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: South Chicago SA Associates, L.P._
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
1. feci the Applicant
OR
2. [ ] 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 ILB.l.) State the legal name of the entity in . which the Disclosing Party holds a right of control:_
B. Business address ofthe Disclosing Party: 701 Lee Street, Suite 500_
Pes Plaines, IL 60016_
C. Telephone: 847-768-5100 Fax: 847-635-2148 Email: j finisgPathwaySL.com
D. Name of contact person: Jerome E. Finis_
/'
E. Federal Employer Identification No. (if you have one): 20-5891111_,
F. 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):
To enter into a lease with the City of Chicago for the new South Chicago Senior Center located at 9233 S. Burley Avenue, Chicago, IL_' _
G. Which City agency or department is requesting this EDS? Department of General Services for
Department of Family and Support Service' If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A_and Contract #_
Ver. 09-01-10
Page 1 of. 13
SECTION TI - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Party:
[ ] Person [ ] Limited liability company
[ ] Publicly registered business corporation [ ] Limited liability partnership
[ ] Privately held business corporation [ ] Joint venture
[ ] Sole proprietorship [ ] Not-for-prof...
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