This record contains private information, which has been redacted from public viewing.
Record #: O2014-5827   
Type: Ordinance Status: Passed
Intro date: 7/30/2014 Current Controlling Legislative Body: Committee on Housing and Real Estate
Final action: 9/10/2014
Title: License agreement with Mercy Diagnostic and Treatment Center (d.b.a. Mercy Family Health Center) for use of building space at 1713 S Ashland Ave
Sponsors: Emanuel, Rahm
Topic: AGREEMENTS - License
Attachments: 1. O2014-5827.pdf
OFFICE  OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR
July 30, 2014
 
 
 
 
 
 
 
 
 
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
 
 
Ladies and Gentlemen:
 
At the request of the Commissioner of Fleet arid Facility Management, I transmit herewith ordinances authorizing the execution of license agreements for occupancy of property.
 
Your favorable consideration of these ordinances will be appreciated.
 
Mayor
 
Very truly yours,
 
ORDINANCE
 
 
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
 
 
SECTION 1: On behalf of the City of Chicago, the Commissioner of the Department of Fleet and Facility Management and the Commissioner of the Department of Public Health are authorized to execute a License Agreement with Mercy Diagnostic and Treatment Center (D/B/A Mercy Family Health Center) governing the use of approximately 12,500 square feet of building space located at 1713 South Ashland Avenue; such License Agreement to be approved as to form and legality by the Corporation Counsel in substantially the following form:
 
AGREEMENT NO. 20255
 
LICENSE AGREEMENT
 
THIS LICENSE AGREEMENT (the "Agreement") is made and entered into this
day  of      ,  2014,   by  and  between,  THE  CITY OF
CHICAGO, an Illinois municipal corporation and home rule unit of government (herein referred to as "City") and MERCY DIAGNOSTIC AND TREATMENT CENTER (D/B/A MERCY FAMILY HEALTH CENTER), an Illinois not-for-profit corporation (hereinafter referred to as "Mercy").
 
RECITALS
 
WHEREAS, City's Department of Public Health previously issued a Community Health Centers Request for Proposals (the "RFP") regarding the delivery of health services at various locations including City's Lower West Neighborhood Health Clinic located at 1713 South Ashland Avenue (the "Building"); and
 
WHEREAS, City's Department of Public Health selected Mercy to perform the services as outlined in the RFP within the Building and City's Department of Public Health and Mercy have entered into a Services Agreement attached hereto and made a part hereof as Exhibit A; and
 
WHEREAS, City has agreed to allow Mercy to use, and Mercy has agreed to use, approximately 12,500 square feet of office space located on the ground floor of the Building (the "Premises") together with access to an adjacent parking lot all as legally described on Exhibit B and as depicted on Exhibit C attached hereto and made a part hereof to be used by Mercy as provided herein; and
 
WHEREAS, the Premises do not have a present municipal use; and
 
WHEREAS, Mercy's use of the Premises to deliver medical services shall improve the overall quality of affordable public health services available to area residents.
 
NOW THEREFORE, in consideration of the covenants, terms, and conditions set forth herein, the parties hereto agree and covenant as follows:
 
SECTION 1. GRANT
 
City hereby provides Mercy the use and occupancy of the following described premises situated in the City of Chicago, County of Cook, State of Illinois, to wit:
 
Approximately 12,500 square feet of space on the ground floor of the Lower West Neighborhood Health Clinic and access to an adjoining parking lot all located at 1713 South Ashland Avenue, Chicago, Illinois (part of PINs 17-20-302-001; -005; -006; -009; and -043).
 
 
 
 
 
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This Agreement creates a license only and Mercy acknowledges and agrees that it shall not hold or claim at any time an interest or estate of any kind whatsoever in the Premises by virtue of this Agreement or Mercy's use of the Premises.
 
SECTION 2. TERM
 
2.1 Term. The term of this Agreement ("Term") shall commence on the date of execution of this Agreement (the "Effective Date"), and shall terminate on June 30, 2019, unless sooner terminated as set forth in this Agreement.
 
SECTION 3. RENT, OPERATING COSTS, UTILITIES, TAXES
  1. Rent. Mercy shall pay rent for the Premises in the amount of:
 
One Dollar ($1.00) for the entire Term with the receipt and sufficiency of said sum hereby acknowledged by both parties.
  1. Operating Costs. Mercy shall reimburse City's Operating Costs for the Premises pursuant to Section 3.2.a below as reimbursement for City's costs to operate the Building and the Premises, but not as rent and not as profit.
  1. Calculation of Operating Costs. Mercy shall pay to City Operating Costs (as hereinafter defined) incurred by City with regards to Mercy's "Proportionate Use" of the Building. This Proportionate Use shall be based on the Premises' square footage divided by the Building's total square footage. The Building's total square footage is approximately 14,566 square feet and the Premises are approximately 12,500 square feet, which comprises 85.8 % of the Building's total square footage. "Operating Costs" shall be based on Mercy's 85.8% Proportionate Use. Operating Costs shall include (i) all utilities (including, but not limited to gas, electricity, and water), (ii) custodial services, (iii) landscaping and snow removal, (iv) City engineering services, and (v) Mercy's allocable share of other costs incurred by City in operating and maintaining the Building (excluding any capital improvements that may be required). Mercy may elect to separately contract for custodial services for the Premises. For 2014, Mercy's Operating Costs are estimated to be, and Mercy shall initially pay, $7,078.14 per month (subject to subsequent accounting and adjustment which may serve to increase or decrease these estimated Operating Costs for 2014 and/or subsequent years).
  2. Reimbursement Procedure. Each calendar year as soon as City can secure data for the prior year's Operating Costs, City shall provide Mercy with the estimated Operating Costs for such year. Mercy shall pay to City, one-twelfth (1/12) of such amount in equal monthly installments on the first day of each month during such year following billing by City. The estimated monthly Operating Costs for 2014 are set forth in Exhibit D. Once full data becomes available, City shall provide Mercy with the Actual Operating Costs for the previous year and a statement as to whether Mercy has underpaid or overpaid said Operating Costs. In the event Mercy's payments during the previous calendar year are less than the actual Operating Costs due from Mercy, such underpayment shall be included in Mercy's subsequent monthly installment(s) of Operating Costs spread out for the remainder of the year, or, if said
 
 
AGREEMENT NO. 20255
 
underpayment shall have been made in the last year of the Term, Mercy shall refund said underpayment to City within sixty (60) days of receipt of such notice of underpayment. If Mercy's installments during the previous calendar year are more than the actual Operating Costs due from Mercy, City shall credit said amount against Mercy's subsequent monthly installment(s) of Operating Costs for the remainder of the year, or, if said overpayment shall have been made in the last year of the Term, City shall refund said overpayment to Mercy within sixty (60) days of notice of such overpayment.
 
Operating Expenses shall be paid to City at the Department of Finance, Warrants for Collection, City Hall, 121 North LaSalle, Room 107, Chicago, Illinois 60602 or at such place as City may from time to time, hereby designate in writing to Mercy. City shall invoice Mercy for such Operating Expenses on a monthly basis. In the event that Mercy does not receive such invoice from City, Mercy shall contact City and request such invoicing. City's failure to invoice Mercy for Operating Expenses or other expenses incurred under this Agreement does not constitute a waiver of any such charges.
  1. Utilities. City shall pay for gas, electricity, and water supplied to the Building. Mercy shall pay when due all charges for telephone or other communication service provided to the Premises. In the event that Mercy uses the City's telephone lines, such costs shall be a reimbursable Operating Cost.
  2. Taxes. In the event that or Leasehold taxes are ever assessed against the Premises as a result of Mercy's tenancy, Mercy shall pay when due any leasehold taxes assessed or levied on Mercy's portion of the Premises without reimbursement or other setoff from City. Mercy acknowledges that leasehold taxes are one (1) year in arrears in Cook County and that as a result Mercy will be responsible for satisfaction of all leasehold taxes assessed or levied on the subject Premises at least one year after Mercy vacates the Premises. Notwithstanding the foregoing, nothing contained herein shall preclude Mercy from contesting any charge or tax levied against the Premises. The failure of Mercy to pay such taxes during the pendency of the contest shall not constitute a default under this Agreement. Mercy's tax responsibilities under this section shall survive the expiration, cancellation, or termination of this Agreement, but payment of leasehold taxes may be a requirement for contesting such taxes.
  3. Accord and Satisfaction. No payment by Mercy or receipt by City of a lesser amount than any installment or payment of the rent or Operating Costs or other costs due hereunder shall be deemed to be other than on account of the amount due, and no endorsement of statement or any check or any letter accompanying any check or payment of rent shall be deemed an accord and satisfaction. City may accept such check or payment without prejudice as to City's right to recover the balance of such installment or payment to pursue any other remedies available to City.
 
SECTION 4. CONDITION AND ENJOYMENT OF PREMISES, ALTERATIONS AND ADDITIONS, SURRENDER
 
4.1 Covenant of Quiet Enjoyment. City covenants and agrees that Mercy, upon paying the rent, Operating Costs, and upon observing and keeping the covenants, agreements,
 
 
 
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and conditions of this Agreement on its part to be kept, observed, and performed, shall lawfully and quietly hold, occupy, and enjoy the Premises (subject to the provisions of this Agreement) during the Term without hindrance or molestation by City or by any person or persons claiming under City.
  1. Maintenance. City shall take reasonable efforts to maintain the Building in a condition of good repair and good order. Mercy shall notify City regarding any issues with maintenance of the Premises and/or Building. Mercy shall also notify City regarding any issues with other services provided to the Premises and/or Building by City or through City's contractors. City shall be responsible for resolving any building code violations issued on the Building and/or Premises. In the event such building code violations were caused by Mercy, Mercy shall resolve such issues at Mercy's cost or City can perform such repairs subject to reimbursement from Mercy.
  2. City's Right of Access. City shall have the right of reasonable access to the Premises and/or Building, upon reasonable prior written notice to Mercy, for the purpose of inspecting and making City repairs to the Premises and/or Building. City shall also have the right of reasonable access to the Premises and/or Building for the purposes of monitoring Mercy's compliance with Services Agreement attached hereto and made a part hereof as Exhibit A. City shall always have access to the Premises and/or Building in the event of maintenance emergencies or security emergencies.
  3. Use of the Premises. Mercy shall not use the Premises in a manner that would violate any law. Mercy further covenants not to do or suffer any waste or damage any portion of the Premises and/or Building, and to comply in all respects with the laws, ordinances, orders, rules, regulations, and requirements of all federal, state, and municipal governmental departments which may be applicable to the Premises or to the use or manner of use of the Premises, disfigurement or injury to any building or improvement on the Premises, or to fixtures and equipment thereof. Any activities on the Premises must be limited for the delivery of health services as agreed between Mercy and the City's Department of Public Health. All such activities must be provided consistent with Mercy's not-for-profit purposes and so as to lessen the burdens of government by providing such health care services.
  4. Alterations and Additions. Mercy may make alterations, additions, and improvements on the Premises. Any such alterations, additions and improvements shall be in full compliance with any applicable laws, permit requirements, and building codes. In addition, Mercy will comply with all insurance requirements under this Agreement including, but not limited to, Section 6.1 (f). Mercy must obtain the prior written consent of the Commissioner of the Department of Fleet and Facility Management before commencing any alterations, additions, and or improvements including, but not limited to, telephone network switch and upgrades. Any permanent additions and improvements shall be without cost to City and shall become property of City at Agreement termination without offset or other credit to Mercy.'
 
SECTION 5. ASSIGNMENT, SUBLICENSE, AND LIENS
 
 
 
 
 
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  1. Assignment and Sublicense. Mercy may assign this Agreement in whole or in part or sublicense the Premises or any part thereof upon the prior written consent of the Commissioner of the Department of Fleet and Facility Management. Such consent shall not be unreasonably withheld, conditioned, or delayed.
  2. Mercy's Covenant against Liens. Mercy shall not cause or permit any lien or encumbrance, whether created by act of Mercy, operation of law or otherwise, to attach to or be placed upon City's title or interest in the Premises. All liens and encumbrances created by Mercy shall attach to Mercy's interest only. In case of any such lien attaching, Mercy shall immediately pay and remove such lien or furnish security or indemnify City in a manner satisfactory to City in its sole discretion to protect City against any defense or expense arising from such lien. Except during any period in which Mercy appeals any judgment or obtains a rehearing of any such lien, or in the event judgment is stayed, Mercy shall immediately pay any judgment rendered against Mercy, with all proper costs and charges, and shall have the lien released and any judgment satisfied. If Mercy fails to pay and remove any lien or contest such lien in accordance herewith, City, at its election, may pay and satisfy same, and all sums so paid by City, with interest from the date of payment at the rate set at 12% per annum.
 
SECTION 6. INSURANCE AND INDEMNIFICATION
 
6.1 Insurance. Mercy shall procure and maintain at all times at Mercy's own expense, during the term of this Agreement, the insurance coverages and requirements specified below, insuring all operations related to the Agreement with insurance companies authorized to do business in the state of Illinois.
 
