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This record contains private information, which has been redacted from public viewing.
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Ordinance
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Passed
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Title:
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Zoning Reclassification Map No. 1-G at 1300-1344 W Fulton St, 301-329 N Ada St, 1301-1345 W Carroll Ave and 300-330 N Elizabeth St - App No. 18546
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ZONING RECLASSIFICATIONS - Map No. 1-G
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FWAL FOR PUBLICATION SUBSTITUTE ORDINANCE BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO SECTION 1: Title 17 of the Municipal Code of Chicago, the Chicago Zoning Ordinance is hereby amended by changing all the M2-3 Light Industry District symbols and indications as shown on Map No. 1-G in an area bounded by: West Carroll Avenue; North Elizabeth Street; West Fulton Street; North Ada Street to the designation of C3-5 Commercial, Manufacturing and Employment District and a corresponding use district is hereby established in the area above described. SECTION 2: Title 17 of the Municipal Code of Chicago, the Chicago Zoning Ordinance is hereby amended by changing all C3-5 Commercial, Manufacturing and Employment District symbols and indications as shown on Map No. 1-G in an area bounded by: West Carroll Avenue; North Elizabeth Street; West Fulton Street; North Ada Street to the designation of Commercial Manufacturing Planned Development No. which is hereby established in the area above described, subject to such use and bulk regulations as are set forth in the Plan of Development herewith attached and made a part thereof and to no others. SECTION 3: This Ordinance shall be in force and effect from after its passage and due publication. FINAL FOR PUBLICATION COMMERCIAL MANUFACTURING PLANNED DEVELOPMENT NO. PLAN OF DEVELOPMENT STATEMENTS The area delineated herein as Commercial Manufacturing Planned Development No. consists of approximately 136,282 square feel of property which is depicted on the attached Planned Development Boundary and Property Line Map ("Property") and is owned or controlled by the Applicant, 1330 W. Fulton, 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 applications for amendments, modifications or changes (administrative, legislative or otherwise) to this Planned Development are made, shall be under single ownership or under single designated control. Single designated control is defined in Section 17-8-0400 of the Zoning Ordinance. 3. 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 adjustments of right-of-way, shall require a separate submittal to the Department of Transportation on behalf of the Applicant or its successors, assignees, or grantees. APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17, 2015 FINAL FOR PUBLICATION 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 ofany Part II approval, the submitted plans must be approved by the Department of Transportation. As part of this project, Applicant agrees to contribute $50,000 towards the cost of installation of a turn bay onto West Carroll Avenue from West Ogden Avenue. The Applicant further agrees to contribute $199,500 towards the cost of the installation of a traffic signal and related improvements at West Fulton Street and West Ogden Avenue. Both payments must be made to the City of Chicago Department of Transportation prior to the Certificate of Occupancy of the building located on the northeast corner of Fulton Street and Ada Street, with address ranges of 1324-1342 North Fulton and 301-329 APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17,2015 FINAL FOR PUBLICATION North Ada. This Plan of Development consists of these fifteen (15) Statements; a Bulk Regulations and Data Table; a Vicinity Map; an Existing Land Use Map; an Existing Zoning Map; a Sub Area Diagram; a Site Plan; a Landscape Plan; a Green Roof Diagram; and Building Elevations prepared by architect Gensler dated October 14, 2015. 