Record #: Or2013-353   
Type: Order Status: Passed
Intro date: 6/5/2013 Current Controlling Legislative Body: Committee on Finance
Final action: 6/5/2013
Title: Tag day permit(s) for Blue Island Citizens for Persons with Developmental Disabilities d.b.a. The Blue Cap; Chicago Fund on Aging and Disability; Hegewisch Little League; Mercy Home for Boys and Girls; and Southern Poverty Law Center
Sponsors: Burke, Edward M.
Attachments: 1. Or2013-353.pdf
PERMIT NO. 2013- 17
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:
2013-17
GROUP NAME:
Blue Island Citizens for Persons with Developmental Disabilities
 
(d/b/a Blue Cap)
ADDRESS:     1962 Broadway, Blue Island, IL 60406
TELEPHONE NUMBER:
708-389-8137
CONTACT PERSON:
A. Michael O'Connor
DATE WRITTEN REQUEST WAS RECEIVED:      May 1,2013
SOLICITATION DATE:
August 23-24, 2013
 
 
 
 
 
 
 
 
CITY COUNCIL DATE:
June 5,2013
COMPLETION OF FILE DATE:
 
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:
 
DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013
 
VIOLATION (S)
COMMITTEE LETTER SENT:
COMPLY RECEIVED:
 
 
COMMENTS:
 
 
 
APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
 
 
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
 
,      j-      •      Blue Cap Foundation, Inc.
  1. Name of organization: *
Address:      1962 Broadway, Blue Island IL 60406 Telephone Number:    708-389-8137     Ext. 801
  1. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
A. Michael Connor
Treasurer, Blue Cap Foundation, Inc. 201 Whitefawn Trail, Downers Grove, IL 60516 630-796-6161    Ext. 149
  1. List the date and approximate Iocation(s) of solicitation:
August 23 & 24 2013 Locations attached
  1. Approximately how many persons will be engaged in the solicitation?
250
 
 
5.      Explain the methods your organization will use to solicit funds:
Handing out Lemonhead candy and Tag Day cards for donation
of any size.
 
6.      Has your organization ever been allowed to solicit funds in prior years in the
City ofChicago? If so, when?
yes, August 20,21 2010,  September 30, October 1 2011, and October 5,6 2012
  1. Include the following with your application:
    1. A copy of the registration statement filed with the Attorney General of the State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
    2. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
  1. Plea's^ rficl^e "any-otheir'V'elevant information which would assist the Committee on Finance in reviewing this application.
BlSHN^ap■ serves "over "300 individuals with developmental disabilities from the City of Chicago and over 30 surrounding communities.
 
 
Chicago Locations
Rock Island RR-103rd and Longwood* Rock siandRR-107* and Longwood*
,.  !nH rr - ill* and Longwood*
 
5*1 Western - East/West/North/Sou h "western- East/West/North/South SI Western-East/West/North^outh S* 1 Kedrfe - East/West/North South 5-^d-East/West/Nort^^ 119* & Western (Walgreens with the.r perm A few Loop locations
Union Station* LaSalle Street Station*
 
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
 
 
 
 
 
 
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE.   (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
 
Signature    &^ U> ;V>g=^-      Title c^,.      Date tj.£&-&
 
 
Signature      Title      Date_
 
 
 
Signature      Title      Date_
 
HOLD HARMLESS AGREEMENT
 
 
 
 
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
 
 
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
 
 
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
 
 
 
 
Blue Cap Foundation, Inc,
Name of organization
 
 
 
 
 
Signature of organization officer
 
 
 
 
 
Date
 
BLUE CAP
 
Blue Island Citizens for Persons with Developmental Disabilities
Visit us at: www.blue-cap.org Like us on Facebook
Mission Statement Blue Cap is an organization dedicated to the discovery, pursuit and achievement of personal growth and dignity for individuals of all ages having or at risk for developmental disabilities.
 
 
 
 
Youth Services
Sunshine Kids Day Care integrates children, ages 2 to 6, with and without disabilities, in a structured and nurturing day care setting.
Early Intervention provides educational and consultant therapeutic support to children with delays and disabilities, birth to three years of age, and to their families.
School Program provides educational, therapeutic, self-help and pre-vocational services to students, 3 to 21 years of age, diagnosed with severe developmental disabilities and/or autism.
Before and After School Care provides supervised care before and after school for students of all abilities.
 
 
Adult Services
Adult Day Services offers individualized support and education to persons with developmental disabilities, 18 years and older, with an emphasis on vocational training and teaching of daily living skills.
  • A Workshop facility provides a supervised work environment in which adults with developmental disabilities are trained to do a variety of jobs contracted from local industries.
  • Supported Employment offers individualized support to adults with developmental disabilities who are interested in community job placement, while providing businesses with quality employees
  • Senior Program offers older individuals living with developmental disabilities the opportunity to retain their current life skills while embracing their golden years.
Residential offers a variety of supportive living arrangements in the community for adults with developmental disabilities.
Specialized Services offers a facilitator to support families receiving nome-based services for adults with developmental disabilities.
 
Overview of Services In 1967, Blue Cap responded to the needs of the community by providing a school program that served 28 students with developmental disabilities. Today, Blue Cap offers eight different programs which provide educational, vocational, therapeutic and residential services to more than 400 infants, children and adults. Blue Cap serves the south side of Chicago and more than 30 suburban communities.
 
 
Instructional Center (Youth Services)
1962 Broadway Blue Island, IL 60406 708/389-8137
 
Adult Services Building Main Office
2155 Broadway Blue Island, IL 60406 708/389-6578
 
FileNumber 4385-733-9
 
 
 
 
 
 
 
 
To all to Whom these Presents Shall Come, Greeting:
I, Jesse White, Secretary of State of the State of Illinois, do hereby certify that lam the keeper ofthe records of the Department of Business Services. I certify that
 
BLUE ISLAND CITIZENS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, INC., A DOMESTIC CORPORATION, INCORPORATED UNDER THE LAWS OF THIS STATE ON JANUARY 27,1964, APPEARS TO HAVE COMPLIED WITH ALL THE PROVISIONS OF THE GENERAL NOT FOR PROFIT CORPORATION ACT OF THIS STATE, AND AS OF THIS DATE, IS IN GOOD STANDING AS A DOMESTIC CORPORATION IN THE STATE OF ILLINOIS.
 
