICES '^S^i^i ^03'3'W95^trMtJCh'ica^ <|Subcoritractd'rj ^^275,000 ¦¦.¦ t f .' Safety Programs,
GROUND 60DZ 11509 S. Elizabeth Street, Chicago, IL 60643 Subcontractor 98,000 Public Way Maintenance
?AWAflCHJND^AivlUSEMENr iHC-V^.i'A- :2U42WDrvisibnSt/^^ j:MM%f:<. .r-^jteS**-' ?l •{Subcontractor". •v" %* J.i/^Customer'Attraction A'.,';-''^:':^'<-"^"'^:iBif^?p::,
L WASHINGTON DESIGNS, LLC P.O. Box 436955, Chicago, IL 60628 Subcontractor 5,000 Public Way Aesthetics
IRuDContra^r-
MOBILE BEACON - CLEARWIRE 2419 Hartford Ave, Johnston, Rl 02919 Subcontractor 1,200 Customer Attraction
LIBERTY FLAGS & BANNERS 4740 N. Cumberland Ave, Chicago, IL 60656 Subcontractor 5,000 Customer Attraction
:;io,a»: Vsfr
HALL & ASSOCIATES 21145 Ridgeland Manor Ave, Matteson, IL 60443 Subcontractor 2,000 Accounting (Bookkeeper)
gis^^i^^^^^^aia^^^^g^g^l ffSubmlitractorJ S^i^^Si^4'^untini'(AT7dltof))
TOTAL 424,200
9923 S. Halsted Street Suite D | Chicago, IL 60628 | 0: (773) 941-4833 | F: (773) 941-5252 | E: info@farsouthcdc.org | www.farsouthcdc.orR | www.ssa45.org | www.ssa49.org | www.partnersportal.org
2. i'iie Disclosing I'.i' iv iiiiil. li the Disclosing f'.stty is a lei';'! -cuiity. al! of those peisun-. ot entities identified it; Section ! H i :if this f!>S
a a re not presently debarred, suspended, proposed, lor debarment, declared ineligible or \ oluntanly excluded from any transactions hy any federal, state or local unit of government.
have not. withii: a five-year period preceding the date of this LiDS. been convicted ofa criminal offense, adjudged guilty, or hud a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public ( federal, stale oi local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes, fraud: embezzlement, rheft; forgery: bribery: falsification or destruction of records: making false statements', or receiving stolen property.
are nol presently indicted for; or. criminally or ciV^||y;^(;h4^ged(by^:g'0.v.C(til1tc'nttil entity (federal, state or local I with committing any of the offenses set forth in clause B.2,b.of this Section V.
have not. withina five-year period:preceding the date of thisEDS. had one or more public transactions (federal, suite,or local) rermimucd for cause or - rfcCa.uk : 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 iii any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, a'ny state, or any other unit of local government.
3. The certifications m subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (moaning any contractor or subcontractor-used by the Disclosing Party in connection with ihe Ma iter, including but nor limited to all persons or legal entities disclosed iukIci 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, oi 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 tacilities and equipment; common use of employees, or organization ofa business entity following the ineligibility ofa business entity lo do business with federal or stale or local government, including the City , using substantially the same management, ow nership, or principals as the ineligible entityt with respect to C ontractors. the term Affiliated Entity means a person or entity that directly or indirectly ccuiMols ih,. Contractor, is controlled by it, oi. with ihe Contractor, is under common control of another pe:son or entity.
any responsible off cial of the Disclosing Party, any Contractor or an\ Affiliated Entity oi am other official, agent or employee of the Disclosing Party, any Connactoi or any Affiliated I ntitv. acting pursuant to the dnection or authorization ofa iesponsibie official of the Disclosing Party, anv Contractor oi jnv Affiliated Fntitv (colleedv elv "Aeenis")
Neithei ihe Disclosing Pam. nor any Conductor, not any A ('filiated I:ntiiy of e:ther the Disclosing Parly or any.('ontt:Ktor nor anv \gciits.|ui-ve. during the fjv e years before the dale this L OS is signed, or, with icspeu to a ('unrrac'or. an Affiliated l-ntiiv. or an Affiliated tnliiy ofa Contractor during the five vea r\ tie fore the date of such ( onlraetor's oi Affiliated Entity's contract or engagement tn connection v» >th the .Vlawcr
a bribed or attempted to bribe, or been convicted 01 adjudged guilty of bribery or attempting to bribe, a public officer ur employee of the City, the Stale 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 oi colluded with other bidders or prospective bidders, or been a party to any such
agreement, or b>::en 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 oi otherw ise, or
e. made an admission of such conduct described in a or b. above that is a matter of record, but have not been prosecuted lor such conduct: or
d- violated the provisions of Municipal Code Section 2-02-610 (Living Wage Ordinance).