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 shall be allowed within the area herein delineated as Commercial Manufacturing Planned Development: - Office; High Technology Office; Electronic Data Storage Center Accessory and Non-accessory Parking Artist Work or Sales Space Business Equipment Sales and Service Business Maintenance Services Business Support Services; Copying and Reproduction, Business/Trade School, Day Labor Employment Agency, Employment Agencies Urban Farm; Indoor Operation, Outdoor Operation, Rooftop Operation Day Care Communication Service Establishments Entertainment and Spectator Sports; Indoor Special Event Class A and B including incidental liquor sales, Small venues (1-149 capacity) Financial Services; Bank, Savings Bank, Savings and Loan Association, Currency Exchange, and Credit Union, Automated Teller Machine Facility APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17,2015 FINAL FOR PUBLICATION Food and Beverage Retail Sales; Liquor Store (package goods), Liquor sales (as accessory use) Personal Service; Hair Salon, Nail Salon, or Barbershop, Massage Establishment, Repair or Laundry Service, Consumer; Dry Cleaning drop-off or pick up (no on-premise plant) Sports and Recreation, Participant; Indoor, Children's Play Center Manufacturing, Production and Industrial Services; Artisan, Limited, General Wireless Communication Facilities, Co-located, Freestanding (Towers) Medical Service Eating and Drinking Establishments; Restaurant - Limited, Restaurant - General Tavern, Outdoor patio (if located on a rooftop), Outdoor patio (if located at grade level) Retail Sales, General Sales of goods produced and services offered on site by tenants of the property 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 and Data 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 and Data Table has been determined using a Net Site Area of 136,282 square feet. APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17,2015 FINAL FOR PUBLICATION 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 ofany 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, Environment and Buildings, under Section 13-32-125 of the Municipal Code, or any other provision of that Code. 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. 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 APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17,2015 FINAL FOR PUBLICATION access throughout the Property. Plans for all buildings and improvements on the Property 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 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. . New buildings will conform to the Chicago Sustainable Development Policy and are eligible for Building Certification and will provide green roof to cover al least 50% of the net roof area of any new building. "Net roof area" is defined as total roof area minus any required perimeter setbacks, roof top structures, and roof-mounted equipment. Unless construction of the new improvements contemplated in this Planned Development has commenced within six (6) years following adoption of this Planned Development, and unless completion is thereafter diligently pursued, then this Planned Development shall expire and the zoning of the property shall automatically revert to the C3-5 Commercial, Manufacturing and Employment District classification. APPLICANT: 1330 W. FULTON, LLC ADDRESS: 1300-1344 WEST FULTON STREET, 301-329 NORTH ADA STREET, 1301- 1345 WEST CARROLL AVENUE, 300-330 NORTH ELIZABETH STREET, CHICAGO, ILLINOIS INTRODUCED: OCTOBER 14, 2015 PLAN COMMISSION: DECEMBER 17, 2015 FINAL FOR PUBLICATION { c 01 O z z < < UJ LU li-l LL. LL. LU HI hi LL. OC. LU < < Qi => Z> < a a r% LO LO .H Ol VO CO CTco 01 LO 00" LO I u o lo a: o; k a < < < <|109|z> z> z> a a a a O O LO LO LO LO <"N O O O 00 rN vo" iH VO m 00 vo t-H VO i-H > o > O CL < Cti OL Q- Q. CL < o o Ln vo o Ln UJ OQ < < a LU 3 CO o; < >-< o Oi _ < UJ 'j- LU Qi ,r, t < — LO LU OS LO t U VO LO ~~O L_ M Qi lu O Z S. I X < O Qi Oi < Oi O O Oi < UJ LU LL. LU Oi <|109|a <£ LO Q •-; _j =! or LU <; CO LU < ' a|109|=> co °P LU LO —' < t I I lo g — ^ Zi ^} 3 ^ -d X CO Z < LU Qi < CO < Q _j D co O oi y LL. LO Q Q Z Z < >- >- Oi <
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Department of Planning and Development
CITY OF CHICAGO
MEMORANDUM
Alderman Daniel S. Solis
Chairman, City Council Committee on Zoning
David L. Reifman Secretary
Chicago Plan Commission
December 18, 2015
RE: Proposed Map Amendment and Commercial Manufacturing Planned
Development in the Kinzie Industrial Corridor for property generally located at 1300-1344 West Fulton Street, 301-329 North Ada Street, 1301-1345 West Carroll Avenue and 300-330 North Elizabeth Street.
