This record contains private information, which has been redacted from public viewing.
Record #: O2014-9992   
Type: Ordinance Status: Passed
Intro date: 12/10/2014 Current Controlling Legislative Body: Committee on Housing and Real Estate
Final action: 1/21/2015
Title: Sale of City-owned property at 3648 W Ogden Ave, 3652 W Ogden Ave, 3654 W Ogden Ave, 3656 W Ogden Ave, 3658 W Ogden Ave and 3662 W Ogden Ave to Lawndale Christian Health Center for improvement of parking lot and open space
Sponsors: Emanuel, Rahm
Topic: PROPERTY - Sale
Attachments: 1. O2014-9992.pdf


City Council - City of Chicago City Hall, Room 200 121 North LaSalle Street
Chicago, Illinois 60602 Telephone (312) 744-6102 - Fax: (312) 744-0770 rsuarez@cityofchicago.org
RAY SUAREZ
Alderman, 31 st Ward
Vice Mayor - City of Chicago

4502 West Fullerton Avenue Chicago, Illinois 60639 Telephone: (773) 276-9100 Fax: (773) 276-2596

www.war.d31 .com


Committee Memberships:
Housing and Real Estate (Chairman)
Committees, Rules and Ethics (Vice-Chairman)
Aviation
Budget and Government Operations Finance
Transportation and Public Way Workforce Development and Audit Zoning, Landmarks and Building Standards







January 21,2015 CHICAGO, ILLINOIS


TO THE PRESIDENT AND MEMBERS OF THE CITY COUNCIL:

Your Committee on Housing and Real Estate which was referred nine (9) ordinances by the Department of Planning and Development
2237 S. Trumbull Ave. (02014-9793)
3128 East 92nd St. (02014-9800)
5438 S. Laflin St. (O2014-10008)
3201W. Warren Blvd./16-18 N. Kedzie Ave. (02014-9827)
5. - 3739 W. Ogden Ave. (02014-9993)
3648,3652-58 & 3662 W. Ogden Ave. (O2014-9992)
4941-45 S. Calumet Ave. (02014-9994)
5125 S. Laflin St. (02014-9997)
3200 S. Kedzie Ave., 3230 W. 31st St. & 3354 W. 31st St. (02014-9821)
22nd WARD 10th WARD 16th WARD 28th WARD 24th WARD 24TH WARD 3rd WARD 20™ WARD 22nd WARD


Having the same under advisement, begs leave to report and recommend that Your Honorable Body Pass the proposed ordinances transmitted herewith.

This recommendation was concurred in by a unanimous vote of the members of the committee present with no dissenting votes.


(signed) <^R<
Ray Sriarez,ttChairman
Committee on Housing & Real Estate

OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR

December 10,2014









TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO


Ladies and Gentlemen:

At the request of the Commissioner of Planning and Development, I transmit herewith ordinances authorizing the sale of City-owned property.

Your favorable consideration of these ordinances will be appreciated.

Mayor

Very truly yours,
ORDINANCE

WHEREAS, the City of Chicago ("City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970, and as such, may exercise any power and perform any function pertaining to its government and affairs; and

WHEREAS, the City is the owner of the vacant parcels of properties located at 3648, 3652-58 and 3662 W. Ogden Avenue, Chicago, Illinois, which is legally described on Exhibit A attached hereto (the "Properties"), which Properties are located in the Ogden/Pulaski Redevelopment Project ("Area") established pursuant to ordinances adopted by the City Council of the City on April 9, 2008, published in the Journal of Proceedings of the City Council for such date at pages 24221 through 24477; and

WHEREAS, Lawndale Christian Health Center, an Illinois not-for-profit corporation ("Grantee"), 3860 W. Ogden Avenue, Chicago, Illinois 60623, has offered to purchase the Properties from the City for the sum of Sixty-Five Thousand and No/100 Dollars ($65,000.00), such amount being the appraised fair market value of the Properties, to improve with a parking lot and open space thereon; and

WHEREAS, pursuant to Resolution No. 14-088-21 adopted on September 18, 2014, by the Plan Commission of the City of Chicago (the "Commission"), the Commission approved the negotiated sale of the Properties to the Grantee; and

WHEREAS, public notice advertising the City's intent to enter into a negotiated sale of the Properties with the Grantee and requesting alternative proposals appeared in the Chicago Sun-Times, a newspaper of general circulation, on August 22, 2014, and August 29, 2014; and

WHEREAS, no alternative proposals were received by the deadline indicated in the aforesaid notice; now, therefore,

BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:

SECTION 1. The City Council of the City hereby approves the sale of the Properties to the Grantee for the amount of Sixty-Five Thousand and No/100 Dollars ($65,000.00).

