RESOLUTION CLASS 6(B) REAL ESTATE TAX INCENTIVE FOR THE BENEFIT OF MARKET PROPERTIES INCORPORATED, AN ILLINOIS CORPORATION, AND REAL ESTATE LOCATED GENERALLY AT 501 NORTH SACRAMENTO BOULEVARDIN CHICAGO, ILLINOIS
PURSUANT TO COOK COUNTY, ILLINOIS REAL PROPERTY ASSESSMENT CLASSIFICATION ORDINANCE
WHEREAS, the Cook County Board of Commissioners has enacted the Cook County Real Property Assessment Classification Ordinance, as amended from time to time (the "Ordinance"), which provides for, among other things, real estate tax incentives to property owners who build, rehabilitate, enhance and occupy property which is located within Cook County and which is used primarily for industrial purposes; and
WHEREAS, the City of Chicago (the "City"), consistent with the Ordinance, wishes to induce industry to locate and expand in the City by supporting financial incentives in the form of property tax relief; and
WHEREAS, Market Properties Incorporated, an Illinois corporation (the "Applicant") owns certain real estate located generally at 501 North Sacramento Boulevard, Chicago, Illinois 60612, as further described on Exhibit A hereto (the "Subject Property"); and
WHEREAS, the Applicant intends to rehabilitate an existing approximately 492,000 square foot industrial facility located on the Subject Property that was vacant between August 2009 and January 2014 to be leased to food-service companies (the "Facility"); and
WHEREAS, Dennis Wholesale Foods, Inc., an Illinois corporation, has leased approximately 280,000 square feet of the Facility; and
WHEREAS, the Applicant has filed with the Office of the Assessor of Cook County (the "Assessor") an eligibility application for a Class 6(b) tax incentive under the Ordinance; and
WHEREAS, the Subject Property is located within (i) the City of Chicago Enterprise Zone No. 4 (created pursuant to the Illinois Enterprise Zone Act, 20 ILCS 665/1 et seq., as amended, and pursuant to an ordinance enacted by the City Council of the City, as amended), and (ii) the Kinzie Industrial Corridor Redevelopment Project Area (created pursuant to the Illinois Tax Increment Allocation Redevelopment Act, 65 ILCS 5/11-74.4-1 et. seg., as amended, and pursuant to an ordinance enacted by the City Council of the City), and thepurposes of the Enterprise Zones and Redevelopment Project Areas are also to provide certain incentives in order to stimulate economic activity and to revitalize depressed areas; and
WHEREAS, it is the responsibility of the Assessor to determine that an application for a Class 6(b) classification or renewal of a Class 6(b) classification is eligible pursuant to the Ordinance; and
WHEREAS, the Ordinance requires that, in connection with the filing of a Class 6(b) eligibility application with the Assessor, the applicant must obtain from the municipality in which such real estate that is proposed for Class 6(b) designation is located a resolution expressly stating that the
1
municipality has determined that the incentive provided by Class 6(b) is necessary for development to occur on such real estate and that the municipality supports and consents to the Class 6(b) classification by the Assessor; and
WHEREAS, the intended use of the Subject Property will provide significant present and future employment; and
WHEREAS, notwithstanding the Class 6(b) status of the Subject Property, the redevelopment and utilization thereof will generate significant new revenues to the City in the form of additional real estate taxes and other tax revenues; now therefore,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1: That the City determines that the availability of the Class 6(b) incentive is necessary for the development to occur on the Subject Property.
SECTION 2: That the City supports and consents to the Class 6(b) classification by the Assessor with respect to the Subject Property.
SECTION 3: That the Clerk of the City of Chicago is authorized to and shall send a certified copy of this resolution to the Office of the Cook County Assessor, Room 312, County Building, Chicago, Illinois 60602 and a certified copy of this resolution may be included with the Class 6(b) eligibility application filed with the Assessor by the Applicant, as applicant,in accordance with the Ordinance.
The Honorable Walter Burnett, Jr. Alderman, 27th Ward
SECTION 4: That this resolution shall be effective immediately upon its passage and approval.
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EXHIBIT A
Market Properties Incorporated Class 6b Eligibility Application
Legal Description
PARCEL 16-12-113-032-0000 PARCEL ONE:
LOTS 1 TO 22, BOTH INCLUSIVE, AND THE VACATED PRIVATE ROAD EAST OF AND ADJOINING SAID LOTS 1 TO 22, BOTH INCLUSIVE, TOGETHER WITH THAT PART OF LOT 28 WHICH LIES WEST OF A LINE THAT IS 530 FEET EAST OF AND PARALLEL TO THE WEST LINE OF LOTS 1 TO 17, BOTH INCLUSIVE, AND TO A.SOUTHWARD EXTENSION OF SAID WEST LINE OF LOTS 1 TO 17, BOTH INCLUSIVE, ALL IN GRIFFIN'S SUBDIVISION OF ALL OF LOTS 1 AND 4 ALSO LOTS 2 AND 3 EXCEPT THE EAST 66 FEE THEREOF ALL IN GRAYDON AND CARSON'S SUBDIVISION OF THE EAST 1/2 OF THE NORTH WEST V* OF SECTION 12, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF THE RIGHT OF WAY OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAILWAY, (EXCEPT THE WEST 300 FEET OF THAT PART OF SAID LOTS 1 AND 2 IN SAID GRAYDON AND CARSON'S SUBDIVISION WHICH LIES NORTH OF A LINE DRAWN PARALLEL TO THE SOUTH LINE OF SAID LOT 2 FROM A POINT ON THE WEST LINE OF SAID LOT 2 WHICH IS 305.44 FEET SOUTH OF THE NORTH CORNER OF SAID LOT 1 AND ALSO EXCEPT THAT PART OF SAID PREMISES LYING SOUTH OF A LINE DRAWN EAST FROM A POINT ON THE WEST LINE OF SAID LOT 22,10 FEET NORTH OF THE SOUTHWEST CORNER OF SAID LOT 22 AND AT RIGHT ANGLES TO SAID WEST LINE), IN COOK COUNTY, ILLINOIS.
PARCEL TWO:
THAT PART OF LOTS 2 AND 3 OF GRAYDON AND CARSON'S SUBDIVISION OF THE EAST 72 OF THE NORTHWEST 1/4 OF SECTION 12, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF THE RIGHT OF WAY OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAILWAY COMPANY (WHICH ALSO INCLUDES A PART OF GRIFFIN'S SUBDIVISION OF ALL OF LOTS 1 AND 4, ALSO LOTS 2 AND 3, EXCEPT THE EAST 66 FEET THEREOF, ALL IN SAID GRAYDON AND CARSON'S SUBDIVISON) DESCRIBED AS FOLLOWS:
BEGINNING AT THE POINT OF INTERSECTION OF THE SOUTHWESTERLY LINE OF LANDS OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAILWAY COMPANY WITH THE EAST LINE OF SAID LOT 2, WHICH POINT OF INTERSECTION IS A CORNER OF SAID LOT 2; AND RUNNING THENCE NORTHWESTERLY ALONG SAID SOUTHWESTERLY LINE OF SAID RAILROAD LANDS, WHICH LINE IS ALSO THE NORTHEASTERLY LINE OF SAID LOT 2, A DISTANCE OF 161.60 FEET TO AN INTERSECTION WITH A LINE OF 530 FEET EAST OF AND PARALLEL TO THE WEST OF LOTS 1 TO 17 IN SAID GRIFFIN'S SUBDIVISION; THENCE SOUTH ALONG SAID PARALLEL LINE AND SOUTHWARD EXTENSION THEREOF, A DISTANCE OF 843.63 FEET TO ITS INTERSECTION WITH A LINE DRAWN EAST FROM AND PERPENDICULAR TO THE WEST LINE OF LOT 22 IN SAID GRIFFIN'S SUBDIVISION FROM A POINT THEREON WHICH IS 10 FEET NORTH OF THE SOUTHWEST CORNER OF SAID
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SOUTH LOT 22: THENCE EAST ALONG SAID PERPENDICULAR LINE A DISTANCE OF 43 FEET; THENCE NORTHEASTWARDLY, A DISTANCE OF 104.33 FEET TO A POINT ON A LINE
- FEET EAST OF AND PARALLEL TO THE HEREINBEFORE DESCRIBED PARALLEL LINE, WHICH POINT IS 102 FEET NORTH OF SAID PERPENDICULAR LINE, A DISTANCE OF 75.85 FEET TO A POINT ON THE EAST LINE OF SAID LOT 3 IN GRAYDON AND CARSON'S SUBDIVISION WHICH IS 150 FEET OF THE PLACE OF BEGINNING OF THIS DESCRIPTION; AND THENCE NORTH ALONG SAID EAST LINE OF SAID LOTS 3 AND 2, A DISTANCE OF 150 FEET TO THE POINT OF BEGINNING (EXCEPT THAT PART OF THE FOREGOING DESCRIPTION, LYING EAST OF A LINE 66 FEET WEST OF THE EAST LINE OF LOT 3 IN GRAYDON AND CARSON'S SUBDIVISIONS, EXTENDED NORTH), IN COOK COUNTY ILLINOIS.