On December 17, 2015, the Chicago Plan Commission recommended approval of the proposed map amendment and Commercial Manufacturing Planned Development submitted by 1300 W. Fulton, 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)
121 NORTH LASALUi STREET, ROOM 1 000. CHICAGO, ILLINOIS 60602
CHICAGO PLAN COMMISSION
December 17, 2015
Fulton West
Commercial Manufacturing Planned Development 1330 W Fulton Market
12/17/2015
12/17/2015
'-'--'V'' I'"-'; j - -'--:— : j '
12/17/2015
FINAL
REPORT to the
CHICAGO PLAN COMMISSION from the
DEPARTMENT OF PLANNING AND DEVELOPMENT DECEMBER 17, 2015
FOR APPROVAL: PROPOSED COMMERCIAL MANUFACTURING PLANNED
DEVELOPMENT
APPLICANT: 1330 W. FULTON, LLC
LOCATION: 1300-1344 WEST FULTON STREET; 301-329 NORTH ADA
STREET; 1301-1345 WEST CARROLL AVENUE; 300-330 NORTH ELIZABETH 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 Commercial Manufacturing Planned Development for your review and recommendation to the Chicago City Council. The application for the amendment to the Zoning Ordinance was introduced into the City Council on October 14, 2015. Proper legal notice of the public hearing on the application was published in the Chicago Sun-Times on December 2, 2015. The Applicant was separately notified of this hearing.
The Applicant, 1330 W. Fulton, LLC, is seeking approval to rezone an approximately 136,282 square foot site generally bounded by West Fulton Street, North Ada Street, West Carroll Avenue and North Elizabeth Street, within the Kinzie Industrial Corridor, from M2-3 (Light Industry District) to C3-5 (Commercial, Manufacturing and Employment District), prior to establishing a Commercial Manufacturing Planned Development on the same site. The Applicant intends to complete a partially finished office building and parking garage on the site as part of the overall project. A mandatory planned development is necessary pursuant to Section 17-8-0512-A of the Chicago Zoning Ordinance because the completed project will exceed 80' in height. In addition, Section 17-13-0402 of the Chicago Zoning Ordinance requires a public hearing to be held by the Chicago Plan Commission on applications to rezone land within an industrial corridor from an "M" zoning district classification to any other zoning district classification.
BACKGROUND
The west half of the site consists of a partially completed office building shell at approximately 1330 West Fulton Street that was started by the prior owner in approximately 2000 and then stalled for financial reasons. The building shell has sat as a blight on the site ever since. In addition, a parking garage to the north of the office building shell was partially completed as well and currently serves approximately 170 vehicles. The
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east half of the site is improved with six warehouse-type office buildings that are planned to remain as part of the overall project as well.
SITE AND AREA DESCRIPTION
The subject property is generally located at 1330 West Fulton Street and includes the entire block bounded by West Fulton Street, North Ada Street, West Carroll Avenue and North Elizabeth Street. There are no alleys within the boundaries of the site and it totals approximately 136,282 square feet. The site is currently zoned M2-3 and it is located within the Kinze Industrial Corridor.
The area surrounding the site is also part of the Kinzie Industrial Corridor and immediately to the north, the Kinzie Planned Manufacturing District. Zoning in the area generally consists of M2-3 and C3-3 (Commercial, Manufacturing and Employment District) and C1-5/C1-3 (Neighborhood Commercial District) districts. The immediate area surrounding the site generally includes warehousing, distribution and office uses. However, the site is part of the larger Fulton Market area which consists of a delicate balance of zones of historic and active industrial users, burgeoning high tech office users, as well as some residential uses and entertainment/restaurant venues.
The subject site is served by public transportation. The CTA's Ashland Station on the Green/Pink Lines and the CTA's Morgan Station on the Green Line are several blocks west and east of the subject site, respectively. Bike routes in the area include Ogden, Racine and Hubbard.
The site is not located within the Lake Michigan and Chicago Lakefront Protection District or a Chicago Landmark District. The property is located within the Kinzie Tax Increment Financing District and the Near West Side Community Area.