 
 
 
 
 
 
 
 
In Testimony Whereof, i hereto set
my hand and'cause to be affixed the Great Seal of
the State of Illinois, this 23rd
day of     JANUARY      AD. 2012
 
SECRETARY OF STATE
Aufremicationtf: 1202300581 . Verity at www<cyberdilvelDiBoi5.com
 
 
Illinois Department of Revenue
Office of Local Government Services Sales Tax Exemption Section, 3-520 101 W. Jefferson Street Springfield. Illinois 62702 217 782-8881
February 19, 2010
 
 
 
 
BLUE ISLAND CIT FOR PERSONS WITH DEVELOPMENTAL DISABILITIES 2155 BROADWAY
BLUE ISLAND IL 60406-3097
 
 
 
We have received your recent letter; and based on the information you furnished, we believe
BLUE ISLAND CIT FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
of
BLUE ISLAND, IL is organized and operated exclusively for charitable purposes.
Consequently, sales of any kind to this organization are exempt from the Retailers' Occupation Tax, the Service Occupation Tax (both state and local), the Use Tax, and the Service Service Use Tax in Illinois.
We have issued your organization the following tax exemption Identification number: E9988-5409-06. To claim the exemption, you must provide this number to your suppliers when purchasing tangible personal property for organizational use. This exemption may not be used by Individual members of the organization to make purchases for their individual use.
This exemption will expire on      March 1, 21015/unless you apply to the Illinois Department of Revenue for renewal at least three months prior to the expiration date.
Office of Local Government Services Illinois Department of Revenue
 
 
 
 
 
 
 
 
 
 
 
 
STS-49 (R-2/98) IL-492-3456 11-0000051
 
MKEENE
BLUEISL-Q1
 
DATE |AIM/DD/yvyy>
4/23/2013
CERTIFICATE OF LIABILITY INSURANCE
 
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
■RODUCER
luschbach Insurance Agency, Inc.
615 W. 95th Street
■O Box 5000
)ak Lawn, IL 60455-5000
CONTACT NAME:
iak. no: (708) 425-5077
 
 
NAiC#
 
 
 
1PERMIT NO. 2013- 17
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:2013-17GROUP NAME:Blue Island Citizens for Persons with Developmental Disabilities(d/b/a Blue Cap)ADDRESS:     1962 Broadway, Blue Island, IL 60406TELEPHONE NUMBER:708-389-8137CONTACT PERSON:A. Michael O'ConnorDATE WRITTEN REQUEST WAS RECEIVED:      May 1,2013SOLICITATION DATE:August 23-24, 2013CITY COUNCIL DATE:June 5,2013COMPLETION OF FILE DATE:STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013VIOLATION (S)COMMITTEE LETTER SENT:COMPLY RECEIVED:COMMENTS:
 
APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
 
 
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
 
,      j-      •      Blue Cap Foundation, Inc.
  1. Name of organization: *
Address:      1962 Broadway, Blue Island IL 60406 Telephone Number:    708-389-8137     Ext. 801
  1. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
A. Michael Connor
Treasurer, Blue Cap Foundation, Inc. 201 Whitefawn Trail, Downers Grove, IL 60516 630-796-6161    Ext. 149
  1. List the date and approximate Iocation(s) of solicitation:
August 23 & 24 2013 Locations attached
  1. Approximately how many persons will be engaged in the solicitation?
250
 
 
5.      Explain the methods your organization will use to solicit funds:
Handing out Lemonhead candy and Tag Day cards for donation
of any size.
 
6.      Has your organization ever been allowed to solicit funds in prior years in the
City ofChicago? If so, when?
yes, August 20,21 2010,  September 30, October 1 2011, and October 5,6 2012
  1. Include the following with your application:
    1. A copy of the registration statement filed with the Attorney General of the State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
    2. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
  1. Plea's^ rficl^e "any-otheir'V'elevant information which would assist the Committee on Finance in reviewing this application.
BlSHN^ap■ serves "over "300 individuals with developmental disabilities from the City of Chicago and over 30 surrounding communities.
 
 
Chicago Locations
Rock Island RR-103rd and Longwood* Rock siandRR-107* and Longwood*
,.  !nH rr - ill* and Longwood*
 
5*1 Western - East/West/North/Sou h "western- East/West/North/South SI Western-East/West/North^outh S* 1 Kedrfe - East/West/North South 5-^d-East/West/Nort^^ 119* & Western (Walgreens with the.r perm A few Loop locations
Union Station* LaSalle Street Station*
 
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
 
 
 
 
 
 
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE.   (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
 
Signature    &^ U> ;V>g=^-      Title c^,.      Date tj.£&-&
 
 
Signature      Title      Date_
 
 
 
Signature      Title      Date_
 
HOLD HARMLESS AGREEMENT
 
 
 
 
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
 
 
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
 
 
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
 
 
 
 
Blue Cap Foundation, Inc,
Name of organization
 
 
 
 
 
Signature of organization officer
 
 
 
 
 
Date
 
BLUE CAP
 
Blue Island Citizens for Persons with Developmental Disabilities
Visit us at: www.blue-cap.org Like us on Facebook
Mission Statement Blue Cap is an organization dedicated to the discovery, pursuit and achievement of personal growth and dignity for individuals of all ages having or at risk for developmental disabilities.
 
 
 
 
Youth Services
Sunshine Kids Day Care integrates children, ages 2 to 6, with and without disabilities, in a structured and nurturing day care setting.
Early Intervention provides educational and consultant therapeutic support to children with delays and disabilities, birth to three years of age, and to their families.
School Program provides educational, therapeutic, self-help and pre-vocational services to students, 3 to 21 years of age, diagnosed with severe developmental disabilities and/or autism.
Before and After School Care provides supervised care before and after school for students of all abilities.
 
 
Adult Services
Adult Day Services offers individualized support and education to persons with developmental disabilities, 18 years and older, with an emphasis on vocational training and teaching of daily living skills.
  • A Workshop facility provides a supervised work environment in which adults with developmental disabilities are trained to do a variety of jobs contracted from local industries.
  • Supported Employment offers individualized support to adults with developmental disabilities who are interested in community job placement, while providing businesses with quality employees
  • Senior Program offers older individuals living with developmental disabilities the opportunity to retain their current life skills while embracing their golden years.
Residential offers a variety of supportive living arrangements in the community for adults with developmental disabilities.
Specialized Services offers a facilitator to support families receiving nome-based services for adults with developmental disabilities.
 
Overview of Services In 1967, Blue Cap responded to the needs of the community by providing a school program that served 28 students with developmental disabilities. Today, Blue Cap offers eight different programs which provide educational, vocational, therapeutic and residential services to more than 400 infants, children and adults. Blue Cap serves the south side of Chicago and more than 30 suburban communities.
 