PARCEL THREE:
THAT PART OF LOTS 2 AND 3 OF GRAYDON AND CARSON'S SUBDIVISION OF THE EAST Vz OF THE NORTHWEST 1/4 OF SECTION 12, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF THE RIGHT OF WAY OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAILWAY COMPANY (WHICH ALSO INCLUDES A PART OF GRIFFIN'S SUBDIVISION OF ALL OF LOTS 1 AND 4, ALSO LOTS 2 AND 3, EXCEPT THE EAST
- FEET THEREOF, ALL IN SAID GRAY AND CARSON'S SUBDIVISION) BOUNDED BY A LINE DESCRIBED AS FOLLOWS, TO WIT:
COMMENCING AT A POINT ON THE WEST LINE OF LOTS 22 IN SAID GRIFFIN'S SUBDIVISION, WHICH POINT IS 10 FEET NORTH OF THE SOUTH WEST CORNER OF SAID LOT 22; THENCE EASTERLY ON A LINE PERPENDICULAR TO THE WEST LINE OF SAID LOT 22, A DISTANCE OF 505 FEET, MORE OR LESS, TO THE SOUTHEASTERLY CORNER OF A STRIP OF LAND CONVEYED BY GRIFFIN WHEEL COMPANY AND SPRAGUE, WARNER AND COMPANY BY DEED DATED SEPTEMBER 29, 1941 AND RECORDED IN THE RECORDERS OFFICE OF COOK COUNTY, ILLINOIS, AS DOCUMENT NUMBER 12768767; THENCE SOUTHWESTERLY ON A LINE MAKING AN ANGLE OF 70 DEGREES 16 MINUTES 25 SECONDS WITH SAID PERPENDICULAR LINE, A DISTANCE OF 7.44 FEET, MORE OR LESS, TO POINT 7 FEET SOUTH OF SAID PERPENDICULAR LINE; THENCE WESTERLY AMONG A LINE 7 FEET SOUTH OF AND PARALLEL WITH SAID PERPENDICULAR LINE, A DISTANCE OF 502.49 FEET, MORE OR LESS, TO APPOINT ON THE WESTERLY LINE OF LOT 22 WHICH IS 7 FEET SOUTH OF THE POINT OF BEGINNING; THENCE NORTHERLY ALONG SAID WEST LINE OF LOT 22 TO THE POINT OF BEGINNING, IN COOK COUNTY, ILLINOIS.
PARCEL 16-12-114-005-0000
THE EAST 66 FEET OF LOT 2 IN GRAYDON AND CARSON'S SUBDIVISION OF THE EAST 1/2 OF THE NORTHWEST % OF SECTION 12 TOWNSHIP 39 NORTH, RANGE 13 EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF THE RIGHT OF WAY OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAIL ROAD COMPANY.
PARCEL 16-12-114-013-0000
THE NORTH 71.13 FEET OF THE EAST 66 FEET OF LOT 3 IN GRAYDON AND CARSON'S SUBDIVISION OF THE EAST Vz OF THE NORTHWEST % OF SECTION 12 TOWNSHIP 39 NORTH, RANGE 13 EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF THE RIGHT OF WAY OF THE CHICAGO, MILWAUKEE AND ST. PAUL RAIL ROAD COMPANY.
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
hide d/b/a/ if applicable;
Applicant. State the legal name of the
) State the legal name of the entity in
SECTION I - GENERAL INFORMATION A. Legal name of (he Disclosing Pmty submitting this ODS. In
Market Properties Incorporated
Check ONK of (lie following three boxes"
Indicnle whether the Disclosing Party submitting this F.DS is I ■ [/] 'he Applicant OR'
2. fl legal entity holding a direct or indirect interest in the
Applicant in which the Disclosing Party holds nn interest:
OR
3. f~ fl legal entity with h right of control (see Section II,B,
which the Disclosing Party holds a right of control:
Sacramento Blvd., Unit B
575 North
60612
Chicago, IL
B. Business address of the Disclosing Parly:
C. Telephone:
Email;
(312) 446-4849 ^ (312) 803-23Cj(J)
u, 'Name ui' euuiaoi j^i
£, Federal Employer Identification No. (if you have one):
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);
Cinsi H(b) Appllcullqn bound nn loss U»un Iwoiny-lfjur ('^<l( MiunlM."; r.onUiiuuui; Vdwinuy will) 11 purchase f< r *|nlVJo, apoclnl clioumtjlanwoo imd subfllontlof roliobllHHtlon.
pit ilun. H.<k Cfiail/ AinrtCl «trj,0»li C<Vfi|/ O.^l. .friin.V.p w« EM>wrtrOtul«Fnw»l
G Which City agency or department is requesting this EDS?_
If the Matter is n contract being handled by tho City's Department of Procurement Services, please complete the following:
Specification #
I
and Contra ;t
Vcr. 01-01-12
lJage 1 of 13
INTERESTS
SECTION II - DISCLOSURE OF OWNERSHIP A. NA.TURK OF THE DISCLOSING PARTY
Ity company Hy partnership
1. Indicate the nature of the Disclosing Party:
f J Person f^]Limited Hnb.
[J Publicly registered business corporation "[} Limited Hnb-
corporation, oflt corporation nlso a 501(c)(3))? [ ] No
specify)
rivately held business corporation f 1 Joint venture
[] Solo proprietorship [ ] Nct-for-proflijl
[] General, partnership (Is the not-for-p
[ ] Limited partnership [ ] Yes
[ .1 Tst I ] Other (please
ation or organization, if applionbli
- ; the organization registered to do
2. For legal entities, Ihe state (or foreign country) of incorpo
Illinois
- For legal entities no I organized in the State of Illinois: Ha business in the Slate of Illinois as a foreign entity?
QYes QjNo [7]N/A
13. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
J. List below the full names unci titles of all executive office;1 NOTE: For not-for-profit corporations, also list below all memb
and all directors of the entity, rs, if any, which arc legal entities. If
the legal titleholder(s).
general partnor, managing member, management of the Disclosing Party, own behalf.
If the entity is a general partnership, limited partnership, limits^ liability company, limited liability partnership or joint venture, List below tho name and title oi'oaoh manager or any other person or entity that controls the dny-to-daj NOTE: Each legal entity listed below must submit an EDS on its
Title
Name
Michael Thlskos - Prsslriont and "I roasurar
Anlslln Thlnkos - Vice Prssldont and Soerolary
2, Please provide the following information concerning each indirect beneficial interest (including ownfirslup) in excess of 7.5
jerson or entity having a direct or '<> of the Diaolosing Party. Examples of such an interest include shares in a corporation, partnership interest In a partnership or joint venture,
!