SECTION 2. The Mayor or his proxy is authorized to execute, and the City Clerk or Deputy City Clerk is authorized to attest, a quitclaim deed conveying the Properties to the Grantee. Such deed shall include a covenant obligating the Grantee to use the Properties only for use consistent with the land uses permitted under the redevelopment plan for the Area. Grantee's acceptance of the City's deed shall constitute Grantee's agreement to such covenant. The quitclaim deed shall also contain language substantially in the following form:

This conveyance is subject to the express condition that the Properties are improved with parking and open space within twelve (12) months of the date of this deed. In the event that the condition is not met, the City of Chicago may re-enter the Properties and revest title in the City of Chicago. Grantee, at the request of the City of Chicago, covenants to execute and deliver to the City a reconveyance deed to the Properties to further evidence such revesting of title. This right of reverter and re-entry shall terminate upon the issuance of a certificate of completion, release or similar instrument by the City of

EXHIBIT A

Purchaser: Lawndale Christian Health Center
Purchaser's Address: 3860 W. Ogden Ave., Chicago, IL. Appraised Amount: $65,000.00 Purchased Amount: $65,000.00

Legal Description (Subject to Title Commitment and Survey):

PARCEL 1;

Lots 208 and 209 (except that part taken by Metropolitan West Side Elevated Railroad Company) in Lansingh's addition to Chicago in the Southwest quarter of Section 23, Township 39 North, Range 13 East of the Third Principal Meridian in Cook County, Illinois. Also except that part described as follows: Commencing at Northwest corner of Said Lot 208: thence South 1 degree 36 minutes 21 seconds East, 75.47 feet along the West line of said Lot 208 to a point on a line 10.00 feet North of and parallel with the North right of way line of aforesaid Railroad Company, said point being the point of beginning; thence North 88 degrees 25 minutes 53 seconds, east, 45.36 feet along said parallel line to the East line of said Lot 209, thence South 1 degree 36 minutes 21 seconds East 10.00 feet along said East line to the North right of way line of aforesaid Railroad Company; thence South 88 degrees 25 minutes 53 seconds West, 45.36 feet along said North of way line to the West line of said Lot 208; thence North 1 degree 36 minutes 21 seconds West, 10.00 feet along said West line to the point of beginning.

Address: 3662 W. Ogden Avenue
Chicago, Illinois 60623
Property Index No. 16-23-314-073-0000
PARCEL 2;
That part of Lots 210 and 211 in Lansingh's addition to Chicago in the Southwest quarter of Section 23, Township 39 North, Range 13, East of the Third Principal Meridian, in Cook County, Illinois (except the right of way of Metropolitan West side elevated Railroad Company and except that part described as follows: Commencing at the Northeast corner of said Lot 211, thence South 1 degree 36 minutes 21 seconds East, 124.97 feet along the East line of said Lot 211, to a point on the North right of way line of West Ogden Avenue, said point being the point of beginning, thence South 64 degrees 20 minutes 09 seconds West, 1.11 feet along said North right of way line to the North right of way line of the Metropolitan West Side Elevated Railroad Company: thence South 88 degrees 25 minutes 53 seconds West, 42.98 feet along said North right of way line to the West line of said Lot 210, thence North 1 degree 36 minutes 21 seconds West, 10.00 feet along said west line to a line 10.00 feet North of and parallel with said North right of way line; thence North 88 degrees 25 minutes 53 seconds East; 43.99 feet along said parallel line to the East line of said Lot 211; thence South 1 degree 36 minutes 21 seconds East 9.55 feet along said East line to the point of beginning).

Address: 3656-58 W. Ogden Avenue

Chicago, Illinois 60623 Property Index No: 16-23-314-075-0000 PARCEL 3;
Lot 212 in Lansingh's addition to Chicago in the Southwest quarter of Section 23, Township 39 North, Range 13, East of the Third Principal Meridian in Cook County, Illinois Except that portion thereof described as follows:
Beginning at the Southwest corner of said Lot 212; thence North 1 degree 36 minutes 21 seconds West, 9.55 feet along the West line of said Lot 212; thence North 88 degrees 25 minutes 53 seconds East, 21.53 feet to the Southeastern line of said Lot 212; thence South 64 decrees 20 minutes 09 seconds West 23.39 feet along said Southeasterly line to the point of beginning.

Address: 3654 W. Ogden Ave.
Chicago, Illinois 60623
Property Index No: 16-23-314-077-0000
PARCEL 4;
Lot 213 in Lansingh's addition to Chicago, said addition being a Subdivision of Lots 5, 6, 15 and 16 and the West 146.17 feet of Lots 4 and 17 in J. H. Kedzie's Subdivision in the Southwest quarter of Section 23, Township 39 North, Range 13, East of the Third Principal Meridian, in Cook County, Illinois.

Address: 3652 W. Ogden Ave.
Chicago, Illinois 60623
Property Index No: 16-23-314-038-0000
PARCEL 5;
Lots 4 and 5 in Block 5 in Resubdivision of Blocks 1 to 5 and vacated alleys in Lansingh's Second Addition to Chicago, a Subdivision of Lots 2, 3, 4, 17, 18 and 19 (except the West 146.17 feet of said Lots 4 and 17) in J. H. Kedzie's Subdivision of part of the Southwest quarter of Section 23, Township 39 North, Range 13, East of the Third Principal Meridian, in Cook County, Illinois.

Address: 3648 W. Ogden Ave.
Chicago, Illinois 60623

Property Index No: 16-23-314-066-0000







|1010|
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I - GENERAL INFORMATION
A. Legal name of the Disclosing Parly submitting this EDS. Include d/b/a.' if applicable: Lawndale Christian Health Center

Check ONE of (he following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:
|yj the Applicant
OR
| ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Parly holds an interest'
OR
3. [ ] a legal entity with a right of control (sec Section II.B.l.) Slate the legal name of the entity in
which ihe Disclosing Party holds a right of control:

B. Business address of the Disclosing Parly: 3860 W Ogden Avenue
Chicago, IL 60623
Telephone: JZ?J>88.301_8_ Fax: 872.588.3119 Email: iosephlesch@lawndale.org
Name of contact person: Joseph Lesch

Federal Employer Identification No. (if you have one): .
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):

Negotiated sale 3648-62 and 3739 W Ogden Avenue, Chicago, IL
Which City agency or department is requesting this EDS? Department of Planning and Development

If the Mailer is a contract being handled by the City's Department of Procurement Services, please complete ihe following:

Specification // N/A and Contract U _ _N/A



Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY
( J Limited liability company [ ] Limited liability partnership | | Joint venture [XJ Not-for-profit corporation (Is the not-for-profit corporation also a 501(c)(3))?

!. Indicate the nature of the Disclosing Patty:
[ ] Person (
f] Publicly registered business corporation [
[ ] Privately held business corporation |
| j Sole proprietorship [>
)XJ Yes f ] No
[ j Genera! partnership (]
[ ] Limited partnership
[ ] Trust [
[ ] Other (please specify)


For legal entities, the stale (cr foreign country) of incorporation or organization, if applicable:

N/A

3. For legal entities not organized in the State of Illinois: Has the organization registered lo do business in the State of lllinois as a foreign entity?

[X] N/A

13. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

]. List below the full names and titles of all executive officers and ai! directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which arc legal entities. If there arc no such members, write "no members." For trusts, estates or other similar entities, list below the legal titlcholdcr(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability-partnership or joint venture, list below the name and litle of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Parly. NOTE: Each legal entity hsted below must submit an EDS on its own behalf.

