FINAL FOR PUBLICATION
ORDINANCE
BE i 1 ORDAIN RD BY THE CITY COUNCIL. OF THE CITY OF CHICAGO:
SECTION !. Title 1 7 of the Municipal Code of'Chicago, the Chicago Zoning Ordinance, is hereby amended by changing all of the Residential Business Planned Development 1272 and indications as shown on Map No 3-F in the area bounded by
West North Avenue; North Clark Si reel; A line 120.03 feet south of and parallel to West North Avenue; Sandburg Terrace; A iine 102.05 feet south of and parallel to West North Avenue. 'Noah LaSalle Street.
SECTION 2: To those of a Residential Business Planned Development 1272, as-Amended.
SECTION 3: This ordinance takes effect after its passage and approval;
Common Address of Property 1546-1550 North Clark Street; 101-115 West North Avenue
1555-1565 North LaSalle Street; 121-129 West North Avenue
FINAL FOR PUBLICATION
1272, AS AMENDED
RESIDENTIAL-BUSINESS PLANNED DEVELOPMENT NO.
PLANNED DEVELOPMENT STATEMENTS
. The area delineated herein as Residential-Business Planned Development Number 1272 ("Planned Development") consists of approximately 30,495 square feet of properly which is depicted on the attached Planned Development Boundary and Property Line Map ("Property") and is owned or controlled by the Applicant, 1546 North Clark, LLC.
. The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors. All rights granted hereunder to the Applicant shall inure to the benefit of the Applicant's successors and assigns and, if different than the Applicant, the legal title holder and any ground lessors. Furthermore, pursuant to the requirements of Section 17-8-0400 of the Chicago Zoning Ordinance, the Property, at the time of application for amendments, modifications or changes (administrative, legislative or otherwise) to this Planned Development are made, shall be under single ownership or designated control. Single designated control is defined in Section 17-8-0400 of the Zoning Ordinance.
!. All applicable official reviews, approvals or permits are required to be obtained by the Applicant or its successors, assignees or grantees. Any dedication or vacation of streets or alleys or grants of easements or any adjustment of the right-of-way shall require a separate submittal to the Department of Transportation on behalf of the Applicant or its successors, assigns or grantees.
Any requests for grants of privilege, or any items encroaching on the public way, shall be in compliance with the Plans.
Ingress or egress shall be pursuant to the Plans and may be subject to the review and approval of the Departments of Planning and Development and Transportation. Closure of all or any public street or alley during demolition or construction shall be subject to the review and approval of the Department of Transportation.
All work proposed in the public way must be designed and constructed in accordance with the Department of Transportation Construction Standards for Work in the Public Way and in compliance with the Municipal Code of the City of Chicago. Prior to the issuance of any Part II approval, the submitted plans must be approved by the Department of Transportation.
4. This Plan of Development consists of 16 Statements: a Bulk Regulations Table; an Existing Zoning and Land Use Map; a Planned Development Boundary, Sub-Area and Property Line Map; Site/Landscape Plan; a Green Roof Plan; Right of Way Adjustment Map and Building Elevations (North, South, East and West) prepared by Main Architecture/Richard C. Newman & Associates and dated December 17, 2015, submitted herein. Full-sized copies of the Site Plan, Landscape Plan and Building Elevations are on file with the Department of
Applicant 1546 North Clark, LLC
Address 1546-50 N. Clark Str./101-l 15 W. North Ave
Introduced September 24. 2015
Plan Commission' December 17.2015|1010|
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Planning and Development. In any instance where a provision of this Planned Development conflicts with the Chicago Building Code, the Building Code shall control. This Planned Development conforms to the intent and purpose of the Zoning Ordinance, and all requirements thereto, and satisfies the established criteria for approval as a Planned Development. In case of a conflict between the terms of this Planned Development Ordinance and the Zoning Ordinance, this Planned Development Ordinance shall control.
The following uses are permitted in the area delineated herein as a Residential-Business Planned Development:, multi-family dwelling units, eating and drinking establishments, small and medium venue entertainment uses, financial services (excluding pawn shops, pay day loan stores, and drive through facilities), food and beverage retail sales, personal service, general retail sales, indoor participant sports and recreation, office and accessory uses, accessory parking.
On-Premise signs and temporary signs, such as construction and marketing signs, shall be permitted within the Planned Development, subject to the review and approval of the Department of Planning and Development. Off-Premise signs are prohibited within the boundary of the Planned Development.
For purposes of height measurement, the definitions in the Zoning Ordinance shall apply. The height of any building shall also be subject to height limitations, if any, established by the Federal Aviation Administration.
The maximum permitted Floor Area Ratio ("FAR") for the site shall be in accordance with the attached Bulk Regulations Table. For the purposes of FAR calculations and measurements, the definitions in the Zoning Ordinance shall apply. The permitted FAR identified in the Bulk Regulations Table has been determined using a Net Site Area of 30,495 square feet.
Upon review and determination, "Part II Review", pursuant to Section 17-13-0610 of the Zoning Ordinance, a Part II Review Fee shall be assessed by the Department of Planning and Development. The fee, as determined by staff at the time, is final and binding on the Applicant and must be paid to the Department of Revenue prior to the issuance of any Part II approval.
The Site and Landscape Plans shall be in substantial conformance with the Landscape Ordinance and any other corresponding regulations and guidelines. Final landscape plan review and approval will be by the Department of Planning and Development. Any interim reviews associated with site plan review or Part II reviews, are conditional until final Part II approval.
The Applicant shall comply with Rules and Regulations for the Maintenance of Stockpiles promulgated by the Commissioners of the Departments of Streets and Sanitation, Fleet and Facility Management and Buildings, under Section 13-32-125 of the Municipal Code, or any other provision of that Code.
Applicant 1546 North Clark, LLC
Address. 1546-50 N Clark Str./l 01-115 W. North Ave.
Introduced September 24, 2015
Plan Commission December 17. 2015|1010|
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12. The terms and conditions of development under this Planned Development ordinance may be
modified administratively, pursuant to section 17-13-0611-A of the Zoning Ordinance by the
Zoning Administrator upon the application for such a modification by the Applicant, its
successors and assigns and, if different than the Applicant, the legal title holders and any
ground lessors.
13. The Applicant acknowledges that it is in the public interest to design, construct and maintain
' the project in a manner which promotes, enables and maximizes universal access throughout
the Properly. Plans for all buildings and improvements on the Properly shall be reviewed and approved by the Mayor's Office for People with Disabilities to ensure compliance with all applicable laws and regulations related to access for persons with disabilities and to promote the highest standard of accessibility.
The Applicant acknowledges that it is in the public interest to design, construct, renovate and maintain all buildings in a manner that provides healthier indoor environments, reduces operating costs and conserves energy and natural resources. Al the time of a hearing before the Chicago Plan Commission, all developments must be in substantial compliance with the current City of Chicago Sustainable Development Policy set forth by the Department of Planning and Development. The Applicant shall provide a green roof with 8,000 s.f., of green roof area.
Pursuant to the Chicago Zoning Ordinance (Sec. 17-8-0911), Planned Developments are to give priority to the preservation and adaptive reuse of Chicago Landmark buildings. The Planned Development includes the Village Theater, which is designated as a Chicago Landmark or within a district designated as a Chicago Landmark. Work to designated Chicago Landmarks is subject to the review and approval of the Commission on Chicago Landmarks pursuant to the Chicago Landmarks Ordinance, Section 2-120-740.
The Applicant acknowledges that Ihe Planned Development project includes excavation, new foundations or other work adjacent to the Village Theater, a Chicago Landmark building. Pursuant to the Zoning Ordinance, Section 17-8-0911, the Applicant acknowledges that it is in the public interest lo promote the preservation of historic resources. The applicant shall submit a report, stamped by an engineer, identifying any protective measures that may be required for the historic building and those measures that will be incorporated during construction as part of the project. The report shall be submitted as part of the Part II Review application to the Historic Preservation Division and be subject to the review and acceptance of the Department of Planning and Development.
16. This Planned Development shall be governed by Section 17-13-0612 of the Zoning
Ordinance. Should this Planned Development ordinance lapse, the Commissioner of the
Department of Planning and Development shall initiate a Zoning Map Amendment lo rezone
ihe property lo B3-5 Community Shopping District.
Applicant- 1546 North Clark. LLC
Address. 1546-50 N. Clark Sir /l01 -115 W. North Ave
Introduced: September 24, 20 i 5
Plan Commission: December 17, 2015|1010|
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RESIDENTIAL-BUSINESS PLANNED DEVELOPMENT NO. 1272, AS AMENDED BULK REGULATIONS AND DATA TABLE
Sub Area A: Sub Area B: Total:
31,183 sf 22,961 sf 54,143 sf
AREA OF PUBLIC RIGHT-OF-WAY TO BE VACATED:
NET SITE AREA:
FAR:
Maximum Dwelling Units: Minimum Parking Spaces:
1,428 sf
Sub Area A: Sub Area B: Total:
Sub Area A Sub Area B TOTAL FAR
Sub Area A: Sub Area B:
Sub Area A: Sub Area B:
19,550 sf 10,916 sf 30,466 sf
6.81 FAR (133,118 sf) 1.76 FAR (19,212 sf) 5.0
48
0 - existing condition 59*
0 - existing condition
In the event fewer dwelling units are constructed, fewer parking spaces may also be constructed so long as the 1.2:1 ratio is maintained.
Sub Area A: Sub Area B:
24
0 - existing condition
In the event fewer dwelling units are constructed, fewer bicycle spaces may also be constructed so long as the .5:1 ratio is maintained pursuant to section 17-10-0207-C.
Off Street Loading Berths: Sub Area A:
Sub Area B:
Building Height: Sub Area A:
Sub Area B:
Lot Coverage: Sub Area A:
Sub Area B:|1010|2 - existing condition
116'-6" (116'-6" to top of building; 128'-6" to top of mechanical penthouse) existing one story commercial building
Per Site Plan Existing
Project: 101 North
Applicant: 1546 North Clark Street, LLC
Property: 1546-1550 North Clark Street/101-115 West North Avenue
Submitted: September 24, 2015 Plan Commission: December 17, 2015
FINAL FOR PUBLICATION
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Department of Planning and Development
city of chicago
MEMORANDUM
TO: Alderman Daniel S. Solis
Chairman, City Council Committee on Zoning
FROM:
David L. Reifman Secretary
Chicago Plan Commission DATE: December 18, 2015
RE: Proposed Amendment to Residential Business Planned Development No. 1272 for property generally located at 1546 North Clark Street.
On December 17, 2015, the Chicago Plan Commission recommended approval of the proposed amendment submitted by 1546 North Clark, LLC. A copy of the proposed planned development is attached. I would very much appreciate your assistance in having this introduced at the next possible City Council Committee on Zoning hearing.