 
Instructional Center (Youth Services)
1962 Broadway Blue Island, IL 60406 708/389-8137
 
Adult Services Building Main Office
2155 Broadway Blue Island, IL 60406 708/389-6578
 
FileNumber 4385-733-9
 
 
 
 
 
 
 
 
To all to Whom these Presents Shall Come, Greeting:
I, Jesse White, Secretary of State of the State of Illinois, do hereby certify that lam the keeper ofthe records of the Department of Business Services. I certify that
 
BLUE ISLAND CITIZENS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, INC., A DOMESTIC CORPORATION, INCORPORATED UNDER THE LAWS OF THIS STATE ON JANUARY 27,1964, APPEARS TO HAVE COMPLIED WITH ALL THE PROVISIONS OF THE GENERAL NOT FOR PROFIT CORPORATION ACT OF THIS STATE, AND AS OF THIS DATE, IS IN GOOD STANDING AS A DOMESTIC CORPORATION IN THE STATE OF ILLINOIS.
 
 
 
 
 
 
 
 
 
In Testimony Whereof, i hereto set
my hand and'cause to be affixed the Great Seal of
the State of Illinois, this 23rd
day of     JANUARY      AD. 2012
 
SECRETARY OF STATE
Aufremicationtf: 1202300581 . Verity at www<cyberdilvelDiBoi5.com
 
 
Illinois Department of Revenue
Office of Local Government Services Sales Tax Exemption Section, 3-520 101 W. Jefferson Street Springfield. Illinois 62702 217 782-8881
February 19, 2010
 
 
 
 
BLUE ISLAND CIT FOR PERSONS WITH DEVELOPMENTAL DISABILITIES 2155 BROADWAY
BLUE ISLAND IL 60406-3097
 
 
 
We have received your recent letter; and based on the information you furnished, we believe
BLUE ISLAND CIT FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
of
BLUE ISLAND, IL is organized and operated exclusively for charitable purposes.
Consequently, sales of any kind to this organization are exempt from the Retailers' Occupation Tax, the Service Occupation Tax (both state and local), the Use Tax, and the Service Service Use Tax in Illinois.
We have issued your organization the following tax exemption Identification number: E9988-5409-06. To claim the exemption, you must provide this number to your suppliers when purchasing tangible personal property for organizational use. This exemption may not be used by Individual members of the organization to make purchases for their individual use.
This exemption will expire on      March 1, 21015/unless you apply to the Illinois Department of Revenue for renewal at least three months prior to the expiration date.
Office of Local Government Services Illinois Department of Revenue
 
 
 
 
 
 
 
 
 
 
 
 
STS-49 (R-2/98) IL-492-3456 11-0000051
 
MKEENE
BLUEISL-Q1
 
DATE |AIM/DD/yvyy>
4/23/2013
CERTIFICATE OF LIABILITY INSURANCE
 
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
■RODUCER
luschbach Insurance Agency, Inc.
615 W. 95th Street
■O Box 5000
)ak Lawn, IL 60455-5000CONTACT NAME:
ffigNNEo.E„,(708) 423-2350iak. no: (708) 425-5077
E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGENAiC#
insurer a : Philadelphia InsuranceHSURED
Blue Island Citizens For Persons With Dev Disabll & Core Association Inc 2155 Broadway Blue Island, IL 60406
insurer a: United Heartland
524210
 
 
 
 
 
 
 
 
 
 
REVISION NUMBER:
COVERAGES
CERTIFICATE NUMBER:
 
LIMITS
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.   NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
%rJ^      TYPE OF INSURANCE      POLICY NUMBER
POLICY EFF POLICY EXP (MWDP/YYYYI I (MMrQplTYYYI
 
1,000,000
7/1/2012
7/1/2013
PHPK874583
100,000
5,000
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE j X | OCCUR
EACH OCCURRENCE
DAMAGE TO RESTED      
PREMISES (Ea occurrence)
MED EXP (Any ono person)
 
1,000,000
PERSONAL & ADV INJURY
 
2,000,000
GENERAL AGGREGATE
 
2,000,000
1,000,000
7/1/2012
7/1/2013
PHPK874583
SCHEDULED AUTOS NON-OWNED AUTOS
GEN'L AGGREGATE LIMIT APPLIES PER:
[■policy       ject"   I    I '-OC
ANY AUTO ALL OWNED AUTOS
HIRED AUTOS
AUTOMOBILE LIABILITY
X X X
PRODUCTS - COMP/OP AGG
 
COMBINED SINGLE LIMIT
(Ea accident!      
BODILY INJURY (Pot poison)
BODILY INJURY (Par accident)
PROPERTY DAMAGE IPER ACCIDENT!
 
 
 
1,000,000
EACH OCCURRENCE
7/1/2012
7/1/2013
PHUB385262
1,000,000
AGGREGATE
UMBRELLA UAB EXCESS LIAS
OCCUR CLAIMS-MADE
 
 
 
 
A A
 
DED
RETENTION I
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY      y , u
AMY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatary In NH) II yes. describe under DESCRIPTION OF OPERATIONS below
Directors & Officers Commercial Property
 
2OOO003133
 
 
PHSD744949 PHPKB74583
 
 
10/1/2012
 
7/1/2012 7/1/2012
 
 
10/1/2013
 
7/1/2013 7/1/2013
 
OTH-_ER
V WC STATU-A   TORY LIMITS
E.L EACH ACCIDENT
E L DISEASE - EA EMPLOYEE
E.L DISEASE - POLICY LIMIT
D& O
Blanket Bldg/conlent
 
 
1,000,000
1,000,000
1,000,000
3,000,000 11,021,466
 
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schodide, II more spaco Is required) Tag Day August 23, 2013 and August 24, 2913
 
CANCELLATION
 
 
 
 
 
CERTIFICATE HOLDER
 
 
Blue Island Citizens For Persons w/Dev Disabilities & Core Association, Inc. 2155 Broadway Blue Island, IL 60406
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS.
 
AUTHORIZED REPRESENTATIVE
 
 
© 1988-2010 ACORD CORPORATION. All rights reserved.
 