Neither the Disposing 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-tigging in violation of 720 ILCS _v33E-3: (2j bid-rotating in violation of 720 ILCS 5--33F-4: or (3) any similar offense of any state or of the United States of America thai 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 ofilie following lists maintained by the Office of Foreign Asseis 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 Nationals List, the Denied Persons List, the Unverified Lisi. the Entity Lis! and the Debarred List.
The Disclosing Piriy understands and shall comply with Ihe applicable requirements of Chapters 2-55 (I egislative Inspector General). 2-56 (Inspector General) and 2-!5b (Governmental Ethics) of the Municipal Code.
If the Disclosing Party is unable to certify to any of the above statements in tins Part B iLurthet Certifications), ihe Disclosing Party must explain below.
Page cot I-
If Tic Idler-. "N A." the w ord "None." ni: n.» ic-*ponse appears cn ihe lines -a trove."! I w'i 11 be conclusively presumed thai the Disclosing Party certified tu t.he above statemcn'.s.
__jU/rt___ -- - ~
0 To the best of the Disclosing Party's know ledge after reasonable inquirv, the following is a complete list of all gifts thai the Disclosing Party has given or caused to be given, at any time dining the 1 2-month period preceding the execution date of this EDS. to an employee, or elected or appointed official, of the City of Chicago, For purposes of this statement, a "gift" does not include (i) anything made generally available to City employees or lo the general public, or (ii) food or drink provided in ihe course of official City business and having a retail value of less than !S2() per recipient (if none, indicate with "N.-'V or "none"). As to any aid listed below, please also list the name of the Oiv iccipient
-AlfA- - - • '
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Parly certifies that the Disclosing Party (check one) j. ) is |\^not
a "financial institution" as defined in Section 2-3.2-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges
''We are not and vs ill 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 tlieni will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code We understand thai becoming a predatory lender or becoming an affiliate ofa predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined m Section 2-32-4551 b) of the Municipal C ode) is a predatory lender u irhm the meaning of Chapter 2-*2 of the Municipal ("ode. explain heie (attach additional pages if necessary)
Il the Ictieis "NA." tho word "Nunc." oi no response appears on the lines above, it will be oonclusiv'elv presumed th.it the Disclosing Patty certified to the above statements.
D CERTIFICATION REGARDING INTEREST IN CU V BUSINESS
Any words or lerms that arc defined in Chapter 2-1 56 of the Municipal Code have the same meanings when used in this Pari D.
I In accordance with Section 2-1 5o-l II) of the Municipal Code Docs any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the VJ after? I v es
NOTF: 11 you cheeked "Yes" to Item 1). 1., proceed to Items D.2. and D.3. I f you checked "No" to Item D 1 proceed to Part C.
Unless sold pursuant to a process of competitiv e bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that |i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by v irlue of legal process at the suit of the City (collectively, "City Property Sale") Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale'1
[ j Yes | | No
If you cheeked "Yes" to Item D.L. provide the names and business addresses of the City-officials or employees hav mg such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4 The Disclosing Party funnel cerlifies that no prohibited financial interest in the Mattel w ill be acquired by any Cily official or employee.