Name Title See attached Form "A" for all officers and directors of the entity
No members are legal entities





2. Please provide the following infoimation concerning cacli person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.?% 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

LCHC Board of Directors

Name
Jill Bradley
Richard Juarez
Dave Doig
Joe Atkins
Sylvia Del Raso
Caronina Grimble
Jeanette Park Lee
Thomas Worthy
Anthony Pegues

Amy Coles
Natalie Maust
Chair
Vice Chair
Treasurer
Secretary
Member
Member
Member
Member
Member
Member
Member









LCHC Officers
Name Title
Bruce Miller CEO
Jonathan Wildt COO
Christopher Dons CFO
Roger Cortez CIO

Name N/A
interest ofa member or manager in a limited liability company, or interest ofa beneficiary ofa trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-1 54-030 of the Municipal Code of Chicago ("Municipal Code1'), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.

Business Address Percentage Interest in the
Disclosing Parly






SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Has the Disclosing Parly had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the dale this EDS is signed?

| ] Yes [X] No

If yes. please identify below the namc(s) of such City elected official(s) and describe such relationship(s):
N/A



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 lo retain in connection with the Matter, as well as ihe nature of the relationship, and the tola! amount of the fees paid or estimated lo be paid. The Disclosing Party is not required to disclose employees who arc paid solely through the Disclosing Party's regular payroll.

"Lobbyist" means any person or cnliiy who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) 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 lo influence any legislative or administrative action.

If ihe Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must cither ask the City whether disclosure is required or make the disclosure.





Page 3 of 1 3

Name (indicate whether Business Relationship lo Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
lo be retained) lobbyist, etc.) "'hourly rate" or "t.b.d." is
not an acccplable response.
N/A




(Add sheets if necessary)
[X] Check here if the Disclosing Party has not retained, nor expects lo retain, any such persons or entities. SECTION V - CERTIFICATIONS
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?

( J Yes [ ] No [X] No person directly or indircclly owns 10% or more of the
Disclosing Parly.

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is ihe person in compliance wilh that agreement?

[ ] Yes | ] No
FURTHER CERTIFICATIONS

I. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I"')(vvhich Ihe Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the 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 lo 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 thai 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 m Article 1 supersedes some five-year compliance timeframes in certifications 2 and 3 below.


Page 4 of 13

The Disclosing Party and. if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:

are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, within a five-year period preceding the date of this EDS, been convicted ofa criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting lo 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;
arc not presently indicted for. or criminally or civilly charged by. a governmental entity (federal, slate or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
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

c. 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 slate, or any other unit of local government.
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 lo all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parlies");
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 ofa business entity following the ineligibility ofa 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 lo 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 ofa responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").


Page 5 of 13

Neither the Disclosing Parly, 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 date this EDS is signed, or. with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity ofa Contractor during the five years before the dale of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
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
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
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).

A Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (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 Stales of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any 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.
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.
If the Disclosing Parly is unable to certify io any of the above statements in this Part B (Further Certifications), the Disclosing Parly must explain below:
N/A







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 Parly certified to the above statements.

8. To the best of the Disclosing Parly'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 1 2-month period preceding the execution dale of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A,; or "none"'). N/A



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 lo be given, at any time during the
12-momh period preceding the execution dale of this EDS, lo an employee, or elected or appointed
official, of ihe 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 S20 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.
__N/A__


C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ J is [X] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the 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 ofa predatory lender may result in the loss of the privilege of doing business with the City."

Jf the Disclosing Parly is unable to make this pledge because il 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): N/A



Page 7 of 13

If the letters "NA," the word "None," o> no response appears on the lines above, it will be conclusively presumed that ihe Disclosing Party certified to the above statements.

D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS

Any words or terms that arc defined in Chapter 2-) 56 of the Municipal Code have die same meanings when used in this Pari D

!. In accordance with Section 2-1 56-1 1 0 of the Municipal Code: Docs any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity m the Matter'.'
I J Ves fx] No

NOTE: If you checked "Yes" to Hem D.l proceed to Items D.2. and D.3. If you checked "No" to Item D.l proceed to Part E.
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 (j) belongs to the City, or (it) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "Cily Property Sale"). Compensation foi properly taken pursuant to the City's eminent domain powc does not constitute a financial interest within the meaning of this Pari D.

Docs the. Matter involve a Cily Property Sale?

[ : Yes [ j No
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 infcicsi:

Name Business Address Nature of Interest






A. The Disclosing Parly further certifies that no prohibited financial interest in the Mailer will be acquired by any City official or employee.

h. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Please- check cither J. or 2. below. If the Disclosing Party checks 2 (lie Disclosing Party mu.M disclose below or in an attachment to this EDS all information required by paragiaph 2. Failure to
Page H of 13

comply with these disclosure requirements may make any contract entered into with the Cily in connection with the Matter voidable by the City.