The kinds and amounts of insurance required are as follows:
  1. Workers Compensation and Employers Liability Insurance. Workers Compensation and Employers Liability Insurance and Occupational Disease Insurance, as prescribed by applicable law, covering all Mercy's employees and Employer's Liability coverage with limits of not less than $500,000 for each accident or illness.
  2. Commercial Liability Insurance. (Primary and Umbrella). Commercial Liability Insurance or equivalent with limits of not less than $1,000,000 per occurrence, for bodily injury, personal injury, and property damage liability. Coverage extensions shall include the following: All premises and operations, products/completed operations, defense, separation of insureds, and contractual liability (with no limitation endorsement). The City of Chicago, its employees, elected officials, agents, and representatives are to be named as additional insureds on a primary, non-contributory basis for any liability arising directly or indirectly from the Agreement.
  3. Professional/ Liability. When any professional consultants perform services in the Premises or in connection with Mercy's use of the Premises, Liability Insurance covering acts, errors or omissions related to such activities must be maintained with limits of not less than $3,000,000. Coverage must include contractual liability. A claims-made policy which is not renewed or replaced must have an extended reporting period of 2 years. Mercy shall provide City with copies of the professional licenses and/or certificates for each of the professional
 
 
 
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consultants performing services in the Premises or in connection with Mercy's use of the Premises.
  1. Automobile Liability Insurance. (Primary and Umbrella). When any motor vehicles (owned, non-owned and hired) are used in connection with work to be performed, Mercy shall provide Comprehensive Automobile Liability Insurance with limits of not less than $1,000,000 per occurrence, for bodily injury and property damage.
  2. All Risk Property Insurance. All risk property insurance coverage shall be maintained by Mercy for full replacement value to protect against loss, damage to or destruction of property. The policy shall list the City of Chicago as an additional insured and loss payee.
 
Mercy shall be responsible for all loss or damage to personal property (including but not limited to materials, equipment, tools and supplies), owned or rented, by Mercy.
  1. All Risk Builders Risk Insurance. When Mercy undertakes any construction, including improvements, betterments, and/or repairs, Mercy shall provide All Risk Builders Risk Insurance, at replacement cost, for materials, supplies, equipment, machinery and fixtures that are or will be part of the permanent facility. Coverage shall include but not limited to the following: right to partial occupancy, earth movement, flood including surface water backup and sewer backup and seepage. The City of Chicago shall be named as an additional insured and loss payee.
 
6.2 Other Terms of Insurance. Mercy will furnish the City of Chicago, Department of Fleet and Facility Management, Office of Real Estate Management, Suite 300, 30 North LaSalle Street, Chicago, Illinois 60602, original Certificates of Insurance evidencing the required coverage to be in force on the date of this Agreement, and Renewal Certificates of Insurance, or such similar evidence, if the coverages have an expiration or renewal date occurring during the Term of this Agreement. Mercy shall submit evidence on insurance prior to award. The receipt of any certificates does not constitute agreement by the City that the insurance requirements in the Agreement have been fully met or that the insurance policies indicated on the certificate are in compliance with all Agreement requirements. The failure of the City to obtain certificates or other insurance evidence from Mercy shall not be deemed to be a waiver by the City. Mercy shall advise all insurers of the Agreement provisions regarding insurance. Non-conforming insurance shall not relieve Mercy of its obligation to provide Insurance as specified herein. Nonfulfillment of the insurance conditions may constitute a violation of the Agreement, and the City retains the right to terminate the Agreement until proper evidence of insurance is provided.
 
The insurance shall provide for 60 days prior written notice to be given to the City in the event coverage is substantially changed, canceled, or non-renewed.
 
Any and all deductibles or self-insured retentions on referenced insurance coverages shall be borne by Mercy.
 
Mercy agrees that its insurers shall waive their rights of subrogation against the City of Chicago its employees, elected officials, agents or representatives.
 
 
 
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Mercy expressly understands and agrees that any coverages and limits furnished by Mercy shall in no way limit Mercy's liabilities and responsibilities specified within the Agreement documents or by law.
 
Mercy expressly understands and agrees that any insurance or self-insurance programs maintained by the City of Chicago shall apply in excess of and not contribute with insurance provided by Mercy under the Agreement.
 
The required insurance shall not be limited by any limitations expressed in the indemnification language herein or any limitation placed on the indemnity therein given as a matter of law.
 
The City of Chicago, Department of Finance, Office of Risk Management, maintains the right to modify, delete, alter or change these requirements.
 
6.3 Mercy's Indemnification. Mercy shall indemnify, defend (through an attorney reasonably acceptable to the City), and hold Landlord (its officers, agents, agencies, departments and employees) harmless against all liabilities, judgments, actions, and amounts paid in settlement, arbitration or mediation awards, costs, damages, and expenses (including reasonable attorney's fees, expenses, and court costs) (together the "Claims"), and loss or damage to personal property as set forth in Section 6.1 herein, whether such Claim is related to or arises from personal injury, property damage, or property loss which may be expended by or accrue against, be charged to, or be recovered from Landlord or Mercy by reason of Mercy's performance of, or failure to perform, any of Mercy's obligations under this Agreement, or Mercy's negligent acts or failure to act, or resulting from the acts or failure to act of Mercy's or any of Mercy's contractors, respective officers, directors, agents, employees, or invitees. Mercy shall indemnify, defend and hold Landlord harmless against any and all Claims, including but not limited to, Claims that may arise in relation to the use of the Premises by the general public. The foregoing indemnity shall survive any termination of this Agreement.
 
SECTION 7. DAMAGE OR DESTRUCTION
 
7.1 Damage or Destruction. If the Premises and/or Building are damaged or destroyed or a casualty to such extent that Mercy cannot continue, occupy or conduct its normal business therein, or if, in Mercy or City's opinion, the Premises and/or Building are rendered unusable, either City or Mercy shall have the option to declare this Agreement terminated as of the date of such damage or destruction by giving the other party written notice of such exercise. If either party exercises this option, Mercy shall cease operations immediately and the Operating Costs shall be apportioned as of the date of such damage or destruction. City shall repay to Mercy any prepaid Operating Costs.
 
SECTION 8. CONFLICT OF INTEREST AND GOVERNMENTAL ETHICS
 
8.1 Conflict of Interest. No official or employee of the City of Chicago, nor any member of any board, commission or agency of the City of Chicago, shall have any financial interest (as defined in Chapter 2-156 of the Municipal Code), either direct or indirect, in the
 
 
 
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Premises; nor shall any such official, employee, or member participate in making or in any way attempt to use her or his position to influence any City governmental decision or action with respect to this Agreement.
 
8.2 Duty to Comply with Governmental Ethics Ordinance. City and Mercy shall comply with Chapter 2-156 of the Municipal Code of Chicago, "Governmental Ethics," including but not limited to section 2-156-120, which states that no payment, gratuity, or offer of employment shall be made in connection with any City of Chicago contract as an inducement for the award of that contract or order. Any contract negotiated, entered into, or performed in violation of any of the provisions of Chapter 2-156 shall be voidable as to the City of Chicago.
 