!• CER JTEK 'A7 ION R I-GAR (3IN G S L A V I- R \ h R A I
Please check eilhci i . or 2 below If ihe Disclosing Pjrty checks 2 . ihe Disclosing Party must disclose below oi in an .ittjchmcni :o ibis IDS .ill ir ioi manor, required by paragraph 2 failure 1o
Page * of i '
cmu;'>!\ wuh these i i i - <. losure ivouiremeiiis n;j} make auv conlrad enured mio will) tho Cil\ in comiecUoh "u :ih" !h"j VI afteiToida'ble by '.ho Ci:>
^1 The Disclosing Paily verities that the Disclosing Party has searched any and till records of the Disclosing Partv and any and ail predocessoi entities regarding records of investiTicitis or profits frorr, slavery or slaveholder insurance policies dunng the slavery era (including insurance policies issued to slaveholders that provided coverage for damage ro or injury or death of their slaves!, unci the Disclosing Party has found no such records
2. The Disclosing Parly 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 lhal ihe following constitutes full disclosure of all such records, including the names ot any and all slaves or slaveholders described in those records:
SECTION VI CERTIFICATIONS FOR FEDERALLY Fl.'NDED 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 C ity and proceeds of debt obligations of the City are not federal funding.
A. CERTIFICATION R HOARDING LORRYING
I. List below the names of all persons or entities registered under the federal Lobbying Disclosure A.cl of ] 9s1? who have made lobbying contacts on behalf of the Disclosing Party w ith respect to the Matter (Add sheets if necessary r
(If no explanation appcos or begins on the hues above, or it the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means thai NO persons or eniities registered undei the Lobbying Disclosure Act of I°-°o have made lobbying contacts on behalf of the Disclosing Party w ith respect 'u the Matter )
2 'I be Disclosing Party ha=- not spent and will no! expend any federally appropriated funds to pay any peison oi entity listed in Paiaiiiaph \ I above for his or hei lobbying activities or 'o pav any person oi entity to in flu.Mice or attempt to influence an officer or employee of any jge-icv. as defined b\ applicable tedcia! law a .ncobor of ( om-rrcs- an officer or emp ovee oft ongrcs.-. oi an oir.plovoi. o! a member of Coiigros,, c.'iinci. :ion oh i bo aw a r >) o f .in v 'ederallv funded contra', t, nv:L nio ar, v federally h.iuicd grant or loan, or wnm: mio or. cooperitr. e ;rji eesYiem. or \o e.steml. coniim.e. icr.jv. a mend, or in odi f y an v t ederal ly i: i: o 1 ¦.! . i > i 11: a^ 1. j i an:. I. mm . or coo :ie rati \ e ad eon id. <
Pace - ot : !
3. .FhcDi-sclosmg PaMy will-submit airup Jarcd'Cerlifrcatliuruf the "end uTeach calendar quarter m which there occurs an,» event that materially affects the accuracy of the .statements and information set forth m paragraphs A.l, and A 2 above.
4 The Disclosing Party certifies that either id i( is not an organization described in section 501(c)(4) ol'lhe Internal Revenue Code of 1986; or (n) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1°X6 but has not engaged and will not engage in "Lobbying Activities".
5. If the Disclosing Party is the Applicant.; the Disclosing Party must obtain certilieatioris equal in form and substance to paragraphs A.l. through A.4. above, from all subcontractors' before iLawards a'n-v subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duiation of the Matter and must make such certifications promptly available to the City upon request
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPOR fUNITY
If the Matter is federally funded, federal regulations.require the Applicant and all proposed subcontractors lo submit, the following information with theii bids or in writing at the outset of
negotiations.
Is the Disclosing Party the Applicant'.'
[ 1 Yes [ J 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 CPR Part 60-2.)
I J Yes ( ] No
Have you filed with the Join! Reporting Committee, rhe Director ol'lhe Office of Federal Contract Compliance Piograms. or ihe Equal Employment Opportunity Commission nil reports due under the applicable filing requirements".'
I ] Yes ' | | No
,V Have you participated in any pre\ ions contracts or subcontracts subject to the equal opportunity clause '
[ i Yes II No
It vou checked "No" to uuostior I or 7 above, please provide an explanation
M-.C.'I ION VII A( k:\OU LF. DO M EN I S. ( On TR AC I I.NCORPOK ATION. COM Pl.lANCK, PENALTIES. I)LSCLOSIKE
T he Disclosing Parly understands ami agiees tiiat:
A The certifications, disclosures, and acknowledgments contained in this EDS will become pan of anv contracr 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 actum 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.
B, The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-1 56 and 2-164 of
the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts,
work, business, or transactions. I he full text of these ordinances and a training program is available on
lineaEw^^^ also, be obtained from (lie City's Board pTEihjes, 740 N
Sedgwick St Suite 500. Chicago. IL 60610. (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
C 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 nol rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation m the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statemeii' of material fact may include incarceration and an award to the City of treble damages.