PROJECT DESCRIPTION
The project consists of the construction of an approximately eight plus-story commercial building that will predominantly include office space and other commercial uses on the west half of the proposed planned development. As stated, the shell of the proposed office building was previously started by a previous property owner and the proposal involves reusing and building upon this base shell. Similarly, a parking garage that is partially complete and operating will be expanded and will provide approximately 610 parking spaces to serve the entire development upon completion. Up to160 of these parking spaces will be designated as non-accessory to serve the larger area. In total, the completed commercial building on the west half of the site will include approximately 300,000 square feet of commercial space.
The east half of the site is currently improved with six vintage structures that currently house a variety of office users. These six buildings front on West Carroll Avenue and West Fulton Street while a surface parking area separates the buildings in the middle. The surface parking area is planned to be replaced with a landscaped courtyard serving these
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buildings while parking for the entire site will be provided via the expanded garage. No physical changes to these buildings are contemplated at this time though Applicant does propose the conversion of the ground floor of these buildings into commercial/retail/restaurant space. These buildings total approximately 166,000 square feet of space.
DESIGN
The proposed buildout of the partially complete office building includes a five story brick and glass base topped by three-stories of a generally metal panel/aluminum window wall system setback from West Fulton Street. The uppermost partial floor includes metal panel and glass with access to the roof amenity level. The total height of the commercial building is planned to not exceed 139'. The parking garage is planned to be expanded and is planned not to exceed 93' in height. It will include metal screening as the primary cladding.
LANDSCAPING
The project will fully comply with the Chicago Landscape Ordinance and will adhere to the landscaping goals within the Fulton Market Area. A new landscaped courtyard plaza will be developed in the middle of the east half of the site in an area that is currently used for surface parking. Landscaping will be used to frame in this area as well at the point of the current curb cut along North Elizabeth Street.
ACCESS/CIRCULATION
Vehicular access to the building, both in and out, will be achieved via the garage on North Ada Street as is currently the case. The completed garage will include space for approximately 610 spaces. Loading will be achieved via a berth that is accessed via West Carroll Avenue as well as a berth along North Ada Street. The primary pedestrian access to the new building will be via West Fulton Street and North Ada Street. Access to the garage will be via North Ada Street as well as an internal connection between the garage and the proposed commercial building. Finally, access to the garage and proposed commercial building will be achieved via the new courtyard plaza while also affording tenants of the existing buildings access to the garage.
SUSTAINABILITY
The Applicant will provide approximately 10,800 square feet of green roof and will achieve Building Certification for the proposed new commercial building. The Green Roof Diagram included as an exhibit to this report highlights the location and layout of the green roof on the ninth floor of the new building.
BULK/USE
The proposed maximum Floor Area Ratio (FAR) for this Commercial Manufacturing
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Planned Development will be 5.0, which is the base FAR for the proposed C3-5 zoning district. Per the Chicago Zoning Ordinance, non-accessory parking will be included as floor area as well.
The planned development will allow for a variety of commercial uses that are included in the underlying C3-5 zoning district. Such uses include office, restaurants, retail, day care, artisan and limited manufacturing as well as parking. No residential uses are contemplated or will be allowed under this proposal.
RECOMMENDATION
The Department of Planning and Development has reviewed the project materials submitted by the Applicant. The Chicago Zoning Ordinance in Section 17-13-0400, lays out two types of review and decision making criteria for Map Amendments within Industrial Corridors. The first is that review and decision-making bodies must consider the criteria established in Section 17-13-0308 governing Zoning Map Amendments. The second set of review criteria addresses whether the proposed rezoning will adversely affect the continued viability of the industrial corridor and then proceeds to establish a series of factors to determine industrial viability in Section 17-13-0403. Such factors and an analysis of this proposal follow below:
I. Map Amendments within Industrial Corridors
The size of the district:
The district is approximately 854 acres in size and the site consists of approximately 136,282 square feet (3.12 acres).
The number of existing firms and employees that would be affected:
Approximately 800 companies employ approximately 15,645 individuals in the industrial corridor. The total number of employees within the district will increase as a result 6 this proposal. The immediate completion of the shell office building proposal will result in a net gain of employees and firms.
Recent and planned public and private investments within the district:
The CTA's new Morgan Station was completed in the last several years and serves residents, employees and visitors to the area. CDOT is in the midst of a streetscape improvement project along West Fulton Street.