SECTION 9. HOLDING OVER
 
9.1 Holding Over. Any holding over by Mercy shall be construed to be a tenancy from month to month beginning on July 1, 2019 (the "Holding Over"). During any Holding Over the rent and Operating Costs will be the same as outlined in Section 3.1 and Section 3.2 of this Agreement. During any Holding Over, all other provisions of this Agreement shall remain in full force and effect.
 
SECTION 10. MISCELLANEOUS
 
10.1 Notice. All notices, demands and requests which may be or are required to be given, demanded or requested by either party to the other shall be in writing. All notices, demands and requests by Mercy to City shall be delivered by national overnight courier or shall be sent by United States registered or certified mail, return receipt requested, postage prepaid addressed to City as follows:
 
City of Chicago Department of Public Health 333 South State Street, 2nd Floor Chicago, Illinois 60605
 
City of Chicago
Department of Fleet and Facility Management Office of Real Estate Management 30 North LaSalle Street, Room 300 Chicago, Illinois 60602
 
or at such other place as City may from time to time designate by written notice to Mercy. All notices, demands, and requests by City to Mercy shall be delivered by a national overnight courier or shall be sent by United States registered or certified mail, return receipt requested, postage prepaid, addressed to Mercy as follows:
 
Mercy Family Health Center 2525 South Michigan Avenue Chicago, Illinois 60616-2477
 
 
 
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AGREEMENT NO. 20255
 
 
 
With a copy to:
Mercy Hospital & Medical Center Legal Services
2525 South Michigan Avenue Chicago, Illinois 60616-2477
 
or at such other place as Mercy may from time to time designate by written notice to City. Any notice, demand or request which shall be served upon Mercy by City, or upon City by Mercy, in the manner aforesaid, shall be deemed to be sufficiently served or given for all purposes hereunder at the time such notice, demand or request shall be mailed.
  1. Partial Invalidity. If any covenant, condition, provision, term or agreement of this Agreement shall, to any extent, be held invalid or unenforceable, the remaining covenants, conditions, provisions, terms and agreements of this Agreement shall not be affected thereby, but each covenant, condition, provision, term or agreement of this Agreement shall be valid and in force to the fullest extent permitted by law.
  2. Governing Law. This Agreement shall be construed and be enforceable in accordance with the laws of the State of Illinois.
  3. Entire Agreement. All preliminary and contemporaneous negotiations are merged into and incorporated in this Agreement. This Agreement contains the entire agreement between the parties and shall not be modified or amended in any manner except by an instrument in writing executed by the parties hereto.
  4. Captions and Section Numbers. The captions and section numbers appearing in this Agreement are inserted only as a matter of convenience and in no way define, limit, construe or describe the scope or intent of such sections of this Agreement nor in any way affect this Agreement.
  5. Binding Effect of Agreement. The covenants, agreements, and obligations contained in this Agreement shall extend to, bind, and inure to the benefit of the parties hereto and their legal representatives, heirs, successors, and assigns.
  6. Time is of the Essence. Time is of the essence of this Agreement and of each and every provision hereof.
  7. No Principal/Agent or Partnership Relationship. Nothing contained in this Agreement shall be deemed or construed by the parties hereto nor by any third party as creating the relationship of principal and agent or of partnership or of joint venture between the parties hereto.
  8. Authorization to Execute Agreement. The parties executing this Agreement hereby represent and warrant that they are duly authorized and acting representatives of City and Mercy respectively and that by their execution of this Agreement, it became the binding
 
 
 
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obligation of City and Mercy respectively, subject to no contingencies or conditions except as specifically provided herein.
  1. Termination of Agreement. City and Mercy shall have the right to terminate this Agreement for any reason or for convenience on or after January 1, 2015 by providing each other with ninety (90) days prior written notice. In the event that Mercy undertakes significant improvements to the Premises, the parties may elect to extend the initial date when the parties may elect to terminate this Agreement.
  2. Force Majeure. When a period of time is provided in this Agreement for either party to do or perform any act or thing, the party shall not be liable or responsible for any delays due to strikes, lockouts, casualties, acts of God, wars, governmental regulation or control, and other causes beyond the reasonable control of the party, and in any such event the time period shall be extended for the amount of time the party is so delayed.
  3. Default. Mercy must adhere to all provisions of this Agreement. Failure of Mercy to adhere to all provisions of this Agreement will result in default. In the event of such default, City will notify Mercy in writing as to the circumstances giving rise to such default. Upon written receipt of such notice, Mercy must cure such default within thirty (30) days. If Mercy does not cure such default within thirty (30) days, City may cancel this Agreement with thirty (30) days written notice. City may provide additional time where Mercy cannot reasonably cure such event of default.
  4. No Brokers. Mercy warrants to City that no broker or finder (a) introduced Mercy to the Premises, (b) assisted Mercy in the negotiation of this Agreement, or (c) dealt with Mercy on Mercy's behalf in connection with the Premises or this Agreement. City warrants to Mercy that no broker or finder (a) introduced City to Mercy, (b) assisted City in the negotiation of this Agreement, or (c) dealt with City on City's behalf in connection with the Premises or this Agreement. No payments due under this Agreement shall be made to any brokers.
  5. Amendments. From time to time, the parties hereto may administratively amend this Agreement with respect to any provisions reasonably related to Mercy's use of the Premises and/or City's administration of this Agreement, including, but not limited to, space expansion or reduction within the Building and space remeasurement. Provided, however, that such amendment(s) shall not serve to extend the Term hereof nor serve to otherwise materially alter the essential provisions contained herein. Such amendment(s) shall be in writing, shall establish the factual background necessitating such alteration, shall set forth the terms and conditions of such modification, and shall be duly executed by both City and Mercy. Such amendment(s) shall only take effect upon execution by both parties. Upon execution, such amendment(s) shall become a part of this Agreement and all other provisions of this Agreement shall otherwise remain in full force and effect.
  6. Compliance with Department of Public Health. Mercy shall at all times be in full compliance with the Service Agreement or any agreements entered into between Mercy and City's Department of Public Health relative to the Premises and/or Building.
 