20
PERMIT NO. 2013-
 
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:
2013-20
GROUP NAME:
The Chicago Fund on Aging & Disability
 
d/b/a Meals on Wheels Chicago
ADDRESS:     3047 North Lincoln Avenue, Suite 214, Chicago, IL 60657
TELEPHONE NUMBER:
773-661-4550
CONTACT PERSON:
Andrew Seibert
DATE WRITTEN REQUEST WAS RECEIVED:      May 20,2013
SOLICITATION DATE:
June 20, 2013
 
 
 
 
 
 
 
 
CITY COUNCIL DATE:
June 5, 2013
COMPLETION OF FILE DATE:
 
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:
 
DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013
 
VIOLATION (S)
COMMITTEE LETTER SENT:
COMPLY RECEIVED:
 
 
COMMENTS:
 
 
 
APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
 
(Please neatly print or type. If necessary in answering an question, please attach additional sheets.)
  1. Name of Organization & Contact Information
The Chicago Fund on Aging & Disability D/B/A: Meals on Wheels Chicago 3047 North Lincoln Avenue, Suite 214 Chicago, IL 60657-4999 Phone: 773.661.4550 Contact: Andrew Seibert
  1. List of Officers in the Organization (w/ residence addresses and phone numbers)
President       Chandra Ram
2635 W Lawrence, Unit 4A, Chicago, IL 60625
773.580.5874 Vice President Christopher Campbell
401 10th Street, Wilmette, IL 60009
312.396.7660 Vice President Michelle Covington
4824 North Hoyne Avenue, Chicago, IL 60625
630.946.9636 Treasurer       Justine Knizeski
8841 North Laramie Avenue, Skokie, IL 60077
312.938.4209 Secretary        Kimberly Taylor
1712 West 91st Street, Chicago, IL 60620
312.746.5704
  1. Date & Location(s) of Solicitation
Thursday, June 20, 2013 See attached list of locations.
  1. Approximate Number of Persons Engaged in Solicitation: 60
  2. Methods used to Solicit Funds
Volunteers will stand on sidewalks and ask for donations on behalf of the organization. Individuals making a contribution will receive a box of candy.
  1. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago?
Yes (June 22, 2012 & Sept 14, 2012).
  1. Include the following with your application:
    1. A copy of the Exemption issued by the Attorney General of the State of Illinois
    2. A copy ofthe tag,lbadge;i emblem -which, will be distributed as part ofthe solicitation
  1. Please include any other refev^rit information tf&cri would assist the Committee on Finance in reviewing this application.
See attached information on the organization.
 
 
APPLICATION MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATER THAN 30 DAYS PROIR TO THE COMMENCEMENT OF THE SOLICITATION.
 
 
 
 
I/WE THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
 
 
Date: P^/lf/l'S
Date:      
 
Signature:            Title:       Date:
 
HOLD HARMLESS AGREEMENT
 
The undersigned offer on behalf of the organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
 
The subject organization assumes full responsibility for the risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
The officer ofthe subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
 
Approximate Locations for Solicitation
Meals on Wheels Chicago - June 20, 2013
  1. Michigan Avenue & Wacker Drive - Northwest Corner
  2. Michigan Avenue & Wacker Drive - Southeast Corner
  3. Michigan Avenue & Wacker Place - Northwest Corner
  4. Michigan Avenue & Wacker Place - Southeast Corner
  5. Michigan Avenue & Lake Street - Northwest Corner
  6. Michigan Avenue & Lake Street - Southeast Corner
  7. Michigan Avenue & Randolph Street - Northwest Corner
  8. Michigan Avenue & Randolph Street - Southeast Corner
  9. Michigan Avenue & Washington Street - Northwest Corner
  10. Michigan Avenue & Washington Street - Southeast Corner
  11. Michigan Avenue & Madison Street - Northwest Corner
  12. Michigan Avenue & Madison Street - Southeast Corner
  13. Michigan Avenue & Monroe Street - Northwest Corner
  14. Michigan Avenue & Monroe Street - Southeast Corner
  15. Michigan Avenue & Adams Street - Northwest Corner
  16. Michigan Avenue & Adams Street - Southeast Corner
  17. State Street & Lake Street - Northwest Corner
  18. State Street & Lake Street - Southeast Corner
  19. State Street & Randolph Street - Northwest Corner
  20. State Street & Randolph Street - Southeast Corner
  21. State Street & Washington Street - Northwest Corner
  22. State Street & Washington Street - Southeast Corner
  23. State Street & Madison Street - Northwest Corner
  24. State Street & Madison Street - Southeast Corner
  25. State Street & Monroe Street - Northwest Corner
  26. State Street & Monroe Street-Southeast Corner
  27. State Street & Adams Street - Southeast Corner
  28. Clark Street & Lake Street - Northwest Corner
  29. Clark Street & Lake Street - Southeast Corner
  30. Clark Street & Randolph Street - Northwest Corner
 
  1. Clark Street & Randolph Street - Southeast Corner
  2. Clark Street & Washington Street - Northwest Corner
  3. Clark Street & Washington Street - Southeast Corner
  4. Clark Street & Madison Street - Northwest Comer
  5. Clark Street & Madison Street - Southeast Corner
  6. Clark Street & Monroe Street - Northwest Corner
  7. Clark Street & Monroe Street-Southeast Corner
  8. Clark Street & Adams Street - Northwest Corner
  9. LaSalle Street & Lake Street - Northwest Corner
  10. LaSalle Street & Lake Street - Southeast Corner
  11. LaSalle Street & Randolph Street - Northwest Corner
  12. LaSalle Street & Randolph Street - Southeast Corner
  13. LaSalle Street & Washington Street - Northwest Corner
  14. LaSalle Street & Washington Street - Southeast Corner
  15. LaSalle Street & Madison Street - Northwest Corner
  16. LaSalle Street & Madison Street - Southeast Corner
  17. LaSalle Street & Monroe Street - Northwest Corner
  18. LaSalle Street & Monroe Street - Southeast Corner
  19. LaSalle Street & Adams Street - Southeast Corner
  20. LaSalle Street & Lake Street - Northwest Corner
  21. LaSalle Street & Lake Street - Southeast Corner
  22. LaSalle Street & Randolph Street - Northwest Corner
  23. LaSalle Street & Randolph Street - Southeast Corner
  24. LaSalle Street & Washington Street - Northwest Corner
  25. LaSalle Street & Washington Street - Southeast Corner
  26. LaSalle Street & Madison Street - Northwest Corner
  27. LaSalle Street & Madison Street - Southeast Corner
  28. LaSalle Street & Monroe Street - Northwest Corner
  29. LaSalle Street & Monroe Street - Southeast Comer
  30. LaSalle Street & Adams Street - Northwest Corner
 
 
OFFICE OF THE ATTORNEY GENERAL
May 10, 2012      STATE OF ILLINOIS
 
Lisa Madigan
ATTORNEY GKNKRAL
THE CHICAGO FUND ON AGING AND DISABILITY D/B/A MEALS ON WHEELS CHICAGO
1 NORTH LASALLE STREET CHICAGO, IL 60601
RE: RE: Status of THE CHICAGO FUND ON AGING AND DISABILITY D/B/A MEALS ON WHEELS CHICAGO under the Illinois Charitable Laws CO# 01021950
Dear Registrant:
This letter is pursuant to your request that the Attorney General confirm the status of THE CHICAGO FUND ON AGING AND DISABILITY D/B/A MEALS ON WHEELS CHICAGO under the Charitable Organization Laws.
 