Page 2 of 13
di interest of a beneficiary of a trust, 'rant 16 Section 2-154-030 of the tjiulre any such additional information sclosurs,
interest of a member or manager in a limited liability company, estate or other similar entity, If none, state'"None," NOTE: Pun Municipal Code of Chicago ("Municipal Code"), the City may rt from any applicant which is reasonably intended to achieve full i
Name Business Acldicss
Mlnhaol Thlakos, 218 North Rnolne, Chicago, IL 60S07 - 76% shares
Poifcontage Interest in the Disclosing Party
Anlelln Thlakos, 211) North Racine, Chicago, II. B0B07 - 2!i% shares
SECTION III - BUSINESS RELATIONSHIPS WITH CITY
ITas the Disclosing Parly had a "business relationship," as defi Code, with any City elected official in the 12 months befoie the c:
ELECTED OFFICIALS
od hi Chapter 2-156 of the Municipal Ue this EDS is signed?
lZ1No
□ Yes
(dftl(s).qnd describe such
If yes, please identify below the name(s) of such City elected off! relatlonship(s):
/pwfTTnw rv niscr.o.^Tiwrf, op subcontractors ajisto other retained parties
The Disclosing Parly must disclose the name, and business addjjess of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whilom the Disclosing Party has retained or expects io icsrnir. in coon cc lion with (he. Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to bo paid. The Disclosing daily is not required to disclose employees who aie paid solely through the Disclosing Party's tegklnr payroll,
ofit entity, on an unpaid basis, or (2)
"Lobbyist" means any person or entity who undertakes to inlMeJice any Legislative or administrative
action on behalf of any person or entity other than; (1) a not-for-j:
himself. "Lobbyist" also means any person or entity any part of-^hoso duties as an employee of another includes undertaking to influence any legislative or administrative action,
If the Disclosing Party is \moortain whether a disclosure is re.ip Disclosing Party must either ask the Oily whether disclosure Is ro
Led under this Section, the mired or make the disclosure,
Page 3 of 13
j.|}ilon_a Tsantllls, PC, 33 K1, LnSallo, 25th Floor, Chicago, IL B080Z - Altorrny, Fee i
Name (indicate whether Business retained or anticipated Address to be retained)
Relationship !o Disclosing Party (subcontractor, attorne; lobbyist, etc.)
£5,000 +
Fees (indicate whether paid or estimated,) NOTE; "hourly rate" or "t.b.d," is not a71 acceptable r&sponsc.
_JiL±tj:r>Ci led,
to retain, any such persons-or entities,
(Add sheets if necessary)
f ] Check here if the Disclosing Parly has not relained, nor expec
SECTION V - CERTIFICATIONS
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners oil business entities that contract with the City must remain in compliance with their child suppoit obligations throughout the contract's term,
Has any person who diteevly or indirectly owns 10% or more oft arrearage on any child support obligations by any Illinois court oJ
e Disclosing Party been declared in competent jurisdiction?
[/jNfo QNo Person directly or indlrei tly owns 10% or more of the
~ Disclosing Party,
■,, ■,-1 fincoflin ra n 1'
for payment nf all support owed and
it j uo. m'w n.C ,'wVnO., l: - :.: ■: .: ■■
is the person in compliance with that agreement?
□Ves [>
B. FURTHER CERTIFICATIONS
City or any sister agency; and (Ii) the ticlo I in a continuing requirement'for
1. Pursuant to Municipal Code Chapter 1-23, Article I ("ArtI le I")(which tho Applicant should consult for defined terms (e.g., "doing business") and legal requirmrents), if the Disclosing Party submitting this EDS is the Applicant and is doing business with cljo City, then tlu-. Disclosing Tarty certifies as rollows; (i) neithei the Applicant nor any controlling r'orson is currently indicted or charged with, oi has admitted guill of, or bus even been convicted of, or placed unr.lei supervision for, any criminal offense involving actual, attempted, or conspirhcy to conjimlt bribery, theft, fraud, forgery, perjui y, dishonesty or deceit against an officer or employee of the Applicant lindei.slHiids and acknowledges thht coniplianoe with A
doing business with the City, NOTE; If Article I applies to the A splicnnt, the permanent compliance timcfiame in Article I snpoisedcs some five-year compliance tirnfjframos in certifications 2 and 3 below,
Page 4 of 13
2. The Disclosing Tarty and, if the Disclosing Party is a legal entity, all of those persons or entitles identified in Section II.B. I, of this EDS:
local
a. are not presently debarred, suspended, proposed fbi dobcu excluded from any transactions by any federal, state or
rnent, declared ineligible or voluntarily unit of government;
0.
ijs EDS, been convicted of a criminal against thern in connection with; rjeral, state or local) (runsaction or j- state antitrust statutes; fraud; (uuetion of records; making false
have not, within a five-year period preceding the date oft offense, adjudged guilty, or had a civil, judgment rendered obtaining, attempting to obtain, or performing a public (fe contract under a public transaction; a violation of federal embezzlement; theft; forgery; bribery; falsification or des statements; or receiving stolen property;
!ed by, a governmental entity (federal, in clause II.2,b. of this Section V;
are not presently indicted for, or criminally or civilly oharg1 stale or local) with committing any of the offenses set fort
- have not, within a five-year period preceding the ditto of ti transactions (federal, state or local) terminated for cause o
e. have not, within a five-year period preceding the date oft) guilty, or found liable in a civil proceeding, or in any crim concerning environmental violations, instituted by tlic.Citj state, or any othei unit of local government.
3. The certifications in subparts 3, 4 and 5 concern;
- Hi." PlvT.Wm/i Vartv
is EDS, had one or more public default; and
is EDS, been convicted, adjudged aial or civil action, including actions or by the. federal government, any
s ^ _ . ,
connection with the Matter, including but not limited to allperions ov legal entities disclosed under
control of another person or entity; any responsible official of the Disclosing Party, any Oonfraolor or any Affiliated Entity or any other official, agem oi employee of tho Disclosing Parly, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsibly Contractor or any Affiliated Entity (co)Jcctivciy "Agents"),
Section IV, "Disclosure; of Subcontractors and Other Retained any "Affiliated Entity" (meaning a person or entity that, dire Disclosing Piuty, is controlled by the Disclosing Party, or is, w common control of another person or entity, Indicia of conlroj interlocking management or ownership; identity of interests an and equipment; common use of employees; or organization ofji ineligibility of a business entity to do business with federal or the City, using substantially the same management, ownership with respect to Contractors, rhe term Affiliated DntJly means a indirectly contiols the Contractor, is controlled by it, or, with t
Parties");
3 official of the Disclosing Party, any
dly or indirectly; controls the th tho Disclosing Party, under include, without limitation; ong family members, shared facilities i business entity following the tate or local government, Including or principals as tho ineligible entity); ■>erson or entity that riireotly or e Coir tractor, is under common
Page 5 of 13
ejd Entity of either the Disclosing Party fWe the date this EDS is signed, or, with ty of a Contractor during the five years " br engagement In conneotion with tho
Neither the Disclosing Parly, nor any Oouliactor, nor any AffilJn or any Con tractor not any Agents bavc, during the five years b respect to a Contractor, an Affiliated Entity, or an Affiliated lint, before the date of such Contractor's or Affiliated Entity's contract Matter:
d guilty of bribery or attempting to plinois, or any agency of the federal ' States of America, in that officer's
bribed or attempted to bribe, or been convicted or adjudge bribe, a public officer or employee of the City, the State o government or of nay state or local government in tho Unfed or employee's official capacity;
rs, or been a parly to any such
or oo Illusion among bidders or jy agreement to bid a fixed price or
agreed or colluded with other bidders or prospective biddt agreement, or been convioted or adfudgfld guilty of agreement prospective bidders, in restraint of fiecdom of compelitior otherwise, or
aljiove that is a matter of record, but
made an admission of such conduct described in ti. or b, have not been prosecuted for such r.nnduct; or
(Living Wage Ordinance),
violated the provisions of Municipal Code Section 2-92-6
Neithei tho Disclosing Party, Affiliated Entity or Contract*;, or any of their employees, officials
violation of/20 ILCS 5/31)E-4; oi (3) any similar offense of any state or- of the United States of
agents or partners, is barred from contracting with any unit of sta engaging in or being convicted of (!) bid-rigging in violation of
America that contains the same elements as the offense of bid-rig
0 or local government as a result of ]q ILCS 5/33E-3; (2) bid-rotating in
^ing oi' bid-rotating,
lartment of the Treasury or the iprce or their successors: tho Specially List, the Entity List and the
5, Neither Die Disclosing )Jarty nor any Aiiiuaiuu hnmy j,i u'^uu uj maintained by the Office of Foreign Assets Control of the U.S. D Bureau of Industry and Security of the U.S. Department of Co run Designator! Nationals List, the Denied Persons List, tho Unverifiejr. Debarred List.