 
 
 
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  1. Access to Parking Lot. Mercy, its agents, employees, licensees, contractors, clients, and invitees shall have non-exclusive access to the rear parking lot of the Building on a first-come first-served basis. Such use of the rear parking lot shall be subject to all rules in place, or hereinafter in place, governing the access to the rear parking lot. Mercy acknowledges that City may from time to time lease parts of the parking lot to other parties. City and Mercy acknowledge that in fulfilling City and Mercy's public benefit mission, the parking lot is provided primarily for the benefit of City's clients and Mercy's clients.
  2. Existing Furniture. Mercy may use any furniture and equipment belonging to City and located within the Premises that is not removed by City. The City shall retain ownership of such furniture and equipment.
  3. No Other Rights. The execution of this Agreement does not give Mercy any other right with respect to the Premises and/or Building. Any rights not expressly granted to Mercy through this Agreement are reserved exclusively to City. Unless otherwise specified in this Agreement, execution of this Agreement does not obligate City to undertake any additional duties or services.
  4. Municipal Marketing Efforts. The City shall have the right to install digital advertising sign on the adjoining parking lot as part of the City's municipal marketing efforts, subject to the separate approval of City Council.
  5. No Construction against Preparer. This Agreement shall not be interpreted in favor of either City or Mercy. City and Mercy each acknowledge that both parties participated fully in the mutual drafting of this Agreement.
  6. No Real Estate Interests. This Agreement creates a license only. Mercy acknowledges and agrees that Mercy shall not hold or claim at any time an interest or estate of any kind whatsoever in the Premises by virtue of this Agreement or Mercy's use of the Premises.
 
SECTION 11. RESPONSIBILITIES OF MERCY
  1. Inspection. Mercy has inspected the Premises, Building, and all related areas and grounds. Mercy is satisfied with the physical condition thereof. Mercy accepts the Premises and the Building in "as-is" condition.
  2. Custodial Service. Mercy shall keep the Premises in a sanitary condition, free of insects, rodents, vermin and other pests. City shall provide and pay for custodial services for the Premises and the Building (although City may later elect to eliminate or reduce such services) and such costs shall be included as a reimbursable Operating Cost. At Mercy's cost, Mercy may also choose to supplement City's custodial services for the common areas within the Building. By mutual agreement, at a later date the Premises and the entire Building may also be serviced by Mercy's custodial services provider. In such event, Mercy's custodial costs applicable to the non-Premises within the Building shall be credited against reimbursable Operating Costs.
 
 
 
 
 
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  1. Security. Mercy shall provide security for the Premises. By mutual agreement, at a later date Mercy may provide security services to the non-Premises portion of the Building. In such event Mercy's security costs applicable to the non-Premises within the Building shall be credited against reimbursable Operating Costs. Mercy shall abide by any security rules that may apply to the Building and/or the Premises.
  2. Pest Control. City shall provide and pay for pest control services whenever necessary for the Building and the Premises. Notwithstanding the foregoing, City shall not provide such services where Mercy is negligent in maintaining reasonable sanitary standards within the Premises. City's costs for pest control services shall be included as a reimbursable Operating Cost.
  3. Repairs for Negligence, Vandalism, or Misuse. Mercy shall assume responsibility for any repairs to the Premises and/or Building necessitated by the negligence, vandalism, or misuse of the Premises and/or Building or equipment therein by Mercy's employees, invitees, agents, clients, or contractors.
  4. Fire Extinguishers. City shall provide and maintain fire extinguishers as may be required by applicable code in the Building and the Premises at all times. City's costs to provide and maintain fire extinguishers shall be included in the reimbursable Operating Costs.
  5. Signage. Mercy may place exterior and interior signage on the Premises and/or Building. Such signage and placement must be approved in writing by the Commissioner of the Department of Fleet and Facility Management.
  6. Hazardous Materials. Mercy shall keep out of the Premises materials which cause a fire hazard or safety hazard. Mercy shall not store any hazardous materials within the Premises and/or Building. Mercy shall dispose of all medical wastes at Mercy's cost and in accordance with any applicable laws.
  7. Trade Fixtures. Mercy shall maintain Mercy's equipment and trade fixtures in the Premises in good condition. Upon the termination or cancellation of this Agreement, Mercy shall remove Mercy's personal property and equipment, provided that Mercy shall repair any injury or damage to the Premises and/or Building resulting from such removal. If Mercy does not remove Mercy's furniture, machinery, trade fixtures and all other items of personal property, City may, at its option, remove the same and deliver them to any other place of business of Mercy or warehouse the same. Mercy shall pay the cost of such removal, including the repair for such removal, delivery and warehousing, to City on demand, or City may treat such property as being conveyed to City with this Agreement serving as a bill of sale, without further payment or credit by City to Mercy.
  8. Illegal Activity. Mercy, or any of its agents or employees, shall not perform or permit any practice that is injurious to the Premises or Building, is illegal, or increases the rate of insurance on the Premises and/or Building.
 
 
 
 
 
12
 
 
AGREEMENT NO. 20255
  1. No Alcohol or Illegal Drugs. Mercy agrees that no alcoholic beverages or illegal drugs of any kind or nature shall be sold, given away, or consumed on the Premises or Building by Mercy's staff, contractors, agents, invitees, or clients.
  2. Licensing and Permits. For any activity which Mercy desires to conduct on the Premises in which a license or permit is required, said license or permit must be obtained by Mercy prior to using the Premises for such activity. The Department of Public Health and the Department of Fleet and Facility Management must be notified of any such license or permit. Failure to obtain and maintain a required license or permit shall constitute a breach of the terms of this Agreement.
  3. Full Liability. Mercy assumes full legal and financial responsibility and liability for any use of the Premises by Mercy, Mercy's staff, Mercy's agents, Mercy's invitees, entering the Premises including, without limitation, clients receiving health services.
  4. Non-Discrimination. Mercy agrees that Mercy shall not discriminate on the basis of race, color, sex, age, religion, disability, national origin, sexual orientation, marital status, parental status, military discharge status, immigration status, age, or source of income with respect to services provided by Mercy on the Premises. Mercy shall not use the Premises for any religious activities.
  5. Building Rules. Mercy shall comply with all reasonable rules and regulations in place at Agreement execution or thereafter promulgated in writing by City for the Building including, but not limited to, any parking lot rules and regulations.
  6. Compliance with HIPAA. Mercy shall at all times comply with all provisions of the Health Insurance Portability and Accountability Act.
  7. Economic Disclosure Statement Affidavit Updates. Throughout the Term, Mercy shall provide City with any material updates to the information previously submitted in Mercy's Economic Disclosure Statement Affidavit. City may also request such updates from time to time. Failure to provide such information on a timely basis shall constitute a default under this Agreement.
  8. Condition on Surrender. Upon the termination or cancellation of this Agreement, Mercy shall surrender the Premises to City in a comparable or better condition to the condition of the Premises at the beginning of Mercy's occupancy, with normal wear and tear taken into consideration.
 
SECTION 12. DISCLOSURES AND REPRESENTATIONS
 
12.1 Business Relationships. Mercy acknowledges (A) receipt of a copy of Section 2-156-030 (b) of the Municipal Code of Chicago, (B) that it has read such provision and understands that pursuant to such Section 2-156-030 (b) it is illegal for any elected official of the City, or any person acting at the direction of such official, to contact, either orally or in writing, any other City official or employee with respect to any matter involving any person with whom
 
 
 
13
 
 
AGREEMENT NO. 20255
 
Ihe elected City official or employee has a "Business Relationship" (as defined in Section 2-156-080 of the Municipal Code of Chicago), or to participate in any discussion in any City Council committee hearing or in any City Council meeting or to vote on any matter involving the person with whom an elected official has a Business Relationship, and (C) notwithstanding anything to the contrary contained in this Agreement, that a violation of Section 2-156-030 (b) by an elected official, or any person acting at the direction of such official, with respect to any transaction contemplated by this Agreement shall be grounds for termination of this Agreement and the transactions contemplated hereby. Mercy hereby represents and warrants that no violation of Section 2-156-030 (b) has occurred with respect to this Agreement or the transactions contemplated hereby.
  1. Patriot Act Certification. Mercy represents and warrants that neither Mercy nor any Affiliate thereof (as defined in the next paragraph) is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury, the Bureau of Industry and Security of the U.S. Department of Commerce or their successors, or on any other list of persons or entities with which the City may not do business under any applicable law, rule, regulation, order or judgment, the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
 
As used in the above paragraph, an "Affiliate" shall be deemed to be a person or entity related to Mercy that, directly or indirectly, through one or more intermediaries, controls, is controlled by or is under common control with Mercy, and a person or entity shall be deemed to be controlled by another person or entity, if controlled in any manner whatsoever that results in control in fact by that other person or entity (or that other person or entity and any persons or entities with whom that other person or entity is acting jointly or in concert), whether directly or indirectly and whether through share ownership, a trust, a contract or otherwise.
  1. Prohibition on Certain Contributions-Mayoral Executive Order No. 2011-4. Mercy agrees that Mercy, any person or entity who directly or indirectly has an ownership or beneficial interest in Mercy of more than 7.5 percent ("Owners"), spouses and domestic partners of such Owners, Mercy's contractors (i.e., any person or entity in direct contractual privity with Mercy regarding the subject matter of this Agreement) ("Contractors"), any person or entity who directly or indirectly has an ownership or beneficial interest in any Contractor of more than 7.5 percent ("Sub-owners") and spouses and domestic partners of such Sub-owners (Mercy and all the other preceding classes of persons and entities are together, the "Identified Parties"), shall not make a contribution of any amount to the Mayor of the City of Chicago (the "Mayor") or to his political fundraising committee (i) after execution of this Agreement by Mercy, (ii) while this Agreement or any Other Contract is executory, (iii) during the term of this Agreement or any Other Contract between Mercy and the City, or (iv) during any period while an extension of this Agreement or any Other Contract is being sought or negotiated. This provision shall not apply to contributions made prior to May 16, 2011, the effective date of Executive Order 2011-4.
 
Mercy represents and warrants that from the date the City approached Mercy or the date Mercy approached the City, as applicable, regarding the formulation of this Agreement, no Identified Parties have made a contribution of any amount to the Mayor or to his political fundraising committee.
 
 
 
14
 
i
 
AGREEMENT NO. 20255
 
 
Mercy agrees that it shall not: (a) coerce, compel or intimidate its employees to make a contribution of any amount to the Mayor or to the Mayor's political fundraising committee; (b) reimburse its employees for a contribution of any amount made to the Mayor or to the Mayor's political fundraising committee; or (c) bundle or solicit others to bundle contributions to the Mayor or to his political fundraising committee.
 
Mercy agrees that the Identified Parties must not engage in any conduct whatsoever designed to intentionally violate this provision or Mayoral Executive Order No. 2011-4 or to entice, direct or solicit others to intentionally violate this provision or Mayoral Executive Order No. 2011-4.
 
Notwithstanding anything to the contrary contained herein, Mercy agrees that a violation of, non-compliance with, misrepresentation with respect to, or breach of any covenant or warranty under this provision or violation of Mayoral Executive Order No. 2011-4 constitutes a breach and default under this Agreement, and under any Other Contract for which no opportunity to cure will be granted, unless the City, in its sole discretion, elects to grant such an opportunity to cure. Such breach and default entitles the City to all remedies (including, without limitation, termination for default) under this Agreement, under any Other Contract, at law and in equity. This provision amends any Other Contract and supersedes any inconsistent provision contained therein.
 
If Mercy intentionally violates this provision or Mayoral Executive Order No. 2011-4 prior to the execution of this Agreement, the City may elect to decline to close the transaction contemplated by this Agreement.
 
For purposes of this provision:
 
"Bundle" means to collect contributions from more than one source which are then delivered by one person to the Mayor or to his political fundraising committee.
 
"Other Contract" means any other agreement with the City of Chicago to which Mercy is a party that is (i) formed under the authority of chapter 2-92 of the Municipal Code of Chicago; (ii) entered into for the purchase or lease of real or personal property; or (iii) for materials, supplies, equipment or services which are approved or authorized by the City Council of the City of Chicago.
 
"Contribution" means a "political contribution" as defined in Chapter 2-156 of the Municipal Code of Chicago, as amended.
 
Individuals are "Domestic Partners" if they satisfy the following criteria:
    1. they are each other's sole domestic partner, responsible for each other's common welfare; and
  1. neither party is married; and
 
 
 
 
15
 
 
AGREEMENT NO. 20255
    1. the partners are not related by blood closer than would bar marriage in the State of Illinois; and
    2. each partner is at least 18 years of age, and the partners are the same sex, and the partners reside at the same residence; and
  1. two of the following four conditions exist for the partners:
  1. The partners have been residing together for at least 12 months.
  2. The partners have common or joint ownership of a residence.
  3. The  partners   have  at   least  two   of the following arrangements:
    1. joint ownership of a motor vehicle;
    2. a joint credit account;
    3. a joint checking account;
    4. a lease for a residence identifying both domestic partners as tenants.
  1. Each partner identifies the other partner as a primary beneficiary in a will.
 
"Political fundraising committee" means a "political fundraising committee" as defined in Chapter 2-156 of the Municipal Code of Chicago, as amended.
  1. Waste Ordinance Provisions. In accordance with Section ll-4-1600(e) of the Municipal Code of Chicago, Mercy warrants and represents that it, and to the best of its knowledge, its contractors and subcontractors, have not violated and are not in violation of any provisions of Section 7-28 or Section 11-4 of the Municipal Code (the "Waste Sections"). During the period while this Agreement is executory, Mercy's, any general contractor's or any subcontractor's violation of the Waste Sections, whether or not relating to the performance of this Agreement, constitutes a breach of and an event of default under this Agreement, for which the opportunity to cure, if curable, will be granted only at the sole designation of the Commissioner of the Department of Fleet and Facility Management. Such breach and default entitles the City to all remedies under the Agreement, at law or in equity. This section does not limit Mercy's, general contractor's and its subcontractor's duty to comply with all applicable federal, state, county and municipal laws, statutes, ordinances and executive orders, in effect now or later, and whether or not they appear in this Agreement. Non-compliance with these terms and conditions may be used by the City as grounds for the termination of this Agreement, and may further affect Mercy's eligibility for future contract awards.
  2. Failure to Maintain Eligibility to do Business with City. Failure by Mercy or any controlling person (as defined in Section 1-23-010 of the Municipal Code of Chicago) thereof to maintain eligibility to do business with the City of Chicago as required by Section 1-23-030 of the Municipal Code of Chicago shall be grounds for termination of this Agreement and the transactions contemplated thereby. Mercy shall at all times comply with Section 2-154-020 of the Municipal Code of Chicago.
 