This organization is currently registered with the Attorney General's Charitable Trust and Solicitations Bureau as CO# 01021950.  It is current in the filing of its financial reports, having filed its report for the period ended December 31, 2010.  Please let us know if you require further information.
 
Sincerely,
 
Takiyah Martin Barnes, Compliance Officer
Charitable Trusts Bureau
100 West Randolph Street. 11th Floor
Chicago, Illinois 60601
Telephone:  (312) 814-2595,
 
File Number 5476-154-6
 
 
 
 
 
 
 
 
To all to whom these Presents Shall Come, Greeting:
 
 
I, Jesse White, Secretary of State of the State of Illinois, do hereby certify that
THE CHICAGO FUND ON AGING AND DISABILITY, A DOMESTIC CORPORATION, INCORPORATED UNDER THE LAWS OF THIS STATE ON AUGUST 10, 1987, APPEARS TO HAVE COMPLIED WITH ALL THE PROVISIONS OF THE GENERAL NOT FOR PROFIT CORPORATION ACT OF THIS STATE, AND AS OF THIS DATE, IS IN GOOD STANDING AS A DOMESTIC CORPORATION IN THE STATE OF ILLINOIS.
 
 
 
 
 
 
 
 
In Testimony Whereof, i hereto set
my hand and cause to be affixed the Great Seal of
the State of Illinois, this   11TH
day of      JULY      A.D. 2011
Authentication #: 111 9202028 Authenticate at: http://www.cyberdriveillinois.com
SECRETARY OF STATE
 
 
PERMIT NO. 2013-18
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:
2013-18
GROUP NAME:
Hegewisch Little League
 
 
ADDRESS:     12700 S. Carondolet, Chicago, IL 60633
TELEPHONE NUMBER:
773-573-6554
CONTACT PERSON:
Chris Banks
DATE WRITTEN REQUEST WAS RECEIVED:      May 1, 2013
SOLICITATION DATE:
June 13-14, 2013
 
 
 
 
 
 
 
 
CITY COUNCIL DATE:
June 5, 2013
COMPLETION OF FILE DATE:
 
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:
 
DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013
 
VIOLATION (S)
COMMITTEE LETTER SENT:
COMPLY RECEIVED:
 
 
COMMENTS:
 
 
 
V
 
APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
 
 
 
(Please neatly print or type. In necessary in answering anv^njicsrlqiijf pjjsftfpgittach
additional sheets.)   WrTl iV- ::
mi *m i i p °.: s ■
.1.        Nameof organization: ^tj^ioiSc/) Lrj-fl< le^ue Address:   H7oo    S ■ C c-ro^'^t Telephone Number:  -p. $ 73.- 6^-^
2.      Use the space below to list names, current positions, residence addresses and
telephone numbers of the officers in the organization:      .      T t . ?J3 i?73 L;$3'-
Ton        A */<.-   ir.-c, /V^Q,,^,  ni" tiv'T^i^ic
  1. List the date and approximate localion(s) of solicitation:
 
 
/,31c, 7'1  ro (3 7 rn
  1. Approximately how many persons will be engaged in the solicitation?
  2. Explain the methods your organization will use to solicit funds:
  3. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when? / c\i ,   -3 & ' A
  1. Include the following with your application:
    1. A copy ofthe registration statement filed with the Attorney General ofthe State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
    2. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
  1. Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
 
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
 
Si xes^
Signa iuv&l^j/f^!_'
 
■ '/>//*
Title   I/ICC -/f^S/P^T^x/li, I,
Signature
 
 
 
 
 
 
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE.    (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
Date
 
 
].■■'''" r      '      \
Signature QeX--^- >1 V ^O^-ia. c\_   Title / /U^-<^^Ajl/i
 
f
HOLD HARMLESS AGREEMENT
 
 
 
 
 
1.      The undersigned officer on behalf of the subject organization agrees to
defend, indemnifys save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
 
 
2.       The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
 
 
3.      The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
e c.^; j e
 
Name of organization
 
 
Signature of organization officer
 
 
 
 
 
 
J% Illinois Department of Revenue
It^-lfi  Office of Local Government Services ^&fj  Sales Tax Exemption Section, 3-520 '$&rf   101 W. Jefferson Street
Springfield, Illinois 62702
217 782-8881
February   8, 2013
 
 
 
 
HEGEWISCH LITTLE LEAGUE JENNIFER BANKS 12700 SOUTH CARONDOLET AVE HEGEWISCH IL 60633
 
 
 
 
We have received -your recent-letter; and~based on the informatibn youfurnished, we bel ieve
HEGEWISCH LITTLE LEAGUE Of
HEGEWISCH, IL
is organized and operated exclusively for charitable purposes.
Consequently, sales of any kind to this organization are exempt from the Retailers' Occupation Tax, the Service Occupation Tax (both state and local), the Use Tax. and the Service Use Tax in Illinois.
We have issued your organization the following tax exemption identification number: E9971-0013-05.   To claim the exemption, you must provide this number to your suppliers when purchasing tangible personal property for organizational use.   This exemption may not be used by individual members of the organization to make purchases for their individual use.
This exemption will expire on       March 1, 2018, unless you apply to the Illinois Department of Revenue for renewal at least three months prior to the expiration date.
Office of Local Government Services Illinois Department of Revenue
 
 
 
 
 
 
 
 
 
 
 
 
STS-49 (R-2/98) IL-492-3456 11-0000078
 
 
PERMIT NO. 2013-21
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:
2013-21
GROUP NAME:
Mercy Home for Boys and Girls
 
 
ADDRESS:     1140 W. Jackson Blvd., Chicago, IL 60607
TELEPHONE NUMBER:
312-738-7560
CONTACT PERSON:
Rev. Scott Donahue
DATE WRITTEN REQUEST WAS RECEIVED:      May 20, 2013
SOLICITATION DATE:
July 1,2013 through December 31,2013
 
 
 
 
 
 
 
 
CITY COUNCIL DATE:
June 5, 2013
COMPLETION OF FILE DATE:
 
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:
 
DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013
 
VIOLATION (S)
COMMITTEE LETTER SENT:
COMPLY RECEIVED:
 
 
COMMENTS:
 
 
 
APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
 
 
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
 
 
Name of organization:  Mercy Home for BoYs & Girls
 
Address: 1140 W. Jackson Blvd. Chicago, IL 60607
Telephone Number: 312-738-7560 .
 
Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
 
 
SEE ATTACHED.
  1. List the date and approximate location(s) of solicitation: Solicitation will begin July 1, 2013 -/kfetW 31,^?OJ£
In the Chicago city limits, including the Loop and neighboring neighborhoods within the Chicago city address.
  1. Approximately how many persons will be engaged in the solicitation?
Approximately 6-7 persons.
  1. Explain the methods your organization will use to solicit funds:
Face to face marketers, identified by aprons will ask individual people to donate to Mercy Home.
The marketers will have binders with information on the Home to share with interested persons. Donation will be
accepted electronically or through paper and pen.
  1. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when?
Yes, in 2010 and 2011 the Finance Committee granted a charitable solicitation permit for the Face-to-Face marketing campaign.
  1. Include the following with your application:
    1. A copy of the registration statement filed with the Attorney General ofthe State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
    2. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
  1. Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
Mercy Home is 99% privately funded, receiving no church or government monies. The face-to-face, canvassing and pin distributions are critical components to our our fundraising - allowing us to raise much needed support to continue to provide a solution for kids in crisis.
 
 
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
 
 
 
 
 
 
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE.   (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
 
 
 
Signature ^Lx ■ (^^^'■^^jgTt^^T^Ie   President      Date 5/12/13
 
 
Signature      Title      Datc_
 
 
 
Signature      Title      Date_
 
HOLD HARMLESS AGREEMENT
 
 
 
 
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
 
 
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
 
 
The officer ofthe subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
 
 
 
Mercy Home for Boys & Girls Name of organization
 
Signature of organization officer
 
 
 
 
May 13, 2013
Date
 
Mission of Our Lady of Mercy, Inc. Mercy Home for Boys & Girls Organization Officers
 
 
CHAIRMAN Durrvl G. Schimeck
1137 Kenilworth Napervilk. IL 60540
(630)416-9447
 
PRESIDENT
1 Vw * .      .   J V, V.1 L L   L-S \Ji Idk l _i v.
Merc> Home for Boys and Girls 1140 W. Jackson BKd. Chicago. IL 6060" (3l2j 738-7560
 
SECRETARY Mary Pat Hay
20 E. Cedar St. Chicago, II. 605T i 312.1 337-4035
 
TREASURER Robert Greco
3416 N Seeks A\e. Chicago. IL 60618 312*834-0980
 
JggJ^ Illinois Department of Revenue
0^$^J>Ai>\   Office of Local Government Services li y^^jSil^y     Sal2» Tax Exemption S-action, 3-52C
101 W. Jefferson Street
Springfield, Illinois 62702
217 782-8881
May 21, 2010
 
 
 
 
CHERYL MURPHY
MERCY HOME FOR BOYS L GIRLS 1140 W JACKSON BLVD CHICAGO IL 60607
 
 
 
VVa have received your recent letter; and based cn the information you furnished, wja believe
MISSION OF OLJR LADY OF MERCY INC DBA MERCY HOME FOR BOYS £< G
of
CHICAGO, IL
is organized and operated exclusively for   religious purposas.
Consequently, sales of any kind to this organisation are exempt from the Retaiiers' Occupation Tax, the. Service Occupation Tax (both state and local), the Use Tax, and the Service Use Tax in Illinois.
We have issued your organization the following tax exemption identification number: E9956-8756-04.   To claim the exemption, you must provide this number to ycur suppliers when purchasing tangible personal property for organizational use.   This exemption may not be used by individual members of the organization to make purchases for their individual use.
This exemption will expire on      June 1, 2015, unless you apply to the Illinois Depart-
ment of Revenue for renewal at least three months prior to the expiration date.
Office of Local Government Services Illinois Department of Revenue
 
 
 
 
 
 
 
 
 
 
 
$"5-49 \R-2:9 c) " i - C \J C C" 0 7 -z
 
 
OFFICE OF THE ATTORNEY GENERAL
October 31,2012      STATE OF ILLINOIS
 
MISSION OF OUR LADY OF MERCY A/K/A MERCY HOME FOR BOYS AND GIRLS 1140 WEST JACKSON BOULEVARD CHICAGO, IL 60607
Lisa Madigan
ATTORNEY GENERAL
 
RE:  RE: Status of MISSION OF OUR LADY OF MERCY A/K/A MERCY HOME FOR BOYS AND GIRLS under the Illinois Charitable Laws CO# 01031077
Dear Registrant:
This letter is pursuant to your request that the Attorney General confirm the status of MISSION OF OUR LADY OF MERCY A/K/A MERCY HOME FOR BOYS AND GIRLS under the Charitable Organization Laws.
 
This organization is currently registered with the Attorney General's Charitable Trust and Solicitations Bureau as CO# 01031077, and has received a religious exemption from filing annual financial reports with our office. Please let us know if you require further mformation.
Sincerely,
 
Charitable Trusts Bureau 100 West Randolph Street, 11th Floor Chicago, Illinois 60601 Telephone:  (312) 814-2595
 
PERMIT NO. 2013-19
COMMITTEE ON FINANCE CHARITABLE SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
 
PERMIT NUMBER:
2013-19
GROUP NAME:
Southern Poverty Law Center, Inc.
 
 
ADDRESS:     400 Washington Avenue, Montgomery, AL 36104
TELEPHONE NUMBER:
334-956-8349
CONTACT PERSON:
J. Richard Cohen
DATE WRITTEN REQUEST WAS RECEIVED:      May 1,2013
SOLICITATION DATE:
June 10, 2013 through September 21, 2013
 
 
 
 
 
 
 
 
CITY COUNCIL DATE:
June 5, 2013
COMPLETION OF FILE DATE:
 
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:
 
DATE PERMIT LETTER WAS SENT TO ORGANIZATION:           June 5, 2013
 
VIOLATION fS)
COMMITTEE LETTER SENT:
COMPLY RECEIVED:
 
 
COMMENTS:
 
 
 
APPLICATION TOR CTIY OF CHICAGO CHAOTJAHT.3S SOUCCPATTON HERMIT
 
(Please neatly print ca: type. If necessary in answering any question, please attach other sheets.)
  1. Name of organization: Southern Poverty Law Center, Inc.
400 Washington Avenue Address:    Montgomery, AL 36104
Telephone Number: 334-956-8349
  1. Use trie space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
J. Richard Cohen, President & CEO      Teenie Hutchison, Secretary/Treasurer
702 Cloverdale Road      1468 Charleton Drive
Montgomery, AL 36106      Montgomery, AL 36106
334-956-8200 334-956-8349
  1. List the date and a^roximate location (s) of solicitation?
May CO Aul)uj101, 2019
  1. TApproxinvitely how many persons will be engaged in the solicitation?
8-10 person
  1. Explain the iivathods your organization will use to solicit funds;
Speaking to potential donors at busy public locations by explaining the goals ofthe organization and any current objectives locally or nationally.
  1. Was your organization ewxr allowed to fjoliait funds in prior years in the city of Chicago?  If so, when?
Yes, through telemarketing, 2008 - current
  1. Include the following with your application:
    1. A copy of the registration stateamarrfc filed with Hie Attorney General of the State of Illinois; or exeiij±iori issued by the Attorney General of the State of Illinois.
    2. A facsimile of the tag, badge, emblem or other token (if any) wMch will be distributed as part of the solicitation., or which will be used by your organization in its solicitation.
  1. Please imlude any other relevant information which would assist the Ocsnaxlttee on Finance in reviewing this application.
 