Also enclosed is a copy of the staff report to the Plan Commission which includes the Department of Planning and Development, bureau of Planning and Zoning recommendation and a copy of the Resolution. If you have any questions in this regard, please do not hesitate to contact me at 744-5777.
cc: Steve Valenziano
PD Master File (Original PD, copy of memo)
12 1 NORTH LASALLE STREET, ROOM 1000. CHICAGO, ILLINOIS 60602
City of Chicago
Plan Commission
LOCATION PLAN
December 17, 2015
/j;v;
LOCATION/ CONTEXT PLAN
SECOND FLOOR PLAN
PROPOSED BUILDING IN CONTEXT
FINAL
REPORT to the
CHICAGO PLAN COMMISSION from the
DEPARTMENT OF PLANNING AND DEVELOPMENT DECEMBER 17, 2015
FOR APPROVAL: PROPOSED AMENDMENT TO PLANNED DEVELOPMENTS 272
(APPLICATION NO. 18479) AND DEVELOPMENT PURSUANT TO THE LAKE MICHIGAN AND CHICAGO LAKEFRONT PROTECTION DISTRICT ORDINANCE (APPLICATION NO. 681)
APPLICANT: 1546 N. CLARK, LLC
LOCATION: 1546 NORTH CLARK STREET
Pursuant to the provisions of the Chicago Zoning Ordinance, Title 17 of the Municipal Code of Chicago, the Department of Planning and Development hereby submits this report and recommendation regarding a proposed amendment to Residential Business Planned Development #1272 for your review and recommendation to the Chicago City Council. The application for this amendment to the Zoning Ordinance was introduced into the City Council on September 24, 2015.
In addition, pursuant to the provisions of the Chicago Zoning Ordinance, Title 16 of the Municipal Code of Chicago, the Department of Planning and Development hereby submits this report and recommendation regarding a proposal subject to the regulations and requirements of the Lake Michigan and Chicago Lakefront Protection Ordinance, as it applies to property located in the Private-Use Zone, for your review and final determination. This application for development approval was filed with the Department of Planning and Development on September 18, 2015.
Proper legal notice of the public hearing for both applications before the Chicago Plan Commission was published in the Chicago Sun-Times on December 2, 2015; the Applicant, 1546 N. Clark, LLC, was separately notified of this hearing.
The subject property is generally located at 1546 North Clark Street. The Applicant is proposing to create a planned development with two Sub Areas. Sub Area A will be a proposed 128'-6" tall mixed use building containing commercial use on the ground floor and 48 dwelling units on the floors above, additionally 59 parking stalls will be provided within Sub Area A. Sub Area B will consist of an existing one story commercial building, this Sub Area currently has zero parking stalls and two loading berths. The Applicant previously received a rezoning of the property from B1-5 (Neighborhood Shopping District) and B3-5 (Community Shopping District) to a B3-5 (Community Shopping District) and then to Residential Business Planned Development #1272.
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This requested amendment is being submitted, pursuant to Section 17-13-0611-B of the Chicago Zoning Ordinance, which states that the proposed change which do not meet the criteria for a minor change must be reviewed and approved by the Chicago Plan Commission.
The subject site is located within the Private-Use Zone of the Lake Michigan and Chicago Lakefront Protection District; therefore, the proposed development of the site is regulated by Section 16-4-100 of the Lake Michigan and Chicago Lakefront Protection Ordinance.
PROJECT BACKGROUND
The planned development was reviewed and approved previously at the Chicago Plan Commission. The applicant has subsequently submitted a letter to the department explaining the potential danger posed to the adjacent historically significant building by the proposed excavation for the previously approved project and subsequently the extensive cost associated with that excavation, as an alternative to the original proposal the applicant has requested that they be allowed to instead raise the building out of the ground which will increase the height from 117'-0" as previously approved to 128'-6" as proposed in this project proposal. The primary function of the area that will now be located above grade is accessory parking for the dwelling units and as such is exempt from FAR calculations, this will result in no additional changes to the bulk and density standards that were previously reviewed and approved. The proposed planned development remains comprised of a Sub Area B which is an existing one story commercial building to remain as is and a Sub Area A which includes a Chicago Landmark, the Village Theatre, which was built in 1916. The applicant has already appeared before the Commission on Chicago Landmarks for the proposed rehabilitation of the front portion of the Village Theater and demolition of the rear portion to accommodate new construction of a larger ground floor retail and residential development on the site and the adjacent property. Thus, Sub Area A would be a proposed new construction building added to the rehabilitated Village Theater building resulting in a mixed use building with commercial uses on the first floor and a portion of the second floor and 48 residential units on the floors above
SITE AND AREA DESCRIPTION
The subject property is located within the Near North Side Community Area, and the Old Town Neighborhood. The subject property is within the 2nd Ward (formerly having been located within the 42nd Ward).
The subject property is located at the southwest corner of North Clark Street and West North Avenue and is located adjacent to business, commercial, and residential uses. East of the subject site are parcels of land zoned POS.-1, Regional or Community Park District, and PD #891, Institutional Planned Development. North of the site are parcels of land zoned B1-3, Neighborhood Shopping District, and RM-5, Residential Multi-Unit District. West of the site are parcels of land zoned B1-5, Neighborhood Shopping District, B3-5, Community Shopping District, RM-5, Residential Multi-Unit District, and RM6.5 Residential Multi-Unit District. South of the site is PD #14, a very large residential planned development. The subject site is located in the Private Use Zone of the Lake Michigan and Chicago Lakefront Protection District. The site is not located within a designated Tax
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Increment Financing (TIF) District. As mentioned previously the site does include the designated Chicago Landmark, the Village Theatre.
The site is served by Chicago Transit Authority bus routes #9 (Ashland), #22 (Clark), #36 (Broadway), #37 (Sedgwick), #70 (Division), #72 (North), #73 (Armitage), #151 (Sheridan) and #156 (LaSalle), all having stops located within approximately 1/2-mile of the site; the Chicago Transit Authority also has the Sedgwick Station along the Brown Line and Purple Line and the Clark Station along the Red Line within !4 mile of the subject site.
PROJECT DESCRIPTION
The site consists of approximately 30,279 square.feet (approximately .67 acres). The site has two parcels which are defined as Sub-Area A and Sub-Area B. Sub-Area A is currently improved with a one story retail restaurant, a two story mixed use building and a landmark theater. In the proposed planned development the front 50-0" of the theater will be preserved, however the interior of the theater will be demolished and reused as part of the new development. The other two buildings will be demolished and a new 128'-6" tall mixed use building with 48 dwelling units and commercial use on the first floor would be constructed; a mechanical penthouse would be located on the roof of the building. Additionally, 59 parking spaces and one (1) loading berth would be provided on this Sub-Area. Sub-Area B is currently improved with an existing one story commercial building, zero (0) parking stalls, and two (2) loading berths all of which will remain as is and there is no proposed construction on that Sub-Area.
DESIGN
The proposed mixed use building will be primarily constructed of masonry. The first two floors (one of which is only half above grade) of the building will be finished in masonry stone, floors two through nine will be finished in face brick and include aluminum windows with stone surrounds, and finally the top floor of the building will be finished in masonry stone. The design will clearly demonstrate that the building has a bottom, middle, and a top. The aforementioned is achieved by using cornices and similar enhancements as suggested in the Chicago Zoning Ordinance under section 17-08-0907-A. The building is also built abutting the sidewalk with doors, windows and active uses adjacent to the public way.
LANDSCAPING AND SUSTAINABILITY
The entire planned development will be compliant with the requirements of the Chicago Landscape Ordinance specifically in terms of parkway trees. Additionally, the proposed development will include storm water compliance.
The subject site will be designed to be in compliance with the current City of Chicago Sustainable Development policy and will provide a vegetated roof totaling a minimum of 50% of the net roof area which equates to 8,900 square feet of area. Additionally, the subject building will obtain a LEED certification.
ACCESS/CIRCULATION
The interior automobile parking, bicycle parking/storage and loading berths will be
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designed to be compliant with chapter 10 of the Chicago Zoning Ordinance. The project will provide 59 parking spaces and 24 bicycle parking spaces. The vehicle parking, bicycle parking, and loading areas will be accessed via two driveways from North Sandburg Terrace.
BULK / USE / DENSITY
The proposed project will be a 48 dwelling unit residential building with commercial uses on the ground floor. The current maximum allowable Floor Area Ratio (FAR) for the proposed underlying zoning district (B3-5) is 5.0; the proposed planned development will be limited to this maximum. The proposed project will have a maximum building height of 128'-6". The minimum lot area per unit (MLA) for the site will be 604 square feet. The proposed planned development will maintain setbacks that are in compliance with the requirements of the B3-5 zoning designation. All remaining bulk, use and density items will be in substantial compliance with the stipulations of Section 17-3-0400 for B3-5 zoning districts.
RECOMMENDATION
The Department of Planning and Development has reviewed the project materials submitted by the Applicant and compared this proposal to the requirements of the Chicago Zoning Ordinance and other development in the community. The area around this project is a diverse mix of commercial, office, open space and residential developments and is near Lake Michigan and Lincoln Park. Based on the entirety of the Department's analysis, DPD has concluded that this proposal is appropriate for this site and supports this development for the following reasons:
Ensures adequate public review of major development proposals (per 17-8-0101), as evidenced by the various public meeting(s) held in the community by the Applicant;
Promotes unified planning and development (per 17-8-0102), as evidenced through the coordination of the proposed use of the subject property; the_ planned development preserves a landmark, creates a sub-area that keeps an existing use intact, and creates a new building the fits the context of the neighborhood in terms of proposed uses and access;
Promotes economically beneficial development patterns that are compatible with the character of existing neighborhoods (per 17-8-0103), as evidenced by the proposed design, massing and proposed uses of the building, with those such specifics being in context with the character of the immediate community;
Ensures a level of amenities appropriate to the nature and scale of the project (per 17-8-0104), as evidenced by the commercial and residential provisions which are designed to serve the building's residents and adjacent community, while being in general accordance with the requirements of the Chicago Zoning Ordinance;
Promotes transit, pedestrian and bicycle use, ensures accessibility for persons with disabilities and minimizes conflicts with existing traffic patterns in the vicinity (per 17-8-0904-A-2, 3 & 4), as evidenced through the site's proximity to public transit, the accommodations made on-site for pedestrian and bicycle use and the site's enhanced level of pedestrian accessibility;
Properly screens associated parking within the building (per 17-08-0904-C-2) and provides active uses around any above-grade multi-level parking structures (per 17-
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08-0904-D-4), as evidenced through the access to the below, and at-grade levels of the enclosed parking being made available for all users;
Provides safe and attractive walkways and pedestrian routes (per 17-8-0905-A-1), as evidenced by the provisions made to improve the city parkways with required landscape improvements as well as required CDOT improvements along the perimeter of the property and the fact that the site is in close proximity to Lincoln Park and the nearby lakefront park and trail system;
Provides structures that allow for pedestrian entrances from the surrounding sidewalks (per 17-8-0905-B-2), as evidenced by the construction to the edge of the site's property lines and the provision of access to the commercial and residential uses from the public sidewalk;
I) Promotes environmentally sustainable development practices (per 17-8-0908-A), as
evidenced through the installation of a green roof system covering approximately
8,900 square feet (50% of roof net site area) and that the building will achieve LEED
certification.