- The Disclosing Party understands and shall comply with th 2-55 (Legislative Inspector General), 2-56 (Inspector General) an Municipal Code,
7. If the Disclosing Party is unable to certify to any of the nbc Certifications), the Disclosing Party must explain below:
applicable requirements of Chapters 12-156 (Governmental Ethics) of the
"e statements in this ParCB (Further
Pageb of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none"). None
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all gifts that the Disclosing Parly has given or caused to.be given, at any time during the
12-month period preceding the execution date of this EDS, to an employee, or elected or appointed
official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything
made generally available to City employees or to the general public, or (ii) food or drink provided in the
course of official City business and having a retail value of less than $20 per recipient (if none, indicate
with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
1. The Disclosing Party certifies that the Disclosing Party (check one)
is not
17
Qs
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss 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 in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the lotleis "NA," the won! "None," or no iespouse appears on ll conclusively presumed that the Disclosing Party certified to the ai:
e lines above, It will be ove statements.
Any words or terms that are definod In Chapter 2-156 of the Mm meanings when used in this Part D.
D. CERTIFICATION REGARDINO INTEREST I.N CITY BUSINESS
: ioipal Code have the same
1. In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee ot the City have a financial interest in his or hoi own name or in (he name of any other peisou or entity in the Matler?
□Yes [7)4o
to
and D.j. If you checked "No"
NOTE: If you checked "Yes" to Item D, 1., proceed to Items D.2 Item D.l, proceed to Part E.
2 Unless sold pursuant to a process of competitive bidding, w|r otherwise permitted, no City
elected official or employee shall have n flnuncial interest in his c any other person oi entity in the purchase of any property that (i) for taxes or assessments, or (iii) is sold by virtue of legal process "City Property Sale") Compensation for property taken pursuant does not constitute a financial intcicst within the meaning of this
Does the Matter involve a City Property Sale?
} hei own name or in the name of belongs to the City, or (ii) is sold ,t the suit of the City (collectively, to tho City's eminent domain power ''art Di
|v_T;
I'1 C";
3, If you checked "Yes" to Horn D, 1,, provide the names and officials or employees having such interest and identify the imtun
'nislnoss addresses of the City of such interest:
of Interest
Na
uro
Name
Business Address
4. The Disclosing Party further certifies that no prohibited fijjianoial interest in the Matter will be acquned by any Cily official oi cinuloyeo. ]|
Ii. CERTIFICATION REGARDING SLAVERY ERA DUSWESB ;
Please check either 1. or 2. below. If the Disclosing Party cJietjics 2., 'the Disclosing Party must disclose below or in an attachment ro this EDS all information reqjuircd by paragraph 2. Failure to
Page 8 of 13
entered into with the City in
comply with these disclosure requirements may make any contract connection with tho Matter voidable by the City.
s searched any and all records of
_LJ- The Disclosing Party verifies that the Disclosing Party h
erja (including insurance policies
the Disclosing Paity and any imd ail predecessor entities regarding Jreoords of investments or profits
from slavery or slaveholder insurance policies dining the slavery <
issued to slaveholder;; that provided coverage for damage to or injujry or death of their slaves), and the Disclosing Party has found no such records. ;
2- TllR Disclosing Party verifies that, as a lesult of conduotbjigi the sca.rch in step 1 above, the
Disclosing Paity has found records of investments or profits from! slavery or slaveholder Insurance policies, The Disclosing Party verifies that the following constitijtes full disclosure of all such records, including the names of any and all slaves or slaveholders! described in those records;
SECTION VI CERTIFICATIONS FOR FEDERALLY FUN )I£D MATTERS
NOTE; If the Matter is federally funded, complete this Section funded, proceed to Section VII, For purposes of this Section VI, and proceeds of debt obligations of the City are not federal fundir
A. CERTIFICATION REGARDING LOBBYING
Vi, If the Matter is not federally tax credits allocated by the City
1. List below ino names or iiji persons ui eiimie,-, n,j;iau'icu'ii|iuO Disclosure Act of 1 995 who have made lobbying contacts on benaii! oi uic Disclosing r'uny wnu respect to the Matter: (Add sheets if necessary):
lytlers "NA" or If the word "None" rreans that NO persons or entities made lobbying conflicts on behalf of the
(If no explanation appears or begins on the lines above, or if the appear, it will bo conclusively presumed that the Disclosing Party registered under the Lobbying Disclosure Act of1995 have i Disclosing Party with respect to tho Matter,)
federally appropriated funds to pay nrbying activities or to pay any
ployee of any agenoy, as defined by c y m of Congress, or an employee of a funded contract, making any ent, or to extend, continue, renew, cooperative agreement.
2, The Disclosing Party has not spent and will not expend anj any person or entity listed in Paragraph A.l. above for his or her I person or entity to influence or attempt to influence an officer or i applicable federal lav/, a member of Congress, an officer or emp! member of Congress, in connection with tho award of any federal federally funded grant or loan, entering Into any cooperative agree amend, or modify any federally funded contract, grant, loan, or
Page 9 of 13
3. The Disclosing Parly will submit an updated certification which lb ere occurs any oven! that rnateiialiy affects the accuracy forth in paragraphs A.l. and A.2. above.
the end of each calendar quarter in df the statements and information set
4. The Disclosing Parly certifies that either: (i) it is not an or 501 (c)(4) of"the Internal Revenue) Code of 1986; or (ii) it is an or 501(c)(4) of the. Internal Revenue Code of J 986 but has not engn Activities11,
;anizatlon. described in section ganizatlon described in section gjerl and will not engage in "Lobbying
1 subcontractors before it awards any mtractora1 certifications for tho
5. If (he Disclosing Party is the Applicant, the Disclosing Party musl obtain certifications equal In
form and substance to paragraphs A. 1. through A.4. above from subcontract and the Disclosing Paity must maintain all such sub;
duration of the Matter and must make such certifications prompt!^ available fo the City upon request.
OPPORTUNITY
B, CERTIFICATION REGARDING EQUAL EMPLOYMENT
pplioant and all proposed or in wiiting at' tho outset of
If the Matter is federally funded, federal regulations require the Aj^pl subcontractors to submit the following information with their bid negotiations.
Is the Disclosing Party the Applicant? ]Ycs [ZIHo
.11 X ft;, vuii>wi'j
tion programs pursuant to applicable
oc
! iNo LJ
J. Have you developed and do you have on file affirmative federal regulations? (See 41 CFR Part 60-2.)
□Yes
2, Have you filed with the Joint Reporting Committee, the D
Contract Compliance Programs, or the Equal Employment Oppor
under the applicable filing requirements?.
□Yes fjNo ,
3. Have you pai th -.mated in any previous conlracls oi subconl
equal oppoi tmiity clause? |
□Yes QNo . |
If you checked "No" lo question I. or') above, please provide nij
rector of the Office of Federal unity Commission all reports duo
acts subject lo the
explanation'.