APPUCAHiCNS MOST BE RECEIVED BY THE CTWHTHEE ON FINANCE NO IATJER THAN 30 DAYS PRIOR TO THE OXM1ENCMENT OF THE SOLICITATION.
 
Signature
 
Title President/CEO      ^te 4^72013
-HJgJL^ A^O tlAW--- Title Secretary/Treasurer      4j^>01 3
Signa
 
 
 
 
I/WE, OFFICER(S) OF THE ABOVE NAMED OBGANIZAIICH, CERTIFY THAT IHE INFtORMAIION BURNISHED IN THIS STAIEMEfff AND ALL ATTACKED SHEETS IS TRQE AND CORRECT TO HIE BEST OP MY/OOR KNOWLEDGE.    (NOTE: AT LEAST ONE OFFICER OF THE CS9GANIZATI0N MUST SIGN AND VERIFY. TEES APPLICATION.)
 
HOLD HARMLESS AGREEMENT
 
 
 
The undersigned officer on behalf ofthe subject organization agrees io defend, indemnity, save and hold harmless the Ciiy ofChicago ibr any loss, liability, damage or cost which the City may incur due ;q the presence of volunteers ofthe subject organization on City premises for ttie purpose o f charitable solicitations.
 
 
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
 
The officer ofthe subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
 
 
Southern Poverty Law Center,
Name of organization
 
Signature of organization officer
 
 
04^2013      
Daw
 
USE OP PUBLIC WAYS AND PLACES
 
the public ways within any zone of quiet established in accordance with this chapter, is hereby declared to be a nuisance, and is hereby prohibited. (Prior code § 36-7)
 
 
ARTICLE II. CHARITABLE SOLICITATION
 
10-8-080 Permit required.
No person shall solicit or collect contributions of funds for charitable purposes upon any portion of the public way without first having obtained a permit for auch purpose from the committee on finance,
(Prior code § 36-8; Added. Coun. J. 12-18-84, p. 12O04)
 
10-8-090 Permit—Issuance requirements.
No permit for solicitation of charitable contributions on the public way shall be issued to any person unless such person is either (a) a benevolent, phil-antliropic, patriotic or eleemosynary organization registered and in good standing with the Attorney General of the State of Illinois under "An Act to regulate solicitation and collection of funds for charitable purposes, providing' for violations thereof, and making appropriations therefor," effective July 26, 1963, as amended; or (b) an organization exempt from compliance with said Act pursuant to section 3 thereof, as amended.
(Prior code § 36-9; Added. Coun. J. 12-18-64, p. 12004)
 
10-8-100 Application.
Application for a charitable solicitation permit shall be made on a form issued by committee on finance. The application uhall include the namo, address and telephone number of the soliciting organization; proof of registration and goad standing, or proof of initial registration and exemption as described in Section 10-8~G80(b) of this code, issued by the Attorney General of tho State of Illinois; the names, residence addresses and telephone numbers of the officers of the organization; the dates and locations of the solicitation; the approximate number of persons engaging in the solicitation; a description, or facsimile of the tag, badge, emblem or other token (if arty) which will be distributed art part of the solicitation; and such other information as the committee on finance may require. Application for a charitable solicitation permit shall be made no less
10*130
 
than 30 days before the commencement ofthe solicitation. The application shall be signed and verified by at least one officer of the organization. (Prior code § 36-10; Added. Coun. J. 12-18-84, p. 12004)
10-8-110 Application—Committee nation.
The committee on finance shall review each application for a charitable solicitation permit at the first meeting following filing of the application. The committee may continue tho hearing on an application if additional proceedings are necessary to determine the applicant's compliance with the requirements of this chapter. If all requirements have not been met, the committee shall deny the application and shall notify tho applicant of its decision and the grounds therefor. Notice ofthe denial shall be sent by mail, addressed to the applicant at the address stated in the application- All decisions of the committee shall be reported to the city council at the next regular meeting thereof. (Prior code § 36-11; Added. Coun. J. 12-18-84, p. 12004)
1.0-8-120 Date and location. conJliots—Preference giv«n when.
If more than one organisation appliee for a permit to solicit charitable contributions on the same date and at the same location, the committee on finance shall resolve the conflict. Preference shall be given to organizations whose fundraising activities are well recognized, ao as to promote the efficiency and coordination of such activities, Any organization which has engaged in solicitation of charitable contributions on the public way in the name maimer and at the same approximate time of year for five consecutive yeare shall be permitted to select its dates one year in advance of actual solicitation. The committee may offer alternate dateB and/or sites an a means of resolving conflicts. (Prior code § 30-12; Added. Coun. J. 12-18-84, p. 12004)
10-8-1S0 Permit legend.
A charitable solicitation permit shall bear the legend "City of Chicago Charitable Solicitation Permit" and shall state the name ofthe organization to which it is issued and the dates and places of the permitted solicitation. Each permit shall bo sequentially numbered to indicate the year of its issuance and the number of permits then outstanding. Each permit shall be signed by the chairman of the committee on finance.
(Prior code § 36-18; Added. Coun. J. 12-18-84, p, 12004)
 
 
T10:9
 
 
lO-tWIO
CHICAGO MUNICIPAL CODE
 
10-8-140 Display of information.
Each person who engages in the solicitation of charitable contributions on the public way shall display on his person a tag or card no smaller than two inches by four inche3, indicating the name of his organization to which tho permit is issued, the facsimile of the permit may be used instead of the tag or card, Each charitable organization must sup* ply those persons soliciting on city streets on their behalf with reflective vests, unless the organization restricts the hours of their solicitation from 8:00 a.m. to 4:00 p.m.
(Prior code § 36-14; Added. Coun. J. 12-18-84, p. 12004; Amend Coun. J. 9-10-97, p. 62407)
10-8-150 Statement to be filed.
Each organization which receives a charitable solicitation permit pursuant to chapter shall, within 60 days after the completion of the activities conducted under the permit, file with the committee on finance a statement of all receipts and disbursements from such activities,
(Prior code § 36-16; Added. Coun. J. 12-18-84, p. 12004)
10-8-16O Committee on finance—Rule adoption.
Tht) committee on finance may adopt rules and regulations consistent with the provisions of this chapter governing the solicitation of charitable contributions on tho public way. The rules and regulations that have been adopted by the committee on finance are as follows:
1) The charitable organization must be registered with the Charitable Trust Division of the Illinois Attorney General's office as a not-for-profit corporation. 2.) Prior to issuance of the permit the charitable organiza- . tion must sign an agreement whereby the organization agrees to indemnify and hold harmless the city, its officers, employees and agents from any and all claims, suits or damages arising from their ubo of the public way to solicit funda. Prior to all soliciting the charitable organization must furniah the committee on finance with an original certificate of insurance evidencing that the organization has procured commercial liability insurance or the equivalent for bodily injury, personal injury and. property damage for the dates on which tho organisation will be soliciting. The City of Chicago is to be named as an additional infiurad, without recourse or right of contribution for any liability aris-
ing from these services. 3.) Persons under tho age of 16 shall be prohibited from soliciting on city streets. 4.) Soliciting on city streets will be allowed only at intersections where vehicles must come to a complete stop and only when those vehicles have come to a complete stop.
2) Prior to issuance ofthe permit the charitable organization must sign an agreement whereby the organization agrees to indemnify and bold harmless, the city, its officers, employees and agents from any and all claims, suits or damages arising from their use of the public way to solicit funds,
S) Prior to soliciting the charitable organization must furnish the committee on finance with an original Certificate of Insurance evidoncing that the organization has procured commercial liability insurance or the equivalent for bodily injury, personal injury, and property damage for the dates on which the organization will be soliciting. The City of Chicago is to be named as an additional insured, without recourse or right of contribution for any liability arising from these services. Upon receipt of the Certificate of Insurance the committee on finance will place the certificate on file with the risk manager in the department of finance.
  1. Persona under the age of sixteen shall be prohibited from soliciting on oity streets.
  2. Soliciting.on city streets will be allowed only at intersections where vehicles must come to a complete stop and only when those vehicles have come to a complete stop,
(Prior code § 36-16; Added. Coun. J. 12-18-84, p. 12004; Amend Coun. J. 9-10-97, p, 52407; Amend Coun. J. 4-29-98, p. 66277)
10-8-170 Violation—Penalty—Corporation counsel to institute action.
Any person who violates any provision of this chapter relating to solicitation of charitable contributions on the public way shall be fined not more than $600.00. Each day that a violation is committed shall be considered a separate and distinct offense. Any charitable organization that violates any provision of this chapter relating to solicitation of charitable contributions, on the public way shall have their privileges suspended for a period of one year. Any chaiitable organization that violates any provision of this chapter a second time shall have their privileges suspended for a second year. Any charitable organization that violates any provision
 
TIO'.IO
 
USB OP PUBLIC WAYS AND PLACES 10-8-280
 
of this chapter a third time shall be prohibited from soliciting charitable contributions on the public way. The corporation counsel, upon learning of violations ofthe provisions of this chapter relating to solicitation of charitablo contributions of the public way, may institute an action in the appropriate court to seek an injunction against such violation in addition to the fines authorized by this section. (Prior code § 36-17; Added. Coun. J. 12-18-84, p. 12004; 1-23-85, p. 12746; Amend Coun. J. 9-10-97, p. 52407)
 
 
ARTICLE HI. REQUIREMENTS AND RESTRICTIONS
 
10-8-180 Snow and ice removal.
Every owner, leasee, tenant, occupant or other person having cbarge of any building or lot of ground in the city abutting upon any public way or public place shall remove the enow and ice from the sidewalk in front of such molding or lot of ground.
If the sidewalk fa of greater width than five feet, it shall not be necessary for such person tp remove snow and ice from the same for a space widor than five foot.
In case the aaow and ice on the sidewalk shall bo frozen ao hard that it cannot be removed without injury to the pavement, the person having charge of any building or lot of ground as aforesaid shall, within tho time specified, cause the side-walk abutting on the said premises to be strewn with ashes, sand, sawdust, or some similar suitable material, and shall, as soon thereafter as the weather shall permit, thoroughly clean said Bidewnlk.
Tho snow which falls or accumulates during the day (excepting Sundays) before four p.m. shall be removed within three hours after the same has fallen or accumulated. The snow which falla or accumulates on Sunday or after four p.m. and during the night on other days shall be removed before ten a.m.
(Prior code § 36-19)
 
10-8.100 Liability for civil damages.
Any person wbo removes snow or ice from tho public sidewalk or street, ahall not, as a result of hia acts or omissions in such removal, be liable for civil damages. This section does not apply to acta or omiasionfl amounting to wilful or wanton misconduct in such snow or ice removal, (Prior code § 36-20)
10-8-200 Loading and unloading from alleys,
EvBry building which faces or abuts upon a public alley where freight, gooda and other commodities are loaded or unloaded through roar doors onto and from any vehicle, shall be equipped with a movable, rolling, folding or collapsible platform, 30 that such vehicle may stand parallel with the building from which said loading or unloading is done; provided, however, that whenever It may not be practical io load or unload any vehicle when thus placed in a parallel position to any building by Teason of large, bulky, unwieldy or cumbersome freight, goods, or other commodities required to be loaded or unloaded, such vehicle may then be placed in a crosswise or cross-alley position.
Whenever the work of loading or unloading such freight goods or other commodities onto or from any vehiole from such platform is completed, such movable, rolling, folding or collapsible platform ahall be removed into the building from which the loading or uidoading was done, (Prior code § 36-21)
10-8-210 House moving.
No owner of any building or contractor for its removal ahall permit the same to be or remain in . any of the public ways or the public grounds of the city for any time longer than may be specified in the permit of the commioaioner of buildings, Every 24 hours such building shall so remain in any Buch public way or public grounds shall constitute a separato and distinct offense, (Prior code § 36-22)
1.0-8-220 Conveying loose materials,
Any person who shall transport upon any public way crushed stone, sand, gravel, sawdust, ashes, cinders, limo, fcunbarks, shavings, waatepaper, ice, mortar, earth, rubbish, manure or other loose material likely to sift, fall or be blown upon the public way, shall convey the same in tight wagon boxeB, and in case the same fall or become scattered in any public way, such person shall cause such fallen substance to bo forthwith removed. (Prior code § 86-23)
10-8-230 Overloading vehicles.
No person shall overload or cause to be overloaded any cart, trucks, wagon, or other vehide in such a manner that the contents or any part thereof shall be scattered in any public way or other public place in the city. It shall be the duty of every person in charge, possession or control of any cart, truck,