The project meets the purpose and criteria set forth in the Chicago Zoning Ordinance and its adoption would not have any adverse impact on the public's health, safety or welfare:
The site lies within the boundaries of the Private-Use Zone of the Lake Michigan and Chicago Lakefront Protection District, the plan of which was originally adopted by the Chicago City Council in 1972; per 17-13-0308-A, this proposed development adheres to the goals and objectives of that plan, as described more thoroughly in a subsequent entry to the Recommendation section of this report.
Per 17-13-0308-B, the perpetuation of the scope and scale of this mixed-use development, within the parameters described above and in a manner that is consistent with adjacent improvements, aligns with the City's long-term goal of establishing sustainable neighborhoods.
Per 17-13-0308-C, the proposed development is compatible with surrounding commercial and residential development in terms of land use, as well as, the density and scale of the physical structures.
Per 17-13-0308-D, the proposed underlying zoning for this planned development (B3-5) is generally consistent with other zoning districts, both adjacent to this site and in the immediate area.
Per 17-13-0308-E, the public infrastructure facilities and City services are adequate to serve the proposed development and the project does comply with the requirements for access in case of fire and other emergencies. The proposed project has been reviewed by the Mayor's Office for People with Disabilities and the Department of Transportation and all requested changes have been made. Copies of this application have been circulated to other City departments and agencies and no comments have been received which have not been addressed in the application.
The Department of Planning and Development has reviewed the project materials submitted by the Applicant and has concluded that this proposal would be in compliance with the applicable Policies of the Lakefront Plan of Chicago and the Purposes of the Lake Michigan and Chicago Lakefront Protection Ordinance, as they apply to development in the
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Private-Use Zone, specifically:
Policy No. 3 (Continue to improve the water quality and ecological balance of Lake Michigan) - This project will comply with all applicable City and Metropolitan Water Reclamation District regulations pertaining to the management of wastewater and storm water runoff and will not negatively impact the purity and quality of the waters of Lake Michigan.
Policy No. 8 (Increase personal safety) - The project will bring increased pedestrian and bicycle activity to the area which will provide a more active presence to the proposed site.
Policy No. 14 (Coordinate all public and private development within the water, park and community zones) - This site is located within the Private-Use Zone and the development has been coordinated with the appropriate City departments and community to minimize the impact of construction and to ensure it remains in context with the surrounding neighborhood.
With respect to the Policies and Purposes not enumerated here, the Department of Planning and Development has determined that they are either not applicable to development in the Private-Use Zone or that the proposed project will not have a detrimental effect on the Lake Michigan shoreline or any wildlife habitats therein. The proposed project also does not contemplate the introduction of new roadways directly connecting to the lakefront, does not reduce existing open space and does not interfere with existing access to, or use of, Lake Michigan and its park system.
Based on the foregoing, the Department of Planning Development has the following dual recommendation:
That this application for establishment of a planned development be approved and that the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be "Passage Recommended"; and,
That this application, being in conformance with the provisions of the Lake Michigan and Chicago Lakefront Protection Ordinance, be approved, subject to compliance with the Site and Landscape Plans and Building Elevations dated September 18, 2014, and presented before you today.
Bureau of Planning and Zoning Department of Planning and Development
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Department of Planning and Development city of chicago
1546 NORTH CLARK STREET PROPOSED AMENDMENT TO RESIDENTIAL BUSINESS PLANNED DEVELOPMENT #1272 (APPLICATION NO. 18479)
RESOLUTION
WHEREAS, the applicant, 1546 N. Clark, LLC, has submitted an application to amend planned development #1272; and,
WHEREAS, the Applicant is proposing to construct a 128'-6" tall, 48 dwelling unit building with retail and restaurant use on the ground floor, the applicant will provide 59 parking stalls onsite; and,
WHEREAS, the Applicant had previously rezoned the property from B3-5 (Community Shopping District) and a B1-5 (Neighborhood Shopping District) to a B3-5 (Community Shopping District) and then to a residential business planned development; and,
WHEREAS, the Applicant's current request to amend the planned development and rezone the property from PD #1272 to PD #1272, as amended, was introduced to the City Council on September 24, 2015; and,
WHEREAS, proper legal notice of the hearing for this application before the Plan Commission was published in the Chicago Sun-Times on December 2, 2015 and the Applicant was separately notified of this hearing; and,
WHEREAS, the proposed zoning application was considered at a public hearing by this Plan Commission on December 17, 2015; and,
WHEREAS, the Department of Planning and Development recommended approval of the application, with the recommendation and explanation contained in the written report dated December 17, 2015, a copy of which is attached hereto and made a part hereof; and,
WHEREAS, the Plan Commission has fully reviewed the application and all associated informational submissions, the report and recommendation of the
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
Department of Planning Development and all other testimony presented at the public hearing held on December 17, 2015, giving consideration to the applicable provisions of the Zoning Ordinance.
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
THAT the above-stated recitals to this resolution together with the report of the Department of Planning and Development be adopted as the findings of fact of the Plan Commission regarding this zoning map amendment application; and,
Martin Cabrera, Jr. Chairman
Chicago Plan Commission
THAT this Plan Commission recommends approval to the City Council Committee on Zoning, Landmarks and Building Standards of the final zoning map amendment application dated September 24,2015, as being in conformance witj^he provisions, terms and conditions of the Zoning Ordinance.
PD No.: 1272, as amended Approved: December 17, 2015
121 NORTH LASALLE STREET. ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
Department of Planning and Development city of chicago
LAKE MICHIGAN AND CHICAGO LAKEFRONT PROTECTION ORDINANCE
APPLICATION NO. 681 1546 NORTH CLARK STREET
RESOLUTION
WHEREAS, The Applicant, 1546 N. Clark, LLC, proposes to construct a 128'-6" tall, 48 dwelling unit building with retail/restaurant use on the ground floor and onsite parking for 59 cars within the Private Use Zone of the Lake Michigan and Chicago Lakefront Protection District; and
WHEREAS, an application for Lake Michigan and Chicago Lakefront Protection Ordinance approval was filed with the Department of Planning and Development on September 18, 2015; and
WHEREAS, proper legal notice of a hearing before the Chicago Plan Commission on the Lake Michigan and Chicago Lakefront Protection Ordinance application was published in the Chicago Sun-Times on December 2, 2015; the Applicant was separately notified of this hearing; and
WHEREAS, the Lake Michigan and Chicago Lakefront Protection Ordinance application was considered at a public hearing by this Plan Commission on December 17, 2015; and
WHEREAS, this Plan Commission has reviewed the application with respect to the Lake Michigan and Chicago Lakefront Protection Ordinance and finds that the proposal would be consistent with the Purposes of that Ordinance and the Policies of the Lakefront Plan of Chicago; and
WHEREAS, the Department of Planning and Development recommends approval of the application, which recommendation and the explanation thereof is contained in the Department's written report dated December 17, 2015, a copy of which is attached hereto and made a part hereof; and
WHEREAS, this Plan Commission has fully reviewed the application and ail informational submissions associated with the proposed development, the report and recommendation of the Department of Planning and Development and all
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
other testimony presented at the public hearing held December 17, 2015, giving consideration to the Lake Michigan and Chicago Lakefront Protection Ordinance;
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
THAT the above-stated recitals to this resolution together with the report of the Department of Planning and Development be adopted as the findings of fact of the Chicago Plan Commission regarding this application; and
THAT the final application dated September 18, 2015, be approved as being in conformance with the provisions of the Lake Michigan and Chicago Lakefront Protection Ordinance.
Lakefront Application No. 681 Approved: December 17, 2015
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
RECEIVED
DEC 1 7 2015
APfifolfi^lONNUM BER
CITY OF CHICAGO
AN APPLICATION TO THE CHICAGO PLAN COMMISSION UNDER THE LAKE MICHIGAN AND CHICAGO LAKEFRONT PROTECTION ORDINANCE
(This Application Must Be Typewritten)
The Chicago Plan Commission has provided this Application Form in accordance with Section I94B-6.I (a) of the Lake Michigan and Chicago Lakefront Protection Ordinance. The Conditions under which the provisions of this Ordinance are applicable are stated in Section 194B-5.1 of the Ordinance. The process of Plan Commission review and public hearing on each proposal within the Lake Michigan and Chicago Lakefront Protection District will commence with the Applicant's submission to the Chicago Plan Commission of a completed Application Form and the required proof of notice. Strict compliance with Section 194B-6.1(c) is required.
The staff of the Department of Planning is available to provide technical assistance to the Applicant, before preparation of his application, during the processing stages, and lo review the application at submission to the Chicago Plan Commission. Copies of the Ordinance and this Application Form and examples of forms for both notification and proof of notice, are available from the Commissioner of Planning, in Room 1003, Lakefront Unit, City Hall, 121 N. La Salle Street, Chicago, Illinois 60602. Phone 744-6551.
This Application Form consists of Five Parts on 17 pages:
Part One: General Information
Part Two: Character of Proposal
Part Three: Zoning Information
Part Four: Potential Impact of Proposal (2 Sections)
Part Five: Disclosure Forms (6 Sections)
A copy of this Application will be available for public inspection in the office of the Commissioner of Planning, Room 1000, five days prior to the date of which the public hearing on this Application before the Chicago Plan Commission is to commence.
-SECTION BELOW FOR OFFICE USE ONLY-
. Z.BA action necessary?
Status:
Date of Applicant Notice to taxpayers of record _
Date set for public hearing:
_yes_
Disclosure necessary?
Simultaneous Planned Development
processing yes no
Date on which Plan Commission published newspaper notice:
Previous Application this address?
yes no. number:
Date of publication of report . Zoning map amendment? yes... no: #_
of Commissioner of DP: .
DISPOSITION
Dale forwarded to. D1S _ _: DSS _ : Approved
DPW : Pk. D._l_ : Disapproved
Other Continued . lo:
Date Applicant notified of decision:
sitf AnnRP« 1546-50 N. Clark St/101-115 W. North Ave tr. AUUKC»s_^_^^Sa|)&S(reeH21=2MV_North Ave
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GUIDELINES FOR COMPLETING PART ONE OF THE APPLICATION
Pari One of this Application provides general information to the Plan Commission for use in preparing its public notices of the proposal set forth in the Application and in preparing its review of that proposal.
The date entered in I. should be the date on which the Application is filed.
The location of the site of the proposal should be given by street address; if there is no address, the location must be described in relation to existing streets, rights-of-way or other fixed points of reference.
The Applicant must state his own name, address and telephone number and the name, address and telephone number of the owner of the subject property. The Applicant must be either the owner of the subject property or his duly authorized agent or representative, and, if the Applicant is an agent or representative, the Applicant must submit proof to the Commission that he is authorized to represent the owner of the subject property.
Whenever the ownership of the subject property is complex - a partnership, corporation, land trust or association - the Applicant shall so indicate. Further, the Commission may require disclosure of all real parties of interest in the subject property.
The description of a proposal should include, at a minimum, types of land uses and space uses, floor area, number of dwelling units and height of proposed structures in feet or stories. Additional concise information may also be included.
Under the provisions of Section 194B-6.1(c) of the Lake Michigan and Chicago Lakefront Protection Ordinance, the Applicant must submit to the Commission at the time of filing an Application a list of the names and last known addresses of the owners of all property on which notice must be served, the method of service employed, the names and addresses of persons so served, and a statement certifying that the Applicant has complied with the noticing provisions of Section 194B-6.1(c) of the Lake Michigan and Chicago Lakefront Protection Ordinance. The Commission will not accept an application unless and until the Applicant furnishes the required list and certificate.
6. If there are any other approvals required from other public agencies before the Applicant
can proceed with his proposal, they should be listed; except that other City of Chicago
licenses and permits may be omitted as items requiring listing herein. If no other
approvals are required, enter "NONE" under VI A. Examples of items which should be
listed include approval of FHA financing, a U.S. Corps of Engineers permit, Federal
Aviation Authority Approval, among others.
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PART ONE: GENERAL INFORMATION
I. Date of Application: September 17 , 20__ .
TI. Address or location of the Site of the Proposal: 1546-50 N. Clark st/101-115 w. North Ave and 1555-65 N. LaSalle Street/121-29 W. North Avenue
III. Information on the Applicant and the Owner A. Applicant
Name: 1546 N. Clark, LLC Phone: 312-961-1333
Address: 1229 N. North Branch, Suite 206, Chicago, IL 60646
B. Owner
Name: Same As Applicant Phone:
Address:
If the Applicant is not the owner, check here that proof has been attached
to this Application that the Applicant is the duly authorized agent or representative of the owner.
If the ownership of the subject property is complex, the Applicant shall indicate the type of ownership:
1. Land Trust 2. Partnership or Association
3. Corporation 4._X Limited Liability Company
IV Brief Description of the Proposal" Amendment to RBPD 1272, Sub Area "A"; Applicant proposes to
construct a 116'-6" tall building (128'-6" to top of mechanical penthouse) with up to 48 residential dwelling
units and a minimum of 59 parking spaces, and retail uses on the first floor.
The noticing provisions of Section 194B-6.1 (c) have been completed as they apply to the Applicant: Check here X _
The Applicant must also obtain the following approvals in addition to the approval of the Plan Commission:
Nature of Approval: Planned Development Approval
Agency. Department of Planning and Development
Nature of Approval:
Agency: \
Nature of Approval:
Agency:
Address: 1546-50 N. Clark St/101-115 W. North Ave
1555-65 N. LaSalle Street/121-29 W. North Ave
GUIDELINES FOR COMPLETING PART TWO OF THE APPLICATION
All graphic materials must be submitted in an 8.5" x 11" format and must be suitable for clear and sharp, black and white reproduction. Each map or diagram should have a scale and a north arrow. Each sheet of graphic material must be labeled with the appropriate figure number. If there are multiple sheets comprising one figure - for example figure 4 - those sheets should be labeled consecutively, for example Figure 4-1, Figure 4-2, etc., and each sheet should contain the address of the site of the proposal in the lower left corner.
For Figure 1, the Applicant should consider the "vicinity of the site" to be at least as extensive as the area for which he is required to give notice plus any intervening streets or other public rights-of-way.
For Figures 3 and 4, the Applicant should consider that "recreation areas" and "recreation space and facilities" include game courts, swimming pools and pool areas, game rooms, exercise rooms, party rooms, community rooms, observation decks and sun decks.
The required narrative statement should describe the features of the proposed development, including size and mix of dwelling units, mix of uses on the site, etc. It should present a basic rationale for the development.
For Figure 6, the Applicant is urged to provide any materials at 8.5" x 11" which will facilitate the review of his Application.
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PART TWO: CHARACTER OF THE PROPOSAL
This portion of the Application must be completed by attaching the following items, correctly sized and labeled, to the Application:
T. Figure 1: A Map of the Vicinity of the Site, showing Lake Michigan, lakefront parks, preferential streets, schools, parks, major institutions. All streets on this map should be named, and the outline and height on all structures on properties immediately adjacent to the site of the proposal must be shown.
Figure 2: A Map of the Existing Site, showing locations and dimensions of lot lines; contour intervals (5-foot) ; existing structures, walkways, driveways, special features.
Figure 3: The Proposed Site Plan, showing locations and dimensions of proposed structures, driveways and walkways; proposed exterior parking areas; proposed exterior open space and recreation areas.
Figure 4: Proposed Floor Plans, including the ground floor, a typical floor, any floor with recreation space or facilities.
Figure 5: An Elevation or Cross-section, showing the height and number of stories for all proposed structures.
Narrative: A Statement Describing the Proposed Development.
In addition, the Applicant is encouraged to provide additional graphic materials, visual aids; e.g., photographs, renderings, data tables, among others. Any such exhibits shall be labeled Figure 6.
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ZONING INFORMATION
The Applicant shall provide the basic data on zoning considerations for the site of the proposal. Calculations may be shown below on this page and on page 8.
I. Is a planned development ordinance or an amendment to an existing planned development required or permitted for the subject site?
X required permitted no
If a planned development approach is required, or if it is permitted and the Applicant chooses to seek a planned development amendment, the Applicant is not required to complete the remainder of Part Three of this Application Form.
Address: 1546-50 N. Clark St/101-115 W. North Ave 1555-65 N. LaSalle St/121-29 W. North Ave
II Is Zoning Board of Appeals approval a variation or a special use either necessary or
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contemplated in relation to the Applicant's proposal? If "yes," please explain the nature of the approval.
III. Net Site Area and Existing Zoning District Classification (list that portion of the net site
area in each): see attached bulk table
District Classification Area
A. sq. ft.
¦ sq. ft.
sq. ft.
D. Total Net Site Area: sq.ft.
IV. Dwelling Units see attached bulk table
Maximum units allowed
Without efficiency units: .
With maximum percent of efficiency units:
Proposed number of units
Dwelling units: .
Efficiency Units: .
Total Units:
C. Does the Applicant intend to increase allowable floor area by reducing the number of
units constructed below the maximum allowed?
yes _______ no.
If "yes" there will be units fewer than the maximum allowed, and the Floor
Area Ratio for the site will be increased by %.
Address: 1546-50 N. Clark St/101-115 W. North Ave 1555-65 N. LaSalle St/121-29 W. North Ave
This page for calculations.
Address: 1546-50 N. Clark St/101-115 W. North Ave
1555-65 N. LaSalle St/121-29 W. North Ave
Bulk see attached bulk table
Base Floor Area Ratio (F.A.R.), without bonuses: .
Proposed F.A.R., include all bonuses: .
List all bonuses used in computing B., above:
1.
2. "
j.
Proposed Floor Area: sq. ft.
Percentage of floor area devoted to interior recreation space, meeting rooms, etc. :
_ %.
Off-street Parking and Loading see attached bulk table
Minimum Required Number Proposed
Parking Spaces
Loading Docks
Setbacks
Minimum Proposed
Front
Side
Rear
Address: 1546-50 N. Clark St/101-115 W. North Ave 1555-65 N. LaSalle St/121-29 W. North Ave
PART FOUR: POTENTIAL IMPACT OF THE PROPOSAL
|10 10|CITY OF CHICAGO
AN APPLICATION TO THE CHICAGO PLAN COMMISSION UNDER THE LAKE MICHIGAN AND CHICAGO LAKEFRONT PROTECTION ORDINANCE
PART FOUR: POTENTIAL IMPACT OF THE PROPOSAL
The Chicago Plan Commission requires that the Applicant address the Fourteen Basic Policies of the Lakefront Plan of Chicago and the Thirteen Purposes of the Lake Michigan and Chicago Lakefront Protection Ordinance, as listed below, in a written statement to the Commission attached to this Application Form and labeled Part Four. The statement should indicate which policies or purposes are or are not applicable to the Applicant's proposal, and, for those policies and purposes which are applicable, the statements should discuss the potential impact of the proposal.
I. Fourteen Basic Policies
Complete the publicly owned and locally controlled park system along the entire Chicago lakefront.
RESPONSE: The park system is not impacted by the proposed project.
2.
Maintain and enhance the predominantly landscaped, spacious and continuous character of the lake shore parks.
3.
RESPONSE: The lake shore parks are not impacted by the proposed project. Continue to improve the water quality and ecological balance of Lake Michigan.
RESPONSE: The water quality and ecological balance of Lake Michigan are not impacted by the proposed project.
4.
Preserve the cultural, historical, and recreational heritage of the lakeshore parks. RESPONSE: The lake shore parks are not impacted by the proposed project.
Maintain and improve the formal character and open water vista of Grant Park with no new above-ground structures permitted.
RESPONSE: Grant Park is not impacted by this project.
lncreas_e the diversity of recreational opportunities while emphasizing lake-oriented leisure time activities.
RESPONSE: Recreational opportunities and leisure time activities are not impacted by this project.
Protect and develop natural lakeshore park and water areas for wildlife habitation.
RESPONSE: Lakeshore park and water areas are not impacted by this project.
Increase personal safety.
RESPONSE: By redeveloping an under-utilized site with new, high quality residential and retail opportunities, personal safety of neighboring residents is increased.
Design all lake edge and lake construction to prevent detrimental shoreline erosion.
RESPONSE: The proposed project will have no impact on shoreline erosion.
Ensure a harmonious relationship between the lakeshore parks and the community edge, but in no instance will further private development be permitted East of Lake Shore Drive.
RESPONSE: The proposed project is west of Lake Shore Drive and continues the harmonious relationship between the lakeshore parks and the community edge.
Improve access to the lakeshore parks and reduce through vehicular traffic on secondary park roads.
RESPONSE: The proposed project will not have an impact on vehicular traffic through secondary park roads or on the access to the lakeshore parks.
Strengthen the parkway characteristics of Lake Shore Drive and prohibit and roadway of expressway standards.
RESPONSE: The proposed project does not have an impact on Lake Shore Drive.
Ensure that all port, water supply, and public facilities are designed to enhance lakefront character.
RESPONSE: Port, water supply and public facilities are not impacted by the proposed project.
Coordinate all public and private development within the water, park, and community zones.
RESPONSE: The project is not within the park, water or community zones.
II. Thirteen Purposes
1. To promote and protect the health, safety, comfort, convenience, and the general welfare of the people, and to conserve our natural resources.
RESPONSE: The proposed project promotes and protects the health, safety, comfort, convenience and general welfare of the people and conserves natural resources. The project as designed is consistent with the character of surrounding development and serves as a transition from the high rise buildings lo the lakefront.
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To identify and establish the Lake Michigan and Chicago Lakefront Protection District and to divide that District into several zones wherein any and all development or construction, as specified in Article V hereinafter, shall be specifically restricted and regulated.
RESPONSE: No response required.
To maintain and improve the purity and quality of the waters of Lake Michigan.
RESPONSE: The project will not have an adverse impact on the purity and quality of the waters of Lake Michigan.
To insure that construction in the Lake or modification of the existing shoreline shall not be permitted if such construction or modification would cause environmental or ecological damage to the Lake or would diminish water quality; and to insure that the life patterns of fish, migratory birds and other fauna are recognized and supported.
RESPONSE: No construction in the Lake or modification of the existing shoreline will occur.
To insure that the Lakefront Parks and the Lake itself are devoted only to public puiposes and to insure the integrity of and expand the quantity and quality of the Lakefront Parks.
RESPONSE: The proposed project will not impact the lakefront parks or lake.
To promote and, provide for continuous pedestrian movement along the shoreline.
RESPONSE: The proposed project will not have an adverse impact on pedestrian movement along the shoreline.
To promote and provide for pedestrian access to the Lake and Lakefront Parks from and through area adjacent at regular intervals of one-fourth mile and additional places wherever possible, and to protect and enhance vistas at these locations and wherever else possible.
RESPONSE: The project will not have a direct impact on pedestrian access to the lake or lakefront parks. However, by constructing the proposed streetscape and sidewalk improvements, the pedestrian experience in the vicinity of the lakefront area will be improved.
To promote and provide for improved public transportation access to the Lakefront.
RESPONSE: The project will not have an impact on public transportation.
To insure that no roadway of expressway standards, as hereinafter defined, shall be permitted in the Lakefront Parks.
RESPONSE: The project will not have an impact on this policy.
To insure that development of properties adjacent to the Lake or the Lakefront Parks is so defined as to implement the above-stated purposes, provided, however, that with respect to property located within the Private Use Zone as established by Article V, VT. and IX of this Ordinance, the permitted use, special use, lot area per dwelling unit, and floor area ratio provisions of the Chicago Zoning Ordinance, Chapter 194A of the Municipal Code of Chicago, shall govern except where such provisions are in substantial conflict with the puiposes of this Ordinance or the Fourteen Basic Policies of the Lakefront Plan of Chicago.
RESPONSE: The project shall conform to the zoning requirements as set forth by the City of Chicago.
To achieve the above-stated puiposes, the appropriate public agency should acquire such properties or rights as may be necessary and desirable.
RESPONSE: No response is required.
To define and limit the powers and duties of the administrative body and officers as provided herein.
RESPONSE: No response is required.
13. Nothing contained in the Lake Michigan and Chicago Lakefront Protection
Ordinance shall be deemed to be Waiver or consent, license or permit to use
any property or to locate, constrict or maintain any building, structure or
facility or to carry on any trade, industry, occupation or activity which may
be otherwise required by law.
RESPONSE: No response is required.
6277725.1
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i 8
RECEIVED
RECEIVED
DEC 1 7 2015
. Ttiitial: y^^J. (A,
^ 4 2U\5 ~ CITY OF CHICAGO
Init ial: APPLICATION FOR AN AMENDMENT TO
THE CHICAGO ZONING ORDINANCE
ADDRESS of the property Applicant is seeking to rezohe:
1546-50 N Clark Street/ 101-115 W North Ave and 1555-65 N. LaSalle Street/121-29 W. North Avenue
Ward Number that property is located in:_?
APPLICANT 1546 N.Clark. LLC .
ADDRESS 1229 N. North Branch, Suite 206 CITY Chicago
STATE IL ZIP CODE 60642 PHONE 312-961-1333
EMAIL hiweiner@gmail.com CONTACT PERSON Howard Weiner
Is the applicant the owner of the property? YES * NO
If the applicant is not the owner of the property, please provide the following information regarding the owner and attach written authorization from the owner allowing the application to proceed.
OWNER Same as Applicant
ADDRESS CITY
STATE ZIP CODE PHONE_
EMAIL CONTACT PERSON
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY Katriina S. McGuire c/o Thompson Cobum LLP
ADDRESS 55 E Monroe Street 37th Floor
CITY Chicago STATE IL ZD? CODE 60603
PHONE 312-580-2326 FAX 312-782-1826 EMAIL, _ kmcguire@thompsoncoburn.com
If the applicant is a legal entity (Corporation, LLC, Partnership, etc.) please provide the names
of all owners as disclosed on the Economic Disclosure Statements.
One Eleven North, LLC
737 Investment & Development Co, LLC
Chicago Development Ptinners. LLC
Wmmore North & Clark, LLC
On what date did the owner acquire legal title to the subject property?_
Has the present owner previously rezoned this property? If yes, when?
Yes. March 18. 2015
Present Zoning District RBPD1272 Proposed Zoning District RBPD 1272, as amended
Lot size in square feet (or dimensions') 30,472 square feet
Current Use of the property Mixed Use
Reason for rezoning the property t0 construct a mixed use building in Sub Area "A" of Residential Business Planned Development 1272.
Describe the proposed use of the property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building. (BE SPECIFIC)
Sub Area "A" of Residential Business Planned Development 1272 will be developed with a 116'-G" tall d28'-G" lo top of mechanical equipment) mixed use building with up to 48 residential dwelling units and 59 parking spaces.
On May 14lh. 2007. the Chicago City Council passed the Affordable Requirements Ordinance (ARO) that requires on-site affordable housing units or a financial contribution if residential housing projects receive a zoning change under certain circumstances. Based on the lot size of the project in question and the proposed zoning classification, is this project subject to the Affordable Requirements Ordinance? (See Fact. Sheet for more information)
NO X
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
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:
[_] die Applicant
OR
f_J a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest: 1546 North Clark, LLC
OR .
3. m 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:
Business address of the Disclosing Party: 350 W. Ontario, Suite SE
Chicago, IL 60654.
Telephone: 312-253-3101 Fax: " Email: jmarkowicz@winmorcapilal.com
Name of contact person: John R. Mark'owicz
E. 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):
Amendment to Residential Business Planned Development 1272 at 1546-50 N. Clark St/101-115 W. North Ave
Department of Planning and Development, Committee
„ . - »- .,- CT-,0o Zoning^ Plan Commission, City Council
Which City agency or department is requesting this EDS? f
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing [j Person
Publicly registered business corporation I | Privately held business corporation j | Sole proprietorship [_J General partnership •_; Limited partnership ; • Trust
[*~] Limited liability company
1 I Limited liability partnership
[J Joint venture
\~~] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
? Yes ' QNo '
! 1 Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Delaware
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'foreigri entity? ,
fJYes [X]No ? N/A
B. IF THE DISCLOSING PARTY IS.A LEGAL ENTITY:
1. 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 beldw must submit an EDS on its own behalf.
Name Title
John R. Markowicz : Manager
Jason Tennenbaum Member ¦ ¦
Igor Gabal Member
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
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party- - _._
John R. Markowicz 350 W. Ontario, Suite 5E, Chicago. IL 60654 "j
Jason Tennenbaum 350 W. Ontario, Suite 5E, Chicago. IL 60654 .
Igor Gabel 350 W. Ontario, Suite 5E, Chicago, IL 60654 !
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party 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 date this EDS is signed?
n Yes . .. -^J.No •
If yes, please identify below the name(s) of such City elected official(s) and describe such
relationship(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 Party'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 pf whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the 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.
(Add sheets if necessary) ,.
Check here if the Disclosing Party has not retained, nor expects to 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 bf the.Disclqsing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
fl Yes No O No 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?
CI Yes HNo ' "
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter I -23, Article I ("Article I")(which the 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 inyolvingactual, 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, 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting 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;
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;
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
¦e— have-not, within a five^year-period_preceding_th_e_date_pf rhk 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 subparts3, 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 TV, "Disclosure of Subcontractors 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 either 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 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:
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 thatis a matter of record, but have not been prosecuted for such conduct; or
violated
Neither the Disclosing Party, Affiliated Entity of 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 (1) 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 theiUnited States of < America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the.Disclosing Partjj nor .any Affiliated'Entity is listed oh any of the following lists maintained by the Office of Foreign Assets Control of me U.S. Departmentof-the Treasury or the. Bureau of Industry and Security of the U.SDepartment of Commerce or their successors: the Specially Designated Nationals Lisr^ 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 lnspector ,General), 2-56 (inspector General) and 2-156 (Governmental Ethics) of the Municipal Code .
If the Disclosing Party is unable to certify to any of the above statements in this Part B. (Further Certifications), the Disclosing Party must explain below:
W& : — ———- : ^
Page 6 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who'were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none").
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 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.
N/A - - - •¦¦„•¦
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[Jis Bis 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 are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of-them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a.predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on 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.
In accordance with Section 2-156-110 of the Municipal Code: Does any official oremployee 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? 1
Yes (3 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.3.,proceed to PartE.,
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.
Does the Matter involve a City Property Sale?
Yes 0No
If you checked "Yes" to Item D.l., provide the names ahd'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.
I"*] 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.'
|109|12. 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 airy 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 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 whohave 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 tie 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 bf 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 Party certifies that either: (i) it is hot 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".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.I. 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
If the 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? . '
Yes QNo
If "Yes," answer the three'questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
Yes DNo"
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 DNo"' .
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 the Applicant and the City 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 2-164 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.cityofchicago.orp:/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.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or dther agreement in connection with which it is submitted may be rescinded or be'void or voidable, arid 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.
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. 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 to 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 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.J. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois 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 City. 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 Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties 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 to be hired in connection with the Matter certifications equal in form and substance to those in F. 1. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does hot provide such certifications or that the Disclosing ^Party has reason to. believe has-nqt provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in'F.L, Fi2; or F.3'. above, an explanatory statement must be attached to this.EDS.
CERTIFICATION
Under penalty of .perjury, the person signing below: (!) warrants that he/she is. authorized to execute this EDS and.Appendix A (if applicable) on behalf bf 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'Ci
(PrinfoKtype name of Disclosing Party)
/(Sign here) . .
(Print or type name of person signing)
Ml
(Print or type title of person signing)
Signed and sworn to before me on (date)
t * * • "* * »' * m t* m
OFFICIAL SEAL - >. TIMOTHY W KEATING Notary Public - State of Illinois My Commission Expires Nov 26,2016
at Cqq|< County, V^\iv\(state). •
^—^^^^^^^^Zll^r^ Notary Public.
Commission expires: \ | ^(^j/^C)}^ ¦
Page 12 of 13
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 Parmer 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 Party 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,^ stephrbther br stepsister or half-brother or half-sister. - —
"Applicable Party" means (1) all executive officers of the Disclosing Parry listed in Section JXB.I.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, 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 lega} 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 official or department head?
? Yes BNo
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.
None
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
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 (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to rj^ujiicipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code'scofflaw or problem landlord pursuant to'Section 2-92-416 of the Municipal Code?
f~|Yes fx]No
If the Applicant is a I jigal entity publicly traded on any exchange, 3s,any officer or director of the Applicant ideritifted'as a:Buildin£ code scqfflaw:or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
?jYes [~~|No . fit] Not Applicable
If yes to (I) or (2) above,' please identify belowthe name ofthe person or legalentity identified as a building.code scofflaw orproblem landlord and the address ofthe building or buildingsto which the pertinent code violations apply.
None
FD-.LING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT-THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO, AND MADE APART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX BARE SUBJECT TO THE CERTIFICATION MADE TJNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Page 14 of 14
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:
Chicago Development Partners, LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
__ die 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 Party holds an interest: 1546 North Clark, LLC
OR
3. [7] 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: 1229 N. North Branch, Suite 206
Chicago, IL 60642
Telephone: 312-961-1333 Fax: 312-266-2597 • Email: hjweiner@gmail.com
Name of contact person: Howard Weiner _______
E. 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):
Amendment to Residential Business Planned Development 1272 located at 1546-50 N. Clark St/101-115 W. North Ave
Department of Planning and Development, Committee
_ „. , ^ . . ,,. rno, Zoning. Plan Commission, City Council
Which City agency or department is requesting this EDS? i
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # . and Contract #
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY I. Indicate the nature of the Disclosing Party:
Person rxj Limited liability company
L_j Publicly registered business,corporation ? Limited liability partnership
| | Privately held business corporation [__ Joint venture
f-] Sole proprietorship Q Not-for-profit corporation
(_J General partnership (Is the not-for-profit corporation also a 501(c)(3))?
Limited partnership f~~1Yes [~|No
f": Trust __ Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois
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? •
fJYes QNo HN/A
B. IF THE-DISCLOSING PARTY IS A LEGAL ENTITY:
1. 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 arid title of each'general partner, managing member, manager or,any otherperson- 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
Howard Weiner Manager.
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
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or odier similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
Howard Weiner 1333 N. Kingsbury, Suite 206. Chicago. IL 60642 i ~]
Susan Zerin 1333 N. Kingsbury, Suite 206, Chicago, IL 60642 ¦
Alexandra Weiner 1333 N. Kingsbury, Suite 206. Chicago. IL 60642 , ;
Jacob Weiner 1333 N. Kingsbury, Suite 206, Chicago, IL 60642
Cathi Weiner 1333 N. Kingsbury. Suite 206, Chicago, IL 60642 ; [
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party 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 date this EDS is signed?
? Yes [_No •
If yes, please identify below the name(s) of such City elected official(s) and describe such relationship^): •
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 ofthe fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party'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: (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 to influence any legislative or administrative action.
If the 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.
(Add sheets if necessary)
L_9 Check here if the. Disclosing.Party has not retained, nor expects to 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 vthroughout the contract's term.
Has any person who directly or indirectly^bwns 10% or 'more, of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction? •
[_] Yes £J No QNo 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 arid; is the person in compliance with that agreement?
? Yes ? No
FURTHER CERTIFICATIONS "
1. Pursuant to Municipal Code Chapter 1-23, Articled ("Article I")(which the Applicant should consult for definedterms' (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 Applicarit'hor any controlling pers'on 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. Tie Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section I1.B.1. 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting 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;
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;
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
have not,.within. a7fiv.c_y^p^^d_ptecc^g_^jdat&.of this BDS,-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 bf 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 of Subcontractors 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 ofthe 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").
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Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either 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 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:
bribed or attempted to bribe, or beenJcohvicted 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
d. violated the provisions of'Muriicipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party; Affiliated Entity ot 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 (1) 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.statc or ofthe United States 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 A:ssete'Cdntrcir-bf - the UiS.'Department of the Treasury or the
Bureau of Industry and Security tiftfajiJSllfifciitttftdBt 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 arid 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 .
7. If the Disclosing Party is unable to certify to any of die above statements in this Part B (Further
Certifications), the Disclosing Party must explain below: N/A
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If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
8. To the best of the Disclosing Parry's knowledge after reasonable inquiry, the following is a complete list of all current employees ofthe 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").
-
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts diat the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this ED.S, 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.
N/A • •
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
? is 0 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 are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. Wc understand that becoming a predatory lender or becoming an affiliate of a.predatory lender may result in the loss ofthe privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) ofthe Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
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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.
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, ,. : . SJNo . . ,
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.
Unless sold pursuant to a process of competitive bidding, or odierwise 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 properly 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 dieCleaning of this Part D.
Does the Matter involve a City Property Sale?
flYes [3 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 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
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comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
1 X 1 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.
|it j 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: 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 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, -amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
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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. arid A.2. above.
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 die Internal Revenue Code of 1986 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 paragraph's AM. through A A. above from all subcontractors before it awards any subcontract arid the Disclosing Party must maintain all such subcontractors' certifications for the duration of die Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the 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?
Yes QNo
If "Yes," answer the.three questions,beIqw:
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 -
Have you filed with the Joint Reporting Committee, die Director of the Office of Federal Contract Compliance Programs, or the Equal .Employment Opportunity Commission all reports due under the applicable filingrequirements?
Yes , . , QNo " [
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
Yes. rjNo-
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 die Applicant and the City 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 coniply 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 2-164 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.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agrccmentin connection with which itis submitted may be rescinded or be void or voidable, andthe 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.
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 maybe 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. 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 to Matters subject to Article I of
Chapter 1-23 ofthe 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:
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F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois 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 City. 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 Party and its Affiliated Entities will not use, nor permit their.subcontractors-to;use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties L'ist System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the DiscIosing'Paftyds the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form arid substance to those iri-F.l. and F.2.'above.and will not, without the prior written consent ofthe City, use any such contractor/subcontractor that does not provide such .certifications or that the Disclosing Party 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.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person si_ning below:-(l) warrants thathc/she is authorized to execute this EDS and Appendix'A (if applicable) dnv'behalf of the Disclosing-Party,- and (2) .warrants mat all certifications and statements contained in this EDS and Appendix A (if applicable), are true, accurate and complete.as bf the date furnished to the'City.
isclpsing Party)
(Print or
(Sign here)
Chicago Development Partners, LLC .;
Howard Weiner
(Print or type name of person signing)
Manager
(Print or type title of person signing)
Signed arid sworn to before me on (date)
at CC?O t^ County, Ylllh*if (state).
Notary Public.
Commission a
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 "familiarfelatiohship" exists if 'as of the date tins EDS is signed, the Disclosing Party 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, motherrin-Iaw, 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 ofthe Disclosing Party listed in Section il.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 ofthe 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.
Does the Disclosing Party 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 [__No
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.
None '
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BULLDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
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 (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant. i
Pursuantto Municipal Code Section 2-154-010, is the Applicant or any Owner identified as.a building.code scofflaw or problem landlord pursuant to Sectiori"2-92-^H6 of the Municipal Code?,
No
If the Applicant is a legal entity publicly traded on any exchange, is any. officertor director of the Applicant identified as a biiilding code scofflaw or problemdandlord pursuant to Section 2-:92-416 of the Municipal Code?
| | Yes | [No - fxj Not Applicable
3. If yes to (1) or (2)'above,pleas'ei identify belowthe name ofthe person or legal entity
identified as a building code scofflaw or problem landlord andrthe address ofthe building or buildingsto which thepertinent code violationsapply.
None
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND-'AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO, AND MADE A PART OF, THE ASSOCIATED EDS; AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
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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/ inapplicable: One Eleven North LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
I I the Applicant
OR " ¦
[X] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest: 1546 North Clark, LLC
OR ,.
3. [~] a legal entity with a right of control (see Section II.B.l.) State the legal name of die entity in
which the Disclosing Party holds a right of control:
Business address of the Disclosing Party: 1229 n. North Branch, Suite 206
Chicago. IL 60642 . ¦ ' - •
Telephone: 312-961-1333 Fax: : •Email: hiweiner@Qrnail.com
Name of contact person: Howard Weiner
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):
Amendment lo Residential Business Planned Development 1272 located at 1546-50 N. Clark St/101-115 W. North Ave
Department of Planning & Development, 'Committee on Zoning,
Which City agency or department is requesting this EDS? Plan Commission,.City Council
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification^ . and Contract # : _
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Pari \.Z1 Person
[_j Publicly registered business corporation [ ) Privately held business corporation | 1 Sole proprietorship j" 1 General partnership Limited partnership j" ~ Trust
[J*] Limited liability company
I I Limited liability partnership
f ~l Joint venture
[~] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
? Yes __No | | Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State bf Illinois as a'foreigh entity?
fl Yes ? No [_ N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. 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 titIehoIder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name arid 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 ah EDS on its own behalf.
Name Title
737 Investment & Development Co, LLC \ Co-Manager . '
Chicago Development Partners, LLC . Co-Manager
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
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
737 Investment & Development Co, LLC 1333 N. Kingsbury, Suite 206, Chicago, IL 6D642 40%
Chicago Development Partners, LLC 1333 N. Kingsbury, Suite 206, Chicago, IL 60642 60%
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
? Yes ED No :
If yes, please identify below the narae(s) of such City elected official(s) and describe such
relationship(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 tiirough the Disclosing Party'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: (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 to influence any legislative or administrative action.
If the 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 whetiier 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.
(Add sheets if necessary)
_J Check here if the Disclosing Party has not retained, nor expects to 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 of indirectly owns 10% of more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
Yes . __.No ? No person directly or indirectly awns 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 HNo ' . '. ', '
FURTHER CERTIFICATIONS
1;Pufsuant to Municipal Code Chapter 1 -23, Article I ("Article I")(which the 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 nof any controlling person is currently indicted or charged . with, or has admitted guilt of, or has ever been convicted of, of 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) die 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 23
2. 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, widiin a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting 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;
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;
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
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.insubparts 3,-4. and.S xoncern:
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 of Subcontractprs.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 ofthe Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official ofthe 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 either die 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 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:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or-attempting to bribe,.a.public pfficecor.employee ofthe City, the State of Illinois, or any agency ofthe 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, of been a party to any such
agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or
prospective :biddcrs, in restraint of freedom of competition by agreement to bid a fixed price or
otherwise; or ' ¦ r. ¦
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).- .
4. Neither the Disclosing Party, Affiliafed'Entity of Contractor,- or any of their employees; officials, agents or partners, is barred from contracting with any unit'of 'state'br local'government as a result of engaging in or being convicted of (1) 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-my'state of ofthe United .States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
i' . ': . i, ¦ .;. ; ...... .. ..... , ' ¦' ' •
5.i Neither the:Disclosing Party.nor any Affiliated Entity is Iisted oh any of the following lists
maintained by the Office of Foreign; Assets Control of the U;S/Depa'rtment of the Treasury or the-
Bureau of Industry and Security of ihe^U.S. Department of Commerce or their successors: the Specially
Designated Nationals List,.rhe 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 lnspectbr General), 2-56 (Inspector General) and 2-156 (GovernmentalEthics) of the Municipal Code.
If the Disclosing Party is unable to certify to any of the above statements in •this Part B (Further Certifications), the Disclosing Party 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 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"). 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 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 die City recipient. N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
{_] is 0 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 are not and will not become a predatory lender as defined in Chapter 2^32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a.predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-4S5(b) ofthe Municipal Code) is a predatory lender within the meaning of Chapter 2-32 ofthe 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.
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?
QYes
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.
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. ¦ '
Does the Matter involve a City Property Sale?
fi Yes QNo
If you checked "Yes" to Item D.L, provide the names and business addresses ofthe 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.
! xl 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 tiiat provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
I... ,12. 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: 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 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 "N A" 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, 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. 1. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) ofthe 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. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to1 paragraphs 'A.L through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such „bcdntractors' 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
If the 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? ? Yes nNo
If "Yes," answer the/three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
Yes QNo
Have you filed with the Joint Reporting Committee, the Director of die Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under me applicable .filing requirements? "
Yes ,rjNo
Have you participated in any previous contracts or subcontracts subject to the . equal opportunity clause?
Yes QNo
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 the Applicant and the City 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 2-164 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? ayja?able on line at www.cityofchicaEO.orR/Etfaics , 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.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or'o ther 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 :terininating 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.
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 ofthe 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. 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 to Matters subject to Article I of
Chapter 1-23 of die 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
F.l. The Disclosing Parry is not delinquent in the payment of any tax administered by the Illinois 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 City. 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 Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS11) maintained by the U. S. General Services Administration.
F.3 If the DiscIosingParty is the Applicant, the Disclosing Party will obtain frorti'any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and willnot, without the prior written consent of the City, use any such contractor/subcontractor that does notprovide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If die Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3V 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 arid Appendix A (if applicable)' on behalf of the DiscIosing Party, and (2) 'warrants that all certifications and statements contained hvthis EDS and Appendix A (if applicable) are true, accurate and complete as of the date-furnished to the City.
One Eleven North LLC
(Print or type nairi^of.Disclosing Party) $
(Sphere) (Print or type name of person signing)
(Print or type title of person signing)
Signed and sworn to at
before me on (date County, ill)MA f ' (state).
Notary Public.
OFFICIAL SEAL . LEIGH BAENA NOTARY PUBLIC - STATE OF ILLINOIS MY COMMISSION EXP1RES:05/13/19
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDED 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 tiiis EDS is signed, the Disclosing Party 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 adaption: 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 ILB.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 ofthe 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.
Does the Disclosing Party 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 ElNo
If yes, please identify below (1) the name and tide of such person, (2) the name of the legal entity to which such person is connected; (3) the name and tide ofthe elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.;
None
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT APPENDIX B
BUILDING CODE SCOFFLAVWPROBLEM LANDLORD CERTIFICATION
;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 (ah "Owiier''); It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code? .'
_~]X«' . |T|no ;
If the Applicant, is a legal entity publicly traded oh any'exchange, is any officer or director.of the Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
QVes :\: ( [No ... [x7| Not Applicable
If yes to (1) or (2) above, please identify below the name .'ofthe person or legal entity 'identified as!a building code scofflaw or problem lahdlord^andtfae address of the building or buildingsto which the pertinent code violations apply.
None
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS mCORPORATED BY REFERENCE INTO, AND MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Pa_e 14 of 14
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:
1546 North Clark, LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
fx] the Applicant/Owner
OR
__J a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest:
OR .
3. f7] a legal entity with a right of control (see Section II.B.l.) State the legal name ofthe entity in
which the Disclosing Party holds a right of control:
B. Business address of the Disclosing Party: 1229 N. North Branch, Suite 206
Chicago, Illinois 60642 . - . , ¦
Telephone: 312-961-1333 Fax: _' Email: hiweiner@gmail.com :':
Name of contact person: HovVard Weiner
Federal Employer Identification No. (if you have one): .
Brief description of contract, transaction or odier undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of.property, if applicable):
Amendment to Residential Business Planned Development 1272 located at 1546-50 N. Clark St/101-115 W. North Ave
Department of Planning & Development, Committee on Zoning,
Which City agency or department is requesting this EDS? Plan Commission. Citv Council . ¦¦
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIF INTERESTS
A. NATURE OF THE DISCLOSING PARTY
I. Indicate die nature ofthe Disclosing Party:
¦"j Person [x] Limited liability company
i_j Publicly registered business corporation __ Limited liability partnership
I | Privately held business corporation _J Joint venture
f~] Sole proprietorship (71 Not-for-profit corporation
}"' ! General partnership (Is the not-for-profit corporation also a 501(c)(3))?
J_j Limited partnership QYes | |No
i_ : Trust [_) Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization/if applicable: Illinois
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'fdfeign entity?
['J Yes ? No __ N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. 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 legaieritities.-If there arc no such members, write "no members." For trusts, estates.pr 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 arid title of each general partner, managing member, managerorany other person or entity that controls the day-to-day management ofthe Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name ¦ Title
One Eleven North, LLC Co-Manager
Winmor North &CIark, LLC , . . , . - Co- Manager .
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
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
One Eleven North, LLC 1333 N. Kingsbury, Suite 206, Chicago, IL 60646 40%
Winmor North & Clark, LLC 350 W. Ontario, Suite 5E, Chicago, IL 60654 60%
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
? Yes __ No •
If yes, please identify below the. name(s) of such City elected official(s) and describe such. relationship(s):
SECTION TV - 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 Party'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: (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 to influence any legislative or administrative action.
If the 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.bid." is
not an acceptable response.
Katriina S. McGuire c/o Thompson Coburn, LLP 55 E. Monroe St, 37th FI. Chicago, IL 60603 Attorney Est $20.000
(Add sheets if necessary)
•' j Check here if the Disclosing Party has not retained, nor expects to 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 owns110% or more of the Disclosing Party been declared (in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[_| Yes [X] No ? No person directly or indirectly owns 10% or more of the
DiscIosingParty.
If "Yes," lias the person" entered into a couft-apprbved agreement for payment of all support owed and is the person in compliance with that agreement?
? Yes . r ' DNo '
FURTHER'CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined terms (e.g.V"doihg business") an_TIegal requirements), if the Disclosing Party submitting this EDS is the Applicant and is domg'busmess with the Cityj 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).die 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
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 tins 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting 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;
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;
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
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.
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 of Subcontractors 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 either 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 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:
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 ofthe federal government or of any state or local government in the United. States of.America,.m.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 competitionby agreement to bid a fixed price or otherwise; of
made an admission of such conduct described in a. or b. abovethat 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).
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 governmenfas. 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.
Neither the Disclosing-Party nor any Affiliated Entity is listed on any ofthe 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.Si Departmentof Commerce ortheir 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 Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party 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 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 ofthe 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"). 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 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 hone, indicate
with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
N/A ' ' Y
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
1. The Disclosing Party certifies that the Disclosing Party (check one)
? is _9 is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
2. . If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on 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 tiiat are defined in Chapter 2-156 of the Municipal Code have the same meanings wheirused in this Part D. '
In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee ofthe Cily have a financial interest in his or her own name or in the name of any other person or entity in the Matter?
Yes £_JNo
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.
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-Gity, 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.
Does the Matter involve a City Property Sale?
Yes __No
If you checked "Yes" to Iteni 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.
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.
I , j 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: 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 City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all persons or entities registered under die 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 die 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 ah 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 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 die Internal Revenue Code of 1986 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 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
If the Matter is federally funded,.federal regulations require.the Applicant and all proposed subcontractors to submit the following information with their bids of in writing'at the outset of ' negotiations.
Is the Disclosing Party the Applicant? '
Yes QNo
If "Yes," answer, the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable' federal regulations? (See 41 CFR Part 60-2.)
Yes QNo
•
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' ' ' ' . ,
Have you participated in any previous contracts or subcontracts subject to ithe 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 the Applicant and the City in connection with the Matter, whether procurement, City assistance, or odier 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 2-164 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.cityofchicago.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.
If 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 of 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.
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. 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 to Matters subject to Article I of
Chapter 1-23 ofthe 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 ofthe Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois 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 City. 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 Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties 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 to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.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 the Disclosing Party 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.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.
1546 North Clark. LLC
By: ff^tJ^C===, __
(Sign here) . (Print or type name of person signing) (Print or type title of person signing)
Signed and sworn to before me on (date! y^P'TC/h^/Z^X
at WlPlL^ County, lllMP}) We). 7
Commission expires
Notary Public.
OFFICIAL S_AL | Page 12 of 13
LEIGH BAENA
^ss&sssssss
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 Parry" 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 ofthe date this EDS is
signed, the Disclosing Party 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, fatherrin-law, mother-in-law, son-in-law, daughter-in-law, stepfather
or stepmother^ stepson or stepdaughter, stepbrother or stepsister.or.halfbrorher.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 ofthe 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 Party 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 __No
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.'
None
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUBLDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed onlyby (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a
building code scofflaw or problem landlord pursuant to Section 2-92-416 of the'Municipal
Code? " ' '
[~~]Ycs fx] No
If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of the Applicant identified as abuildihg code scofflaw or problem'Iandlofd pursuant to. Section 2-92-416 of the Municipal Code?
QYes '[~~|no • [x~| Not Applicable . .
If yes to (1) or(2) above, please identify belowthe name of the person or lcgal.entity., identified as abuilding';code scofflaw or problem landlord and the address of the building or buildings to which me pertinent code violations apply.
None .
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCpRPORATED BY REFERENCE INTO, AND MADE A PART OF, THE, ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE INTHIS APPENDIX BARE SUBJECT TO THE CERTEFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Page 14 of 14
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: 737 Investment & Development Co, LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
f~| 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 Party holds an interest: 1546 North Clark, LLC
OR ;.
3. [~] a legal entity widi a right of control (see Section II.B.l.) State the legal name of die entity in
which the Disclosing Party holds a right of control:
Business address of the Disclosing Party: 1229 N. North Branch, Suite 206
Chicago. )L 60642 1
Telephone: 312-266-8885 Fax: 312-266-2597 " Email: gemig(ai4gio.com
Name of contact person: Glenn Emig
E. 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):
Amendment to Residential Business Planned Development 1272 located at 1546-50 N. Clark St/101-115 W. North Ave
Department of Planning & Development, Committee on Zoning,
Which City agency or department is requesting this EDS? Plan c°""issi°". ™* C°""°il
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract # J
Page 1 of 13
SECTION II — DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
I. Indicate the nature of the Disclosing Party:
__j Person fx] Limited liability company
L_j Publicly registered business corporation ? Limited liability partnership
, 1 Privately held business corporation F_J Joint venture
f~~] Sole proprietorship Q Not-for-profit corporation
'(_] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
r ; Limited partnership __Yes __]No
j ; Trust r_ Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois
3. For legal entities not organized in the State of Illinois: Has the organization registered to do busihess'inthe State ofIllinois as a'foreigh entity?''
FJ Yes ? No 0 N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. 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 beiow 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 'tide bf 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 ah EDS on its own behalf:'
Name Title
Glenn Emig ¦ . - Sole Member and Manager ¦
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
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
DiscIosingParty
Glen Emig 1333 N. Kingsbury, Suite 206, Chicago, IL 60642 '<
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, witii any City elected official in the 12 months before the date this EDS is signed?
? Yes [xj No •
If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(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 die fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party'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: (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 to influence any legislative or administrative action.
If the 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.
(Add sheets if necessary) . .
_xj Check here if the 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 directlyior 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?
Yes 2) No Q No person directiy or indirectly owns 10% or more of the
DiscIosingParty.
If "Yes,"'has thepersoh entered into-a court-approved agreement'for payment of all support owed and is the person in compliance with that agreement?
Yes. QNo '
B. FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the 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 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, 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 of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting 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;
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;
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
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 of Subcontractors 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 purs.uant to the direction or authorization of a responsible official ofthe 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 either 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 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:
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 Hlihois, or any agency of the federal government or of any stateoH'ocaigovernment-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 MuhiciparCode Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party/ Affiliated Entity:or Contractor^ of any of their employees, officials, agents or partners, is barred from contracting with any unit of state.of local government as a result of engaging in or being convicted of (1) 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.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Avssets Control df the UJS; 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 LisL/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),5 2-56 (Inspector General) and 2-l'56XGovernmental Ethics) of the Municipal Code. .
If the Disclosing Party is unable to certify to any of the above;statetnents in this Part B (Further Certifications), the Disclosing Party must explain below:
N/A
Page 6 of 13
If tie 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"). N/A
9. To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a
complete list of all gifts diat 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.
N/A ' '" '"' :
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
? is g] 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 are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a.predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "N A," 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.
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? ''
• QYes ' ' 0 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. '
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 bf this Part D.
Does me Matter involve a City Property'Sale?
QYes _)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 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 Part}' 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.
! xJ I. 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.
|109|j 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 DiscIosing.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 FEDERALLYTUNDED 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 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, 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 ofthe statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) ofthe Internal Revenue'Code of 1986; or (ii) it is an organization described in section 501(c)(4) of die Internal Revenue Code of 1986 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 AL through A'.4. above from all subcontractors before it awards any subcontract and' the Disclosing" Party must'maiiitain all such subcontractors' certifications for the duration ofthe Matter and must make.such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the 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? ¦. >
Yes _jNo
- . .' >
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
Yes Q No
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 me applicable filiiig requirements? ' -
Yes ? 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 ah 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 the Applicant and the City 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 2r156 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.cityofchicago.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.
If 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), 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.
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. 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 to Matters subject to Article I of
Chapter 1-23 ofthe 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 2-154-02.0 ofthe Municipal Code. ..
The Disclosing Party represents and warrants that:
Page 11 of. 13
F. 1. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois 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 City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
FJ2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated'Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List-System (-EP-LS")-maintained-by-the U. S.-General Services A.dministration. . .
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form arid substance to those in E.I. and F.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 the . DiscIosing Party has reason to believe has nbt pfovided or cannot provide truthfurcertifications.
I . t • ' . . ^ • ......
NOTE: If the Disclosing Party cannot certify as to any of the items in F. 1F.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 arid Appendix' A (if applicable) otf 'behalf of the Disclosing Party, and (2) warrants that all certifications ahd stafeihents contained inthisEDSand Appendix A (if applicable);are true,.accurate and complete as of the date furnished to the'City.
737 Investment & Development CO, LLC
(Sign here)
(Print or type name ofDisqhJspg Party) By:.
Glenn Emio
(Print or type name bf person'signing)
Sole Shareholder and Manager
(Print or type title of person signing)
Signed and sworn to before me on (date) >1$phC^lef^i< J1/' ^Z7l^~ zt GSC? V- County, UllnPlJ (state).
Notary Public.
Commission expires:
OFFICIAL SEAL LEtGHBAENA
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 Parmer 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 Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer of any city department head as spouse or domestic partner or as any ofthe 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, spn-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 ILB.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, if the Disclosing Party is a limited hability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest-in the DiscIosing Party. "Principal officers" means the pfesident, 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 official or department head?
? Yes __No
If yes, please identify below (1) the name and title of such person, (2) the name of the legal enti ty to which such person is connected;- (3) the name and tide 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. i
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUDLDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the'AppHcant exceeding 7.-5,percent (an "Owner"). It is hot to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-^010, is the Applicant or any Owner identified as a
- - building code scofflaw of problem Iandlord:pursuant to Section 2-92-416" of the Municipal
¦ Code? ¦ ¦ • ' "
[~~|Yes ' [T|No
2. If the Applicant is a legal entity publiclytfaded oh any exchange, is any officer or director bf
the Applicant identified as a building; code^scofflaw or problem landlord pursuant to
2-92-416 ofthe Municipal Code?
| |'Yes '. ¦, | |No [x] Not Applicable
3. If yes to (1) or (2) above, please identify belbwthe name of the person or legal endty
identified'as .a building eode scofflaw or problem; landlord and the address ofthe building of >
buHdings to which the. pertinent code :vioIatiohs;'apply.
None
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENTjpHAT THIS APPENDIX B IS. INCORPORATED BY REFERENdE' mtOrA^mJM A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN TfflS APPENDIX B ARE SUBJECT TO THE CERTHfiCAtiON MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
Page 14 of 14
(DO NOT SUBMIT THIS PACK W1TII YOUR F.DS. Tho purpose uflhis page is lor you to recertify your liDS prior lo submission to Cily Council or on the dale of closing. If unable to recertify truthfully, the Disclosing Parly must complete a now liDS with correel or corrected information)
RECEKTIKICATION
Generally, for use with Cily Council mailers. Nol fur City procurements unless requested.
Amendrnont to Residential Business Planned Development This reccrtification is being submitted in connection with 1272 at 1546-50 N. Clark Sl/101-115 W. North Ave [identify the Matter]. Under penalty of perjury, the person signing below: (I) warrants that he/she is authorized to execute this EDS reccrtification on behalf of llic Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original FDS arc true, accurate and complete as of the date furnished lo the City and continue to be true, accurate and complete as ofthe date of this reccrtification. and (3) reaffirms its acknowledgments.
Winmore North 4 Clark. LLC Dale: (Print or type legal name of Disclosing Party)
^Z/Vjoz/l.'
Print or type name ofsignalory:
John R. Markowicz
Title ofsignalory:
Mnnngor
Signed and sworn to before me on fdatel bfKU Hn 3UI5 . by
tjV^n rZ- MflrKOA/lf-X • at tail County. T_l-
(yV\( fi 11U1 -niUmtfLD Notary Public.
OFFICIAL SEAL MARISSA MORENO Notify Public - Stile of Illinois My Commliilon Eipirts Feb 27.2017
Vcr. IIJIIJI5
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested.
Amendment to Residential Business Planned Development This recertification is being-submitted in connection with 1272 at 1546-50 N. Clark st/10l-lt5 W. North Ave [identify the Matter], Under penalty of perjury, the person signing below: (I) warrants that he/she is authorized to execute this EDS recertification on behalf ofthe Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as ofthe date furnished to the City and.continue to be true, accurate and complete as of the date of this recertification, and (3) reaffirms its acknowledgments.
737 Investment & Development Co. LLC
(Print or type legal name of Disclosing Party)
(sign here) Print or type name of signatory:
Glenn Emiq
Title of signatory:
Sole Shareholder and Manager
Commission expires:_ 0*/ /'o//2
WWWVVVWVVVVVVvVtMArWrVV
OFFICIAL SEAL SANDRA E LEBRON NOTARY PUBUC - STATE OF IUJN0i3 MT COMMISSION EXPIRES.-04/KV18
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested.
Amendment to Residential Business Planned Development This recertification is being submitted in connection with.1272 at ^-^N- Clark syioi-115 w. North Ave [identify the Matter]. Under penalty of perjury, the person signing, below: (1) warrants that he/she is authorized to execute this EDS recertification on behalf ofthe Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as of the date furnished to the City and continue to be true, accurate and complete as of the date of this recertification, and (3) reaffirms its acknowledgments.
Chicago Development Partners. LLC . .
(Print or type legal name of disclosing Party)
(sign here)
Print or type name ofsignalory: Howard Weiner
Title of signatory:
Manager
Signed and sworn to -before me on [date] '^77 >5 ' . ,by
fW^W VrtAm^ at Wait- County, ill \V}j)}\ [state]•
IX/hjf\ h^U^KA-^ Notary Public.
Commission expires:.
OFFICIAL SEAL LEIGH BAENA
NOTARY PU6UC - STATE OF IUINOIS MY COMMISSION EXPRES:05/13/19
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDSprior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested.
Amendment to Residential Business Planned Development This recertification is being submitted in connection w-itK--ig7^at1546^p,N.:Giark-st/ipi-il5Vy. North Ave [identify the Matter].- Under penalty bf perjury, the person.signing below: (1) warrants that he/she is authorized'tb execute this EDS recertification oh behalf of the'Disclosing Party, (2) warrants-that'all Certifications and statements contained in the Disclbsihg'Party's original EDS are true, accurate and complete as ofthe date furnished to the City-arid continue to'be true, accurate and complete as of the date'bf this recertification, and (3) reaffirms its acknowledgments.
One Eleven North LLC ' ' . Date: ... ^ ^^/AJ^
(Print or type legal name of Disclosing Party)
Print or type name of signatory:
Howard Weiner
Title of signatory:
Manager
Signed and sworn to before me oh [date] ^ j i^) , ' by rVt/Vffll, WQnj^ ., , at OPcJl^ County, f./TlMt)
ission expires:_
Notary Public.
OFFICIAL SEAL LEIGH BAENA
NOTARY PUBLIC - STATE OF ILLINOiS WrCCf^SSIONEXPIRES 0S'1.3'9
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Parly must complete a new EDS with correct or corrected information)
RECERTIFICATION
Generally, for use with City Council matters. Not for City procurements unless requested.
Amendment to Residential Business Planned Development This recertification is being submitted in connection with 1272 at 1546-50 N. Clark St/101-115 W. North Ave [identify the Matter]. Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS recertification on behalf of the Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as of the date furnished to the City and continue to be true, accurate and complete as of die date of this recertification, and (3) reaffirms its acknowledsnnents.
1546 North Clark, LLC Date: ^ ^ Y9 // ^'
(Print or type legal name of Disclosing Party)
(sign here)
Print or type name of signatory: Howard Weiner
Title of signatory:
Sole Manager
Signed and sworn to before me on [date] / 7-\ 1 /^T , by .
rfPl'Vflrtfl W-eiYUY , at County, li}i At>U [state].
Notary Public.
Commission expires:
.juuijuinpirri^
OFFICIAL SEAL LEtGHBAENA
NOTARY PUBLIC • STATE OF ILLINOIS MY COMMISSION EXPIRES «i13/19