 
 
 
 
16
 
 
AGREEMENT NO. 20255
  1. Cooperation with Inspector General and Legislative Inspector General. It is the duty of every officer, employee, department, agency, contractor, subcontractor, user of City's real property, and every applicant for certification of eligibility for a City contract or program, to cooperate with the City's Legislative Inspector General and with the City's Inspector General in any investigation or hearing undertaken pursuant to Chapters 2-55 and 2-56, respectively, of the Municipal Code of Chicago. The Foundation understands and will abide by all provisions of Chapters 2-55 and 2-56 of the Municipal Code of Chicago.
  2. 2011 City Hiring Plan Prohibitions.
 
(i)      The City is subject to the June 24, 2011 "City of Chicago Hiring Plan" (the "2011
City Hiring Plan") entered in Shakman v. Democratic Organization of Cook County, Case No 69
C 2145 (United States District Court for the Northern District of Illinois). Among other things,
2011 City Hiring Plan prohibits the City from hiring persons as governmental employees in non-
exempt positions on the basis of political reasons or factors.
 
(ii)      Mercy is aware that City policy prohibits City employees from directing any
individual to apply for a position with Mercy, either as an employee or as a subcontractor, and
from directing Mercy to hire an individual as an employee or as a subcontractor. Accordingly,
Mercy must follow its own hiring and contracting procedures, without being influenced by City
employees. Any and all personnel provided by Mercy under this Agreement are employees or
subcontractors of Mercy, not employees of the City of Chicago. This Agreement is not intended
to and does not constitute, create, give rise to, or otherwise recognize an employer-employee
relationship of any kind between the City and any personnel provided by Mercy.
  1. Mercy will not condition, base, or knowingly prejudice or affect any term or term or aspect to the employment of any personnel provided under this Agreement, or offer employment to any individual to provide services under this Agreement, based upon or because of any political reason or factor, including, without limitation, any individual's political affiliation, membership in a political organization or party, political support or activity, political financial contributions, promises of such political support, activity or financial contributions, or such individual's political sponsorship or recommendation. For purposes of this Agreement, a political organization or party is an identifiable group or entity that has as its primary purpose the support of or opposition to candidates for elected public office. Individual political activities are the activities of individual persons in support of or in opposition to political organizations or parties or candidates for elected public office.
  2. In the event of any communication to Mercy by a City employee or City official in violation of Section 12.7(H) above, or advocating a violation of Section 12.7(iii) above, Mercy will, as soon as is reasonably practicable, report such communication to the Hiring Oversight Section of the City's Office of the Inspector General ("IGO Hiring Oversight"), and also to the head of the relevant City Department utilizing services provided under this Agreement. Mercy will also cooperate with any inquiries by IGO Hiring Oversight related to the Agreement.
 
 
[SIGNATURES APPEAR ON THE FOLLOWING PAGE]
 
 
 
17
 
 
AGREEMENT NO. 20255
 
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the Effective Date.
 
CITY:
 
BY:    THE CITY OF CHICAGO,
an Illinois municipal corporation and home rule unit of government
 
DEPARTMENT OF PUBLIC HEALTH
 
 
By:.
Commissioner
 
DEPARTMENT OF FLEET AND FACILITY MANAGEMENT
 
 
By:      
Commissioner
 
 
APPROVED AS TO FORM AND LEGALITY: BY:    DEPARTMENT OF LAW
 
By:
 
 
 
Deputy Corporation Counsel Real Estate Division
 
 
 
MERCY:
 
BY:    MERCY DIAGNOSTIC AND TREATMENT CENTER (D/B/A MERCY FAMILY HEALTH CENTER), an Illinois not-for-profit corporation
 
 
By:_
Name: Its:
 
 
 
 
 
 
 
18
 
 
EXHIBIT A
 
SER VICES A GREEMENT
(To Come)
 
EXHIBIT B
 
LEGAL DESCRIPTION OF PREMISES
 
 
LOTS 62 THROUGH 71 IN BLOCK 4 OF JOHNSTON & LEE'S SUBDIVISION OF THE SOUTHWEST Va IN SECTION 20, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN IN COOK COUNTY ILLINOIS.
 
PIN#: 17-20-302-001
17-20-302-005 17-20-302-006 17-20-302-009 17-20-302-043
 
Address:
 
1713 South Ashland Avenue
 
EXHIBIT C
 
DEPICTION OF PREMISES
(subject to further revisions)
 
 
 
 
 
EXHIBIT D
 
 
 
 
 
 
Items
Electricity Gas
Custodial Services
Engineering
Other Operating Costs
ESTIMATED OPERATING COSTS FOR 2014
1713 South Ashland Avenue Lower West Neighborhood Health Clinic (subject to further revisions)
 
      Building Amounts (14,566 Sq. Ft.)
$22,614.66 $5,438.04
$51,744.05 $5,712.20
$13,486.00
 
$98,994.95
 
Total Annual Costs
 
 
 
 
$98,994.95 (Annual Building Operating Costs) X (0.858) = $84,937.67 (Annual Premises Operating Costs)
 
Total Monthly Operating Costs = $7,078.14
 
1713 South Ashland Avenue
Mercy Diagnostic and Treatment Center (D/B/A Mercy Family Health Center) Agreement No. 20255
SECTION 2: This Ordinance shall be effective from and after the date of its passage and approval.
 