Page 10 of 13
I
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
in this EDS' will become part of any connection, with the Mutter, whether inducements to the City's execution "[the Disclosing Party understands that this EDS is based,
The Disclosing Party understands and agrees dial, A, The certifications, disclosures, and acknowledgments containe
Inch '
contract or other agreement between the Applicant and the City in procurement, City assistance, or other City notion, and are materia of any contract or talcing other action with respect to the Matter. ' it must comply with all statutes, ordinances, and regulations on v
■ Jrnanoes, Chapters 2-156 and 2-164 of sins or entities seeking City contracts, and a framing program is available on im the City's Board of Ethics, 740 N,
B. The City's Governmental Ethics and Campaign Financing Or the Municipal Code, impose oertain duties and obligations onpe: work, business, or transactions. The full text of those ordinance line at www,cityofchioaco.org/Hthios, and may also be obtained
Disclosing Party must comply fully
The
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. with tho applicable ordinances.
S is false, incomplete or inaccurate, flitted may bo rescinded or be void or or agreement (if not rescinded or ty's participation in the Mutter and/or sections with the City, Remedies at and an award to the City of treble
ED
C. If the City determines that any information provided in this any contract oi other agreement in connection with which it is sul: voidable, and the City may pursue any remedies under (he contract void), at law, or in equity, including terminating the Disclosing I declining to allow the Disclosing Party to piuticipaic in other trai|i law for a false statement of material fact may include incarce
ratiori
ujilic on its Internet site and/or upon iany attachments to this EDS may be
D, It is the City's policy to make this document available to the j. request Some or all of the information provided on this EDS an
arty waives and releases any possible with the public release of information
made available to the public on the Internet, In response to a Freidorn of Information Act request, or
otherwise, By completing and signing this EDS, the Disclosing l ights or claims which it may have against the City In ooniieotion contained in this EDS find also authorises the City to verify the acijuracy of any information submitted in this EDS
ust 1 pal
;he event of chtinges, the Disclosing on the Matter, If the Matter is a Services, the Disclosing Party must Matters subject to Article I of INELIGIBILITY for certain specified be kept current for a longer-period, Code,
B, The information provided in this BDS must be kept current Pai ty must supplement this EDS up to the time the; City takes nctjio|n contract being handled by the City's Department of Procurement update this EDS as the contract requires, NOTE: With respect to Chapter 1-23 of the Municipal Code (imposing PERMANENT "'" offenses), the information provided herein regarding eligibility n as requiicd by Chapter 1-23 and Section 2-154-020 of the Munioi
The Di.s'clu/iinp, Parry represents and warrants vhrrl;
Page 1 i of 13
tax administered by the Illinois Entities delinquent in paying any is not limited to, all water charges, taxes,
any
F.l. The Disclosing Party is not delinquent in the payment of Department of Revenue, nor are the Disclosing Party or its Affiliated fine, fee, tax or other charge owed to the City. This includes, but sewer charges, license fees, parking tickets, property taxes or sales
Parties List System ("EPLS") maintained by theU. S. General Services Administration
F.2 If the Disclosing Party is the Applicant, the Disclosing Ptu use, nor permit their subcontractors to use, any facility listed by f
ty and its Affiliated Entities will not leTJ.S. E.P.A. on the federal Excluded
Party will obtain from any
certifications equal in without the prior written consent of the such certifications or that the rovide truthful certifications.
lot p
F.3 If the Disclosing Party is the Applicant, the Disclosing contractors/subcontractors hired or to be hired in connection with! the Matter form and substance to those in F.l. and F.2. above and will not City, use any such contractor/subcontractor that docs not provide Disclosing Party has reason to believe has not provided or cann
NOTE: If the Disclosing Party cannot certify as to any of the itomjs in F, 1., F.2. or F.3. above, an explanatory statement must be attached io this EDS
CERTIFICATION
Undei 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 ceitifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
Market Pj^psrlles incorporated
type name or disclosing rartyj_
(Sign hero)
Michael Thlakos
(Print or type name of person signing) President
(Print or type title of person signing)
Signed and sworn to before me on (date) 9H \.o>C-\ M
at . XoClVC-. County, L\\\_<JO(state).
}i> / Notary Public.
6 ~"
T "OFFICIAL SEAL"
\ MONIQUE LOPEZ »
\ NOTARY PUBLIC, STATE OF ILLINOIS )
\ My Commission Expires 10/16/2017 >
Commission expires: YO| ^ \q\"\
Page 12 of 13
■STATEMENT!AND AFFIDAVIT
CITY OF CHICAGO. ECONOMIC DISCLOSURE -S
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFALS AND DEPARTMENT HEADS
i
TJm Appendix is to be completed only by (i.) the Applicant, amjl [b) any legal entity which has a divert ownership interest in (.he Applicant exceeding 7,5 percent, It is ndi to be completed by any legal entity which has only an Imlirecl ownership interest in the Applicant,
e>
disclose whether snoh Disclosing Party renlly has a "familial relationship" with ists If, as of the date this EDS Js Domestic Partner (hereof is related to
r;ad as spouse or domestic child, brother or sister, aunt oruncle, on-ln-law, daughter-in-law, stepfather brother or half-sister,
Under Municipal Code Section 2-154-01 5, the Disclosing Paity mi; or any "Applicable Paity" or any Spouse or Domestic Partner thereof ou; any elected city official or department head, A "familial relationship signed, the Disclosing Party or any "Applicable Party" or any Spouse or the mayor, any alderman, the city clerk, the city treasurer or any city department he partner or as any of the following, whether by blood or adoption: paroi niece or nephew, grandparent, grandchild, falher-in-law, mothcr-in-Iav or stepmother, stepson or stepdaughter, stepbrother or stepsister or hal
'Applicable Party" means (1) all executive officeis of the Disclosing Furry listed in Section ILB.La,, If the
ib Disclosing Party is a genoral
Disclosing Party is a corporation; all partners of the Disclosing Party, ilrt partnership; all gcnoinl panners and limited partners of the Disclosing
Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Diasldslng Party, if the Disclosing Party is a limiled liability company; (2) all principal officers of the Disclosing Pi rlj; and (3) any person having more than a 7,5 peicent ownership inteiesl in the Disclosing Parly, "Principal offieejo" means the president, chief '.2ix:.'.::'.Z ;'.L.-».*, -,\eo.;. v; ,;:;o."',Oi, Cnei iiiutn>.iai un'mci, uotiMii c.j t»j ,iyvioiflry'Oi n icgai tiijiiiy oi any peiSuii exercising similai authority.
Does the Disclosing Party or any "Applicable Party1' or any Spouse or Domestic Partner thereof currently httve a "familial relationship" with an elected city official or departmort head?
Yos
□
t
is name of the lc-ga! ontlty to which or department head to whom such relationship.
If yes, please identify below (1) the name and title of such person, (: such person is connected; (3) tho name rind title of the elected ciiy offi
person has a familial relationship, and (4) the precise nature of such farhilial
Pago ! 3 of !3
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Legal name of the Disclosing Party submitting this EDS. Jncjlude d/b/a/if applicable:
Dennis Wholesale Foods Inc.
Check ONE of the following three boxes:
Indicate whether the Disclosing Parly submitting this F.DS is: I. r/1 the Applicant
OR j 2- \^\ a legai entity holding a direct or indirect interest in I he 'Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest: i
OR T ~
3. I a legal entity with a right of control (see Section II.B.l.j) State the legal name of the entity in Ii the Disclosing Party holds a right of control:
whTc
B Business address of the Disclosing Party:
575 North Sacramento Blvd.
Chicago, IL 63612
C. Telephone
Email:
(312)446-4849 ^ (312) 803-2300
Michael Thiakos
E. Federal Employer Identification No. (if you have one);
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):
ikro, sijocial clrcunislHncfis and sub.slnnllHl ruhabllllnUon.
Class 6(b) Application b;isod on loss lhaji Iwonly-loui (2-1) muiilhs. '.-onllmJOUH vucancy wllh a puioriaso for'
uuu CttA T.iiritj Aii«Mor*i OI3ta, C»c> Caurlf Oiijji of Hami'ng are. Vwnon*c Dvt»lDjjmiirt
G. Which City agency or department is requesting this EDS?
cnt of Procurement Services, please
If the Matter is a contract being handled by the City's Departir completc the following:
and Contract 'f
Specification //
Vi-r. 01-01-12
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP- INTERESTS
A, NATURE OF THE DISCLOSING PARTY
Indicate tho nature of the Disclosing Party:
[ ] Person
[ ] Publicly registered business corporation [^"Privately held business corporation [ j Sole proprietorship [ ] General partnership [ ] Limited partnership [ I Trust
my company lily partnership
Limited liab
I i
[ ] Limited llab; [ J Joint venture [ ] ■ Not-for-prof t' corporation (Is the not-for-profit corporation also a 501(e)(3))?