X 1. The Disclosing Party verifies that ihe Disclosing Party has searched any and all records of
the Disclosing Parly 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 Parly has found no such records.

2 The Disclosing Parly verifies that, as a result of conducting the search in step 1 above, the
Disclosing Parly has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that ihe 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: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the Cily are not federal funding. The Matter is not federally funded.

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 ihe Matter: (Add sheets if necessary):
N/A



(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, il will be conclusively presumed that the Disclosing Parly 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 Parly 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 lo 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, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13

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.
The Disclosing Parly certifies thai cither: (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 1 986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party 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 Parly must maintain all such subcontractors' certifications for the duration of the Matter and must make such certifications promptly available to the City upon request.


13. CERTIFICATION REGARDING EQUAL. EMPLOYMENT OPPORTUNITY

If the Matter is federally funded, federal regulations require ihe 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?
[ J Yes | ] No
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant lo applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes []No
Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Conlract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
I ] Yes [J No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes [ ] 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:
The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between ihe Applicant and the Cily in connection with the Matter, whether procurement. City assistance, or other City action, and are material inducements to the City's execution of any contract or taking other 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.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-1 64 of the Municipal Code, impose certain duties and obligations on persons or entities seeking Cily contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at ww w, c i I y o fc h i c a g o, o i g / EI h i c s, 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.
Jf the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), al law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Parly 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 Chy of treble damages.
It is the City's policy to make this document available lo 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 oiherwi.se . By completing and signing this EDS, the Disclosing Parly waives and releases any possible rights or claims which il may have against ihe City in connection with the public release of information contained in this EDS and also authorizes the Cily lo 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
Parly must supplement this EDS up lo the time the City takes action on the Matter. If the 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 lo Matters subject to Article I 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 I -23 and Section 2-1 54-020 of the Municipal Code.

The Disclosing Party represents and warrants thai:

Page I I of 1 3
F.l. The Disclosing Parly is noi delinquent in the paymcnl of any lax administered by the lllinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any-fine, fee, tax or other charge owed to the Cily. This includes, but is not limited to. all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.

F.2 If the Disclosing Party is the Applicant, the Disclosing Parly and its Affiliated Entities will not use, nor permit their subcontractors to use. any facility listed by ihe U.S. E.P.A. on the federal Excluded Parlies List System ("EPLS") maintained by the U. S. General Services Administration.

F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or lo be hired in connection with the Matter certifications equal in form and substance to those in F. 1. and E.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that ihe Disclosing Parly has reason to believe has not provided or cannot provide truthful certifications.

NOTE: If the Disclosing Party cannot certify as to any of the items in F. 1., F.2. or F.3. above, an explanatory statement must be attached lo this EDS.

CERTIFICATION

Under penalty of perjury, the person signing below: (1) warrants thai he/she is authorized to execute this EDS and Appendix A (i f applicable) on behalf of the Disclosing Parly, and (2) warrants thai all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to Ihe City.

Lawndale Christian Health Center

Joseph A. Lesch
(Print or type name of person signing)

Director of Facilities Planning and Administration (Print or lypc title of person signing)


Signed and sworn to before me on (dale)
ai Cooler, County, J7J~<^-

cxpircs:_ 2-n-n

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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 Party1' 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 Parly" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any cily 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 Parly, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if ihe Disclosing Party is a limited partnership: all managers, managing members and members of the Disclosing Party, if the 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.

Docs the Disclosing Parly or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?

[ ]Yes [X]No

If yes. please identify below (I) 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.

N/A








Page 13 of 13

Chicago.


The Grantee acknowledges that if the Grantee develops the Properties with a residential housing project, as defined under and that is subject to Section 2-45-110 of the Municipal Code of the City (the "Affordable Requirements Ordinance"), the Grantee and such project shall be obligated to comply with the Affordable Requirements Ordinance.

SECTION 3. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.

SECTION 4. All ordinances, resolutions, motions or orders inconsistent with this ordinance are hereby repealed to the extent of such conflict.

SECTION 5. This ordinance shall take effect upon its passage and approval.