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
 
SECTION I -- GENERAL INFORMATION
A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
 
 
 
Check ONE of the following three boxes:
 
Indicate whether the Disclosing Party submitting this EDS is:
  1. tyfc the Applicant
- OR
  1. [] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Parry holds an interest:      
OR
3.      [] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of.control:      
B. Business address of the Disclosing Party:     /)5^9^<^- H'oUi'cyxvi AwamP      
  1. Telephone:fffc ${A 12><£>0      Fax: ff/t ?Zg ?7Q2-       Email: ^'0(303(06 Wc^-ci^tcay.
  2. Name of contact pcrson:~^°H"<i U'ce^C^Mb      
/       !
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):
 
 
G. Which City agency or department is requesting this EDS?      ,L^^H"tVto^3; cif ^yukltc rjegJf^
Ifthe Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
 
Specification #            and Contract it      
 
Ver. 01-01-12
 
 
 
Page 1 of 13
 
 
SECTION If - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY 1.   Indicate the nature of the Disclosing Party:
Person      [] Limited liability company
Publicly registered business corporation      [ ] Limited liability partnership
Privately held business corporation      [ ] Joint venture
Sole proprietorship      T^f Not-for-profit corporation
General partnership      (Is the not-for-profit corporation also a 501(c)(3))?
Limited partnership      l^kYes      [ ] No
Trust      [ ] Other (please specify)
 
 
2.   For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
nniiwots      
3.   For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
 
[ ] Yes      £4No      [ ] N/A
 
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
 
I.   List below the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
 
Name Title
_W ]A"HarAvi^uAT (      
 
 
 
 
 
 
2.   Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% of the Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
 
Page 2 of 13
 
 
„r interest of a beneficiary of a trust,
 
 
 
Percentage Interest in the
Name      BusinCSS AddrCSS      Disclosing Party
 
 
 
 
 
 
 
[ ] Yes p£No
rf yes, please identify below the name(s) of such City elected official(s) and describe such rclationship(s):
 
 
 
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Parry's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (I) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
Ifthe Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
 
 
 
 
Page 3 of 13
 
 
Name (indicate whether    Business      Relationship to Disclosing Party   Fees (indicate whether
retained or anticipated       Address       (subcontractor, attorney,      paid or estimated.) NOTE:
to be retained)      lobbyist, etc.)      "hourly rate" or "t.b.d." is
not an acceptable response.
V^flA>~            —      
 
 
 
 
(Add sheets if necessary)
^0 Check here ifthe Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
f ] Yes      [ ] No      pCNo person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?
[ ] Yes      [ ] No
 
B. FURTHER CERTIFICATIONS
 
I.   Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined terras (e.g., "doing business") and legal requirements), ifthe Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
 
 
Page 4 of 13
 
 
2. The Disclosing Party and, if the Disclosing Party is a legal entity, a.l of those persons or entity identified in Section II.B.l- of this EDS:
  1. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local u„,t of government,
  2. have not, within a five-year period preceding the date of this EDS, been convicted1 of'.^rirnmal offense adjudged guilty, or had a civil judgment rendered aga.nst them m connection with. obSing, attefnptmg to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud, embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property; •
  3. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
  4. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
  5. 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 criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
 
3.   The certifications in subparts 3,4 and 5 concern:
    • the Disclosing Party;
  • any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure orSubcontractors and Other Retained Parties");
•      any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
• any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
 
 
Page 5 of 13
 
 
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the dale this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
  1. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the Cily, the State of Illinois, or any agency of the federal government or of any state or local government in the United Stales of America, in that officer's or employee's official capacity;
  2. agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
  3. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
  4. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
  1. Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agent-; or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (I) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
  2. Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
  3. The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
  4. Ifthe Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
 
 
 
 
 
 
 
Page 6 of 13
 
 
Ifthe 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").
tOdUL.      
 
 
 
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.
      
 
 
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
  1. The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is      ^is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
  1. Ifthe Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We arc 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 tiie loss of the privilege of doing business with the City."
 
Ifthe 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 the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
 
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
 
Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.
  1. In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter?
[ ] Yes      J>f No
NOTE:  If you checked "Yes" to Item D.l., proceed to Items D.2. and D.3. If you checked "No" to Item D.l., proceed to Part E.
  1. Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.
 
Docs the Matter involve a City Property Sale?
 
[ ] Yes      [ ] No
  1. If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
 
Name      Business Address      Nature of Interest
 
 
 
 
 
 
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
 
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
 
Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
 
 
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
 
\J  1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
 
      2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes 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 FUNDED MATTERS
 
NOTE: Ifthe Matter is federally funded, complete this Section VI. Ifthe Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City are not federal funding.
 
A. CERTIFICATION REGARDING LOBBYING
 
1.   List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
 
 
 
 
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
 
2.   The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, imend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
 
 
3. The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
A.   The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or(ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
5.   Ifthe Disclosing Party is the Applicant, the Disclosing Patty must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration of the Matter and must make such certifications promptly available to the City upon request.
 
 
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
 
Ifthe Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
[ 3 Yes      t ] No
If "Yes," answer the three questions below:
  1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes      [ ] No
  1. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
( ] Yes      [ ] No
  1. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
NYes []No
 
If you checked "No" to question 1. or 2. above, please provide an explanation:
 
 
 
 
Page 10 of 13
 
 
SECTION VII — ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
 
The Disclosing Party understands and agrees that:
  1. The certifications, disclosures, and acknowledgments contained in (his EDS will become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other Cily action, and are material inducements to the City's execution of any contracl or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
  2. The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.citvofchicago.org/Ethics. and may also be obtained from the City's Board of Ethics, 740 N.
 
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
C. If the City determines thai any information provided in this EDS is false, incomplete or inaccurale, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
 
D. It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
 
E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. Ifthe Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article 1 of Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
 
Page 11 of 13
 
 
Department of Revenue, nor are the ^^'^.^^J^^ >, all water charges, fine, fee, tax or other charge owed to the Gty. ^^^ '^ sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If^Disc^gPa^thc^^
 
 
F.3    Ifthe Disclosing Party is the Applicant, the Disclosing Party      equal in
 
 
 
 
NOTE: Ifthe Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
 
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
(Print or type name of Disclosing Party)
(Sign here)
(Printer lypc name of person signing)
(Print or type title of person signing)
 
Signed and sworn lo before mo on (date) if\ II / /'-/
at      County, __V~LtfjQlS (state).
 
. Notary Public.
 
Commission expires:      lL
Page 12 of J 3
OFFICIAL SEAL GERALYNAKILCOYNE NOTARY PUBUC - STATE OF UiHOIS MY COMMISSION exPIHES:l1/2»H
 
 
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT APPENDIX A
 
 
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
 
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent It Is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Parly or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l .a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, ifthe Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city ofiicial or department head?
[ JYes
 
If yes, please identify below (1) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
 
 
 
 
 
 
 
 
 
Page 13 of 13
 
 
Mercy Family Health Center 2013-2014 Board of Directors and Officers
 
Officers 2013-2014
Chairperson:
Vice-Chairperson:
President:
Vice-President:
Secretary:
Treasurer
Board Members:
 
Chekeda Sims-Moore
Yvonne Bryant
Daniel Vicencio, MD (Interim)
Currently vacant
Sr Joella Cunnane, RSM
Sr Catherine McDonagh, RSM
 
Patricia Canessa Lorac Chow Caroline Costello Helen Glenn Claudia Haynes Dorothy Sallis Frank Smith Marian Woodfork