[ ] Yos [ J No
[ ] Other (plause speoify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
l/llnola
he organization registered to do
3. For legal entities not organized in the Stale of Illinois; Ha; business in the State of Illinois as a foreign entity?
□ Yes r~]N[0 r/jN/A
13, IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
Hnd all directors of the entity,
I, List below the full names and titles of all executive officer; NOTE: For not-for-profit corporations, also list below all raeinbtrp, if any, which are legal entities, If
■i-i-nur-V .■■.Ti!i;:i.-:: ii/'?'h-i'"V
liability oompany, limited liability rinerabpartner, managing member, rjanagemeht of the Disclosing Party, o ,vn behalf.
the legal titleholcler(s),
If the entity is a goneral partnership, limited partnership, lirnite l partnership or joint venture, list below the name and title of each manager or any other person or entity that controls tho day-to-day i NOTE: Each legal entity listed below must submit an BIDS on its
Title
N nm o
Mlchaal Thlalios - President
Anlella Thliiltos - 3eoi Btmy
erson or entity'having a direct or }f the Disclosing Party. Examples st in a partnership or joint venture,
2. Plense provide the following information concerning each p indirect beneficial interest (including ownership) in excess of'l.5% of such an interest include shares in a oorporatlon, partnership intqr
Page 2 of 13
i sc.
interost.of a benefioiaiy of a trust, nnt io Section 2-054-030 of the equhe any such additional information closure,
interest of a member or manager in a limited liability company, oi eslato or other similar entity. If none, state "None." NOTE: Pnrs Municipal Code of Chicago ("Municipal Code"), the City may re from any applicant which is reasonably intended to achieve full d
Name Business Address
Michael Thlnlios, 2111 N. Ryolno, Chicago, IL 6(1607 - S0%
PC. Di,
eenlage interest in the Inning Pai ty
AnlallB Thlakos, 2 *ti N. Rnclna. Chlcayo, II. 0OH07 - 50%
ELECTED OFFICIALS
SECTION III ~ BUSINESS RELATIONSHIPS WITH CITY
c ate
Has the Disclosing Party had a "business relationship," as defi. Code, with any City elected official in the 12 months before the
;d in Chapter 2-156 of the Municipal this EDS is signed?
No
Yes-
If yes, please identify below tho namc(«) of such City elected offioial(s) and desoribc such relationship(s);
. ■nipz-n- o^rinir OF «?TIWCONTRACTORS AINU OTHER RETAINED PARTIES.
^ss of each subcontractor, attorney, m the Disclosing Parly has retained iature of tho relationship, and the total rly is not loquirod to disclose ar payroll,
The Disclosing Party must disclose the name and business addr Lobbyist, accountant, consultant and any other person or entity whc. or expects to retain in connection with tho Matter, as well as the amount of the fees paid or estimated to be paid, Tho Disclosing employees who are paid solely through the Disclosing Party's reg
"Lobbyist" means any person or entity who undertakes to mftuop_co any legislative or administrative
action on behalf of any person or entity other (ban: (J) a nol-foi'-pr himself. "Lobbyist" also means any person or entity any part of v another includes undertaking to influence any legislative orudmim
3fit entity, on an unpaid basis, or (2) lose duties as an employee of tratlye action,
qyir
If the Disclosing Party is uncertain whether a disclosure is req Disclosing Paity must either ask the City whether disolosiue is re
ed under this Section, the ■;ed or make the disclosure,
Pago 3 of 13
i
Name (indicate whether retained or anticipated to be retained)
Business Address
Relationship to Disclosl (subcontractor, attorney, lobbyist, etc.)
ig Party Fees (indicate whether
paid or estimated,) NOTE: "hourly rate" or "t.b.d," is-not an acceptable response,
to retain, any such persons or entities,
(Add sheets If necessary) ivfcheolc here if tho Disclosing Party has not rctabed, nor ex.peot: SECTION V ■- CERTIFICATIONS
business entitles that contract with itlons throughout the contract's term,
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-4 J 5, substantial owners i the City must remain in compliance with their child support obliged
Has nny person who directly or indirectly owns 10% or more of tl: arrearage on any child support obligations by any Illinois court of
No
isciosing Party.
j iNo person directly or indirei Disci
Disclosing Party been declared In, ; o m p e t'fin t ju r is d 1 c tio n V
tly owns 10% or more of tho
■ /-,-(■■ n\] oiintinri nweu riiui
If "Yes," has the person, entered imo a cbiui-itppiuruu ag;oc:;:-is the person in compliance with that agreement?
[Z]Vbn Cl^0 JL FURTHER CERTIFICATIONS
prnenls), if the Disclosing Party c CitVj then the Disclosing Party
1. Puwuant to Mutiinlpnl Code Chapter 1-2.3, Article I ("Artiiile i"")(v,'hich the Applicant should
consult for defined terms (e.g., "doing business") and logs! requf submitting this EDS is tho /pplionntimd ia doing business with 1
City or any sister agenoy; and (il) the Hole I is a continuing requirement for plionnl, the permanent oompllanos frame's in certifications 2 and 3 below,
certifies as follows; (i) neither the Applicant nor any controlling rjerson is currently Indicted or chaiged with, or has admitted guilt of, or has aver been convicted of, or plticed under supervision, for, any criminal offense Involving actual, attempted, or conspiracy to corijmit bribery, theft, fraud, forgery.
perjury, dishonesty or deceit against an officer or employee of the Applicant understands and aoknowJodges that compliance with A doing business with the City. NOTE; If Article I applies to the A. timeframe in Article 1 supersedes some five-year compliance tlm
Pitgn 4 of 13
inlity, all of those persons or entities
2, The Disclosing Parly and, if the Disclosing Party ia a legal identified in Section JT.B.l. of this EDS;
jsnt, declared ineligible or voluntarily unit of government;
a. are not pie.vently debarred, suspended, proposed for debar excluded from any transactions by r.ny federal, slate or looi 1,
| EDS, been convlotod of n criminal Lgainnt them in connection with; rsl, state or local) transaction or state antitrust statutes; fraud; ction of records; rnalring false
id by, a governmental entity (federal, in olavuie B.2,b, of this Section V;
a EDS, had one or moie public default; and
have not, within a fivo-yoar period preceding the dato of th offense, adjudged guilty, or had a civil judgment Tenderer, obtaining, attempting to obtain, or performing a public (for contract under a public transaction; a violation of fedora I o embezzlement; theft; forgery; bribery; ftdsifioaljon or destri statements; or receiving stolen property;
arc not presently Indicted for, or criminally or civilly charg state or local) with committing any of the offenses set foitl
have not, within a five-year period preceding" the c|ato of th transactions (federal, state or local) terminated for cause oi
o. have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any crimiiinl or oivll action, including notions conoeining environmental violations, jiiBtiliitert by the City or Vjy the federal government, any state, or any other unit of local government.
3, The certifications In subparts 3, 4 und 5 concern: j r *u "n-iooinyiiK? Pflrt.v:
- any "Contractor" (meaning any contractor oi xuouujiu «ctoj ii-s-" Ey niicios'm.w rmiv m
iioiig family members, shared facilities a business entity following the ftate or local government, including or principals as the ineligible entity); pornon or entity that dirsotly or io Contractor, is under common
connection with the Matter, including but not limited to all'perbons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
- any "Affiliated Entity" (moaning a poison or entity that, dlrgptly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, vflith the Disclosing Party, under common control of another person or entity. In.rlioia uf oojitrafl lnoludo, without limitation;
interlocking management or ownership; identity of interests a and equipment; common use of employoos; or organization of ineligibility of a business ontily lo do business with federal or tho City, using substantially tho same raanugomftnt, ownership with respect to Contractors, the term Affiliated Entity means indirectly controls the Contraotor, is controlled by it, or, with control of another person or entity;
any responsible official of tho Disclosing Party, any Contrncjtor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any
acting pursuant to the direction or nuthow/.alion of a responsible official of the Disclosing Party, any Gontiacloi or any Afflliatod Entity (oolluolivcdy "AgonIn")
Page .5 of 13
, or been a party to any such agreement, or been convicted oi adjudged guilty of ngreenkpnl or collusion among bidders or
ijy agreement to bid fl fixed price or
Noil-hr-j tho Disclosing Parly, nor any Contractor, nor any Afflliat or any Contractor nor any Agents have, during tho five years bofo respect to a Contractor, an Affiliated Entity, or an Affiliated Entity before the date of such Contractor's or Affiliated Entity's contract Matter:
a. bribed or attempted to bribe, or been convicted or adjudgec
bribe, a public officer or employee of the City, the State of
government or of any state or local government iii the Unit
or employee's official capacity;
b, agreed or colluded with other bidders or piospcotivo biddeh
prospective biddeis, in. restraint of freedom of competition otherwise; or
i Enti.ty of either the Disclosing Party > the date this EDS is signed, or, with of a Contractor during the five years r engagement in oouneotion with the
guilty of bribery or attempting to Uinois, or any ngonoy of the federal d States of America, In that officer's
abbivc that is a matter of record, but
made an admission of such conduct described ia a, or b, have not been prosecuted for such conduct; or
d, violated the provisions of Municipal Code Section 2-92-61 !j (Living Wage Ordinance),
:eite or of the United States of ,ng or bid-rotating,
4. Neither the Disclosing Party, Affiliated Entity or Contractor! or any of their employeos, 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 ol'(l) bid-rigging ia violation of 7:i,0 ILCS 5/33E-3; (2) bid-rotating In
violation of 720 ILCS 5/33E-4; or (3) any similar offense of any aii
America.that contains the same.elements as the offense of bid-rlggE
i . .
■co or'tbelr suooessors; the Specially List, tho Entity List and the
5, Neither the Disclosing Party nor any Affiliated Entity Is llsjf d on any of the following lists
mai.ntai.nod by the Office of Foreign A ssets Control of tho U.S. Detjartnient of the Treasury or the
applicable requirements of Chapters
?.-1 56'.(Oovemmonth[ Ethics) of the
Bureau of Industry, and Security of the U,S, Depai tinent of Oomm Designated Nationals List, the Denied Persons List, the Unverifi.ee. Debarred List.
6. The Disclosing Party understands and shall comply with tho
2-r)'j (Legislative Inspector General), 2-56 (Inspector Goncrnl) and
Municipal Code.
ia stntornonts in this Parts (Further
7, If the Disclosing Parly is unable lo certify to any of the abo
Certiiioafions), the Disclosing Party must explain below:
Page 6 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none"). None
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
1. The Disclosing Party certifies that the Disclosing Party (check one)
is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss 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 in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on -tlw linos above, il will be conclusively prosumod that the Disclosing Party certified to the abcve statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS '
Any words or terms that are defined in Chapter 2 -1 56 or the Mnn) meanings when used in this Part D,
1. In accordance with Section 2-156-1] 0 of the Municipal Co of the City have a financial Interest m his or her own name or in th entity in the Matter? _
□Yes [/>
pal Code liayo the same
lo; Does any official or employee name of any other person or
id D.3. If you cheeked "No" to
Otherwise permitted, no City hor own namo or in the name of iljongs to the City, or (li) is sold [ho suit of the City (collectively,
NOTE; If you cheeked "Yes" to Item D.J,, proceed to Items D.2, Item D,]., proceed to Part?,.
2. Unless sold pursuant to a prooosfi of competitive bidding, or elected, official or employee shall have a financial interest in his oi any other person or entity in the pruchaso of any property thai (i) b
for taxes or assessments, or (iii) is sold by virtue of legal proooas a juu mn ul u, ^ynm,w;, "City Property Sale"), Compensation for property taken pursuant I o j 111 o City';) eminolit do nan ill power does not constitute a financial interest within the moaning of this Pa(t D,
Does the Matter involve a City Property Sale? □Yes, (7|No
Iness addroases of tho City if such interest;
3. If you checked "Yes" to Item D.i,, provide the names and b.u officials or employees having such interest and identify the nature
Nu mo
13 ui 11 b s s Address
Nature of Interest
...t.
4. Tho Disclosing Parly further certifies that no prohibited fin melal interost in tho Matter will bo acquired by any City official or employee.
E. C Ii RT 11T C A TI 0 N REGARDING SLAVERY BRA BUSINBSE
>ri by paragraph 2, Failure to
Please cheek olther 1. or 2, below. If the Disclosing Party cheels fe the Disclosing Pnrty must
disoloso below or in an attachment to this EDS all information reqrjiir
Page 8 of 13
■tjsearohod any and all records of
comply with these disclosure requirements may make, any coAlrnol jenlcrod into with the City In commotion with the Mutter voidable; by the City,
J/^.l, The Disclosing Parly verities that the Diselosin/j Party ha ;
the Disclosing Party and any and nil predecessor entities icfiardiui Records oi'invostments or profits from slavery or slaveholder insurance policies during the slavery jua (including insurance policies issued to slaveholders that provided coverage for damage to orir.furry or death of their slaves), imd the Disclosing- Party has found no such records,
. ?-. The Disclosing Party verifies that, as a result of conductir g
Disclosing Party has found records of investments or profits from policies, The Disclosing Party verifies that the following constitute records, Inoluding the names of any and all slaves or slaveholders
do
the search in. step 1 above, the avery or slaveholder insurance s full disolosuro of all such ascribed in those records:
SECTION VI - CERTIFICATIONS FOR FED EH ALLY FUljjpED 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, mix credits allocated by the City and proceeds of debt obligations of the City are no1 fodora! funding
A, CERTIFICATION KUO AK DING LOB DYING
'tT
Disclosure Act of 1993 who have made lobbying contacts on bohaliioi' the Disclosing Party with respect to the Matter: (Add sheets if necessary):
means
!.o
(If no explanation appears or begins on the lines above, or If the k appear, il will be conclusively presumed that tho Disclosing Party registered under the Lobbying Disclosure Act of 1995 have made Disclosing Party with respect io the Matter,)
its "NA" or if tho word "None11 that NO persons or entities bylng contacts on behalf of the
derally appropriated funds to pay ;ying activities or to pay any
oyoo of any agency, as definod by e of Congress, or an omployeo of a unded contract, making any orJinSnt, or to extend, continue, renew, th/e agreement,
2. 'The Disclosing Parly has not spent and will not expend any fi
;m il
any person or entity listed in Paragraph A. 1. above for hia or her I person oj entity to influence 01 attempt to influence an officer or c applicable foil bin I law, a member of Congiess, an office]' or oniployc member of Congress, in connection with the award of any fodoralljy federally funded giant or Joan, entering into any cooperative agn amend, or modify any federally funded contract, grant, lonn, or coppcra
Page 9 of 13
I
- The Disclosing Pnrty will submit an updated certification at the end of eRch calendar quartet in
which there occvus «ny event that materially affcexs the accuracy cf the st'iiteuionts and information set
forth in paragraphs A.l, and A.2, above, j ;
- The Disclosing Party certifies that either; (!) It is not an organization described hi flection 501(e)(4) of the Internal Revenue Code of 1986; or (11) it's an ordaiilzatlon described in section
SOI (e)(4) of the Internal Revenue Code of 19R6 but has not ongagWd and w!d not engage in "Lobbying Activities'1, :
5. ff the Disclosing Parly is the Applicant, the Disclosing Vm-ty must obtain certifications equal In form and substance to parngiaphs A.l. through A.4, above from ajl subcontractors before it awards any subcontract and the Disclosing Party must maintain all such ,subcojn,iniciors' certifications for the duration of tho Matter and must make such certifications piomptly tvadablo to the City upon request,
i
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT M'PORTUNITY
If the Matter is federally funded, federal regulations require the A subcontractors to submit the following information with their bid,1, negotiations.
rs the Disclosing Party the Applicant?