The potential of the district to support additional industrial uses and increased manufacturing employment:
The Kinzie Industrial corridor is situated to support additional industrial uses. There are approximately 85 vacant properties in the corridor that are available for industrial development therefore this change will not substantially weaken the corridor. The corridor is accessible from I-90/94 Kennedy Expressway and is served by public transportation.
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The proportion of land in the district currently devoted to industrial uses:
Approximately 60% of the land in the corridor is devoted to non-manufacturing businesses while 40% is devoted to manufacturing uses. 75% of the land in the corridor is zoned planned manufacturing district.
The area's importance to the city as an industrial district:
This is an important corridor due to its proximity to public transportation, truck route connections and expressways. The area employs an estimated 15,645 individuals in a diverse assortment of industries.
After reviewing the materials submitted by the applicant and analyzing the proposal with respect to the factors above, the Department of Planning and Development has concluded the following pursuant to the 17-13-0403 addressing the viability of the Industrial Corridor:
The proposed rezoning would not adversely affect the continued industrial viability of the Kinzie Industrial Corridor. There are multiple vacant and/or underutilized parcels in the corridor that are available for industrial development. The current use of the subject parcel is an unfinished office building shell and parking garage, as well as several improved office buildings. There would be no loss of jobs in the Corridor due to the proposed development. In addition, no residential uses will be allowed within the project. Therefore, the change in zoning and the redevelopment of the property will not substantially weaken the Kinzie Industrial Corridor or any established industrial users.
II. Zoning Map Amendments
The review and decision-making criteria of Section 17-13-0400 addressing Zoning Map Amendments within Industrial Corridors also requires review under Section 17-13-0308 covering Zoning Map Amendments:
ZONING CONSISTENCY
The site identified is located towards the eastern section of the Kinzie Industrial Corridor. The applicant seeks to rezone the property from a M2-3 District to a C3-5 District. The proposed rezoning is generally consistent with the Chicago Sustainable Industries initiative which recognizes a need to examine the effectiveness of industrial corridors. The rezoning will also allow for the completion of a stalled development project and blighted parcel in the area.
ZONING APPROPRIATENESS
The rezoning of this relatively small site in the corridor from an M2-3 District to a C3-5 District would not adversely affect the remainder of the Kinzie Industrial Corridor. The proposed project and zoning will not allow any residential uses.
C) DEVELOPMENT COMPATIBILITY
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The proposed development project is compatible with the surrounding area. The proposal includes the completion of a partially built office building and parking garage while existing buildings in the proposal will also remain. The scale and height of the proposed commercial building is also compatible with the surrounding area.
D) PROPOSED CLASSIFICATION COMPATIBILITY
The proposed C3-5 zoning classification is generally compatible with the surrounding zoning classifications. The site is surrounded by other M2 districts but a few parcels are zoned C1 and C3.
E) ADEQUACY OF INFRASTRUCTURE AND CITY SERVICES
The development site currently is improved with a partially built commercial building and public garage and is served by existing infrastructure in the area.
Based on the foregoing, it is the recommendation of the Department of Planning and Development that the application for a Zoning Map Amendment in the Kinzie Industrial Corridor be approved and that the recommendation to the City Council Committee on Zoning, Landmarks, and Building Standards be "Passage Recommended."
In addition, the Department of Planning and Development has reviewed the project materials submitted by the Applicant and compared this proposal to existing development in the community. The area around this project consists generally of M2-3 (Light Industry District), C1 and C3 zoning districts and the proposal represents an opportunity to complete construction of a partially constructed and compatible commercial/office development project along West Fulton Street in Chicago's Near West Side Community Area.