D. ft is the City's policy to make this document available lo the public on its Internet site and/or upon request. Some oral! of ihe-information provided on this EDS and any attachments to this EDS. may be made available lo the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS. the Disclosing Purty waives and releases any possible rights or claims which it may bin e against ihe City in connection with the public release of information coniained-in this EDS and also authorizes the City lo verify the accuracy of any information .submitted in this EDS.
I I he information prov tded in (his EDS must be kept current In the event of changes, the Disclosing Parry must supplement this EDS up to the time the City rakes action on the Matter If the -Matter is a contract being handled !•» the City's Department of Proem emeni Services, the Disclosing Party must update this EDS as the contract requires. .NO EE: V\ ith respcci to Matteis subiect to Article I o! Chapter 1-2* of the Municipal ( ode (imposing PERMANENT INELIGIBILITY for certain specified ollense-i. the informatio i pro\ ided herein regaiding eligibiliiv must he kept current tot a longer period as icquired by Chapter 1-2* and Section 2-1^4-020 of the Municipal Code
! he Di.se losing Party rep e-icnC and v. .in.i.nts thai
F.l. The Disclosing. Carry 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. rax or other charge owed to the City. This includes, but is not limited to. all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use. any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F. 1 F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
(Print or type name of Disclosing Party)
(Print or type name of person signing)
(Print or type title of person signing)
f
Signed and sworn to before me on (date) <~J^grp7( /L(~ County, ^LL-,^s>;^s (state).
/
A St
OFFICIAL SEAL SHARONE RJOHNSON Notary Public - State of Illinois My Commission Expires Oct 5, 2017
Commission expires:
CITY Ol' CHIC AGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
V P EE NT) IX
FAMILIAL RELATIONSHIPS WITH ELECTED C ITY 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-nV.tlic. Applicant,
Under Municipal Code Section 2-154-0 IS, the Disclosing,Party must disclose whether such Disclosing Party or any "Appiieabic Party"* or any Spou.se or Domesi*cPartner -thereof curretiOy has a.^fomi-ii'al;relmiou$iiip7, with any-elected city pfTioialor department head. A "familial, relationship" exists il'. as of the date this EDS is signed, the Disclosing Party or any "Applicable Party1' or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city departmeni: head as spouse or domestic partner or as any of the following, v. hether 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 of half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B. l a., if the Disclosing Party.i.s a 'corporation: all partners of the Disclosing Party, if the Disclosing Party is .a general partnership;, all gcneruJ partners and limited partners of the' Disclosing Party, if the Disclosing Part y is a liniired "parfriership:-all managers, riuinaging members and members of the Disclosing Party, if the Disclosing Parly 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 tlie 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 Parly" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head ?
1 ] Yes [vfNo
If yes. please identify below (I) the name and title of such person. (2) the name of ihe legal entity to which such person is connected: i3) the name and title of the elected city olTicial or department head to whom such person has a familial relationship, and i4) the precise nature of such familial relationship.
i
Cm OF CHICAGO ECONOMIC DISCLOSURE SI A I EMIAT AND AFFIDAVIT
APPENDIX B
lil-TI.DING CODE SCOFFLAW /PROBLEM LANDLORD CERTIFICATION
This .Appendix is to be completed only by Crt)the Applicant, and (b) any legal entity wljiclvhasa direct ownership interest in the Applicant/exceeding 7.5 percchtVfan ''OSyner"), It is not to he completed by any legal entity which has drily, an indirect ownership interest in the Applicant.
I 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'' "
2. If the Applicant is a legal entity publicly traded on any exchange, is any olTieer or director of the.Applicant identified as a building code scofflaw or problem landlord pursuant lo Section 2-92-416 of me Municipal Code''
[ j Yes || No | ?fNot Applicable
3 If yes to ( I) oi (2) above, please identify below the name of the person or legal entity
identified as a building code scofflaw or problem landlord and the address of the building or buildings to which the pertinent code violations apply
FILLING OCT 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 \ NDER PENALTY OF PKRJUIU ON PACE 12 OF I HE ASSOCIATED EDS.