L>cs [jNo
L""Yuj," ■ '. th: '!-■!■--. r. i.aIoh.,
1. Tfave you developed and do you have on file affirmative at federal regulations? (See 41 CI'R Part 60-2.)
Q]Vcs □JNc'
3plican): and all proposed iv in writing at the outset of
i programs pursuant to applicable
:;tor of the Office of Federal unity Commission all reports due
- Have you filed with the Joint Repoiting Committee, the Di Contract Compliance Programs, or the Equal Employment Oppor under t.ho applicable filing i equireroonts?
cts subject to tho
□Yes ' ' Ql
- Ifave you pai tieipaiod in any previous eontiaots or subedit equaj opportunity clause?
□Yes fZ)N"
If you chocked "No" to question 1, or2, above, please provide an explanation:
i I
Page 10 of 13
SECTION VI) .- A CKNO WLlfiD GMJ8NTS, C O.N TRACT INCORPORATION,
COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Parly understands nnci agrees (hat:
I hi this EDS will beoomc part of any connection with the Matter, whether inducements to the Clty'a execution Tl! e Dlsolosfng Party understands that wt.ioh this EDS is based.
A, The oerllfications, disclosures, and acknowledgments oontaine contract or other agreement borween tho Applicant and tho City ii procurement, City assistance, or other City action, and are materia , of any contract or talcing other action with respect to tho Matter, it must comply with all statutes, ordinances, and regulations on
Ordiqanoos, Chapters 2-156 and 2-164 of or entities seeking City contracts, a training program is available on the City's Board of Ethics, 740 N.
B, The City's Governmental Ethics and Campaign Financing tho Municipal Code, impose certain duties Hnd obligations onpersjojns work, business, or transactions. The full text of these ordinances line at www.oityofch 1 cago,org/Eth 1 os, and may also be. obtained ftoim
.Sodgwiok fa't., Suite 500, Chicago, IL 6061 0, (3J2) VM-9560, Th with the applicable ordininicns.
C. if tho City determines that any Information provided in this El" any contract oi other' agreement in connection with which it is sub voidable, and the City may pursue any remedies under the contrnc void), at law, or in equity, including terminating tho Discloolng Pi declining to allow tho Disclosing Paity to participate in other tran. law for.a false statement of material fact may include hiearoeratio.
Disclosing Party must comply fully
is false, incomplete or Inaccurate,
iflitted may be rescinded or bo void or t br agreement (if not rescinded or rjy's participation in the Matter and/or actions with the Cily. Remedies at ljund an award to the City of treble
rracy of any Information submitted
D, tt is the City's policy to mtike this document available to the pibllo on its Internet site and/or upon request. Some or all of the information provided on this EDS and tny attachments to this EDS may be made available to the public on the Internet, in response to ti Freedom of Elimination Aot request, or othciwlse. Dy completing and. signing this EDS, the Disclosing Paity waives and releases any possible rights or claims which it may have against tho City hi connection ^th the public release of Information dontained in this EDS and also authorizes the City to verify the ucjc ' in this EDS.
tie event of changes, the Disclosing 5i. on the MntloT, if the Matter is a Services, the Disclosing Parly must Matters subject to Article I of ELIGIBILITY for certain spooifiod-t be leapt current for a longer period, iliil Code.
E, The information provided In this EDS' must bo kept current Party must supplement this EDS up to the time the City takes actl contract being handled by the City's Department of Procurement update this EDS as the contract requires. NOTE: With respect to Chapter 1-2.3 of the Munlcipitl Code (imposing PERMANENT I^: offenses), the information provided horoin regarding eligibility m ns required by Chapter 1 -23 and Suction 2-154-020 of the Mlinioi
'l'lia Dkclu.'Hnft Pmty represents and warrants that,:
Page 11 of 13
any tax. administered by the Illinois iated Entities delinquent in paying any
F.l, The Disclosing Party is not delinquent in the payment of Department of Revenue, nor arc the Disclosing Parly or its Affi fine, fee, tax or other charge-owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes 01 sales taxes
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 Parties List System ("EPLS") maintained by the U. S. General S.,
the U.S. E.P.A. on the federal Excluded irvices Administration.
F.3 If the Disclosing Parly 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. 1. and F.2. above and will not, without the prior written consent oi City, use any such contractor/subcontractor thai does not provide such certifications or that the Disclosing Parly has reason to believe has not provided or canncit provide truthful certifications.
NOTE: Ii' the Disclosing Party eanno! certify as to any of the items in F. 1., F.2. or F.3. above, an explanatoiy statement must be attached to this EDS. j
CERTIFICATION
that he/she is authorized to execute ing Party, and (2) warrants that all
Under penalty of perjury, the person signing below: (1) warrants this EDS and Appendix A (if applicable) on behalf of the Disclo;
certifications and statements contained in (his EDS and Appendipt A (if applicable) are true, accurate and complete as of the date furnished to the City.
Dennis Wholesale Epods Inc. . (Print or Jj^js name^f Disclosing Party) j ji f
(iifjiAcrc) ' Michael Thiakos
(Print or type name of person signing) President
(Print or type title of person signing)
Signed and sworn to bcfoie me on (date) r) j c)\-'\ [ Dy-,^
at COOV^ County, T (state)
..
^:ajj^j^ Nolai'yPublic-
Cornm ission expires: \ O | \ I ('- | oO ~1
Page 12 of 13
MONIQUE LOPEZ , My CommissujnkxpmjW
W D AFFIDAVIT
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT' HEADS
This Appendix, is to bo completed only by (a) (ho Applicant, and ownership interest in the Applicant exceeding 7,5 percent, It is not which has only an indirect ownership interest in tho Applicant.
(b) any legal Dtitity which has n direct to be completed by any legal entity
tdi,
close whether such Disclosing Party a "familial relationship" with ', as of the date this EDS la 5omesiio Partner thereof is related to rtmen.t head as spouse or domestic child, brother or sister-, aunt or unole, on-ln-law, daughter-in-law, stepfather rothcr or half-sister,
Under Municipal Code Section 2-154-015, the Disclosing Party rant or any "Applicable Parly" or any Spouse or Domestic Parlnei thereof crjiilrently has any eleoted city official or department head. A "familial relationship" exists if, signed, the Disolosing Party or any "Applicable Parly" or any Spouse o; the mayor, any alderman, lire city clerk, the city treasurer or any city do parlnei or ns any of tho following, whether by blood or adoption: paren niece or nephew, grandparent, grandchild, father-in-law, mother in-law or stepmother, stepson or stepdaughter, stepbrother or stepsister or haltl 1:
p(>M,\rtf o.h\p.f
Party Unfed in Section R.B.l.a., if the the Disclosing Parry is a general rty, if tho Disolosing Party is a limited Diseasing Party, if the Disolosing Party is a '; and (3) any person having more than
"Applicable Party" means (1) all executive officers of tho Disclosing Disclosing Party is a corporation; all partners of the Disclosing Party, ii partnership; all general partners and limited partners of the Disclosing 1 partnership; nil managers, managing members and members of tho limited liability company; (2) all principal officers of the Disclosing Pa
secretary ui :i j-^rf,
operating officer, executive director, ohief Financial ottidor, treasurer oj exercising similar authority,
Does tho Disclosing Party or any "Applicable Party" or cay Spouso or have, a "familial relationship" with an elected oity official or depart men
Domastio Partner thereof currently lead?
No
Yes
) theriulno of the legal entity to which 1 or department head to whom such ial relationship,
Eyes, please Identity bolow (1) the name and tltlo of such person, (: such person is connected; (3) the name and title of the eleoted city offioic person has a familial relationship, and (4) the precise uaturo of such far
Page 13 of 13