Based on that analysis, the Department of Planning and Development has concluded that this proposal is appropriate for this site and supports this development for the following reasons:
1. The project meets the purpose and criteria set forth in Chapter 17-8 of the Zoning Ordinance and its adoption would not have any adverse impact on the public's health, safety or welfare. Specifically, this project meets the following provisions of Chapter 17-8:
Creates safe and attractive walkways and pedestrian routes (per 17-8-0905A1) by transforming an otherwise unfinished building shell into a new commercial building that is built to the lot line along West Fulton Street and North Ada Street;
Upper-story setbacks should be used to reduce the apparent mass and bulk of tall buildings (per 17-8-0907-B) as evidenced by the proposal's
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incorporation of a significant setback on West Fulton Street at the sixth floor;
Reinforces desirable urban features found within the surrounding area, such as siting patterns, massing arrangements and streetscape characteristics (per 17-8-0906-A), as evidenced by the project's height, mass and site design's overall compatibility with the surrounding buildings in the Near West Side Community Area;
Provides adequate, inviting, usable and accessible open space for workers and visitors associated with the development and provides substantial landscaping of the open areas (per 17-8-0909-A), as evidenced by the incorporation of a new landscaped courtyard plaza on the eastern half of the site;
Conserves non-renewable energy and scarce materials (per 17-8-0908-A) as evidenced by the project's goal of Building Certification;
All sides and areas of the buildings that are visible to the public are treated with materials, finishes and architectural details that are of high-quality and appropriate for use on primary street-facing facade (17-8-0907-A-4), as evidenced through the material callouts in this report and on the elevations.
The public infrastructure facilities and city services will be adequate to serve the proposed development at the time of occupancy. 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 project will comply with the requirements for access in case of fire and other emergencies.
Based on the foregoing, it is the recommendation of the Department of Planning and Development that this application for a Commercial Manufacturing Planned Development be approved and that the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be "Passage Recommended".
Bureau of Zoning and Land Use Department of Planning and Development
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DEPARTMENT OF PLANNING AND DEVELOPMENT CITY OF CHICAGO
ZONING MAP AMENDMENT WITHIN AN INDUSTRIAL CORRIDOR 1300-1344 WEST FULTON STREET; 301-329 NORTH ADA STREET; 1301-1345 WEST CARROLL AVENUE; 300-330 NORTH ELIZABETH STREET
RESOLUTION
WHEREAS, the Applicant, 1330 W. Fulton, LLC, has submitted an. application seeking approval to rezone a 136,282 square foot site within the Kinzie Industrial Corridor from M1-3 to C3-5 and subsequently to establish a Commercial Manufacturing Planned Development on the site; and,
WHEREAS, the Property is located within the Kinzie Industrial Corridor and Section 17-13-0400 of the Chicago Zoning Ordinance requires the Chicago Plan Commission to hold public hearings on requests to rezone land within an Industrial Corridor from an M zoning district to a non-M zoning district; and,
WHEREAS, the Applicant intends to complete construction of a partially completed office building and parking garage project that will include an approximately 9-story commercial building and space for approximately 610 automobiles located at on the western half of the subject site and retain the commercial buildings on the eastern half of the site; and,
WHEREAS, the Applicant's request to rezone the property was introduced to the City Council on October 14, 2015; and,
WHEREAS, proper legal notice of the hearing before the Plan Commission was published in the Chicago Sun-Times on December 2, 2015. The Applicant was separately notified of this hearing and the proposed zoning application was considered at a public hearing by this Plan Commission on December 17, 2015; and,
WHEREAS, the Plan Commission has reviewed the application with respect to the provisions of the Zoning Ordinance and finds that the proposal will be consistent with saiu provisions; and
WHEREAS, the Department of Planning and Development recommended approval of the
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
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 informational submissions associated with the proposed amendment, the report and recommendation of the Commissioner of the Department of Planning and Development and all other testimony presented at the public hearing held on December 17, 2015, giving consideration to 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 Commissioner 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,
THAT this Plan Commission recommends approval to the City Council Committee on Zoning, Landmarks and Building Standards of the final zoning application dated December 17, 2015, and,
Martin Cabrera, Jr. Chairman
Chicago Plan Commissio
CMPD No.
Approved: December 17, 2015
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
DEPARTMENT OF PLANNING AND DEVELOPMENT CITY OF CHICAGO
COMMERCIAL MANUFACTURING PLANNED DEVELOPMENT 1300-1344 WEST FULTON STREET; 301-329 NORTH ADA STREET; 1301-1345 WEST CARROLL AVENUE; 300-330 NORTH ELIZABETH STREET
RESOLUTION
WHEREAS, the Applicant, 1330 W. Fulton, LLC, has submitted an application seeking approval to rezone a 136,282 square foot site within the Kinzie Industrial Corridor from M1-3 to C3-5 and subsequently to establish a Commercial Manufacturing Planned Development on the site; and,
WHEREAS, the Applicant intends to complete construction of a partially completed office building and parking garage project that will include an approximately 9-story commercial building and space for approximately 610 automobiles located at on the western half of the subject site and retain the commercial buildings on the eastern half of the site; and,
WHEREAS, the Applicant's request to rezone the property was introduced to the City Council on October 14, 2015; and,
WHEREAS, proper legal notice of the hearing before the Plan Commission was published in the Chicago Sun-Times on December 2, 2015. The Applicant was separately notified of this hearing and the proposed zoning application was considered at a public hearing by this Plan Commission on December 17, 2015; and,
WHEREAS, the Plan Commission has reviewed the application with respect to the provisions of the Zoning Ordinance and finds that the proposal will be consistent with said provisions; 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 informational
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
FINAL
submissions associated with the proposed amendment, the report and recommendation of the Commissioner of the Department of Planning and Development and all other testimony presented at the public hearing held on December 17, 2015, giving consideration to 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 Commissioner 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,
THAT this Plan Commission recommends approval to the City Council Committee on Zoning, Landmarks and Building Standards of the final zoning application dated
December 17, 2015, and,
Martin Cabrera, Jr. I Chairman
Chicago Plan Commission
CMPD No.
Approved: December 17, 2015
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
CITY OF CHICAGO
AMENDED APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE
ADDRESS of the property Applicant is seeking to rezone:
1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W. Carroll Ave.,
300-330 N. Elizabeth St.
Ward Number that property is located in:.2?
APPLICANT 1330 W. Fulton, LLC
A DDRESS 1040 W. Randolph St. CITY Chicago
STATliJt ZIP CODE PHONE 312-202-3482
EMAIL tKfol@sieriingbay.com CONTACT PERSON Fred Krol
Is the applicant the owner of the property? YES._X NO.A.„
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 133Q w- Fulton, LLC, 300 N. Elizabeth, LLC, 323 N. Ada, LLC and Fulton West Land, LLC
ADDRESS 1040 W. Randolph CITY Chicago
PHONE _312-202-3482
CONTACT PERSON Fred Krol
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY J°hn J. George, Schuyler, Roche & Crisham, P.C.
ADDRESS.2_W0 Prudential Plaza, 180 N. Stetson Avenue, Suite 3700
ZIP CODE 60601
EMAIL J9e0rge@srcatt0meys.com
6. 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.
Fulton West Manager, LLC, Fulton West Realty Company, LLC, Fulton West Venture,
LLC, Gloor Holdings, LLC, Goodman Holdings, LLC, Goodman Management, Inc., Scott L. Goodman Trust, Sterling Bay Capital Management, LLC, Sterling Bay Capital Partners I, LLC, Sterling Principals, LLC
On what date did the owner acquire legal title to the subject property? 01/31/14
Has the present owner previously rezoned this property? If yes, when? No
C3-5 then to Commercial Manufacturing
Present Zoning DistrictM2'3 Proposed Zoning District Planned Development
Lot size in square feet (or dimensions^ 136,282 square feet _ ;
11. Cuircnt Use of the property Offices and various vacant partially constructed structures.
, 0 „ c • ,l .To allow for various commercial and office uses.
J 2. Reason for rezoning the property
13. 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)
Applicant proposes to complete construction of a partially built 8-story commercial building at
1330 W. Fulton St. as well as completion of a partially built parking garage located at 323 N. Ada St.
14. On May 14 , 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)
YES
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:
FULTON WEST MANAGER, LLC _^
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[ ] 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: 1330 W. Fulton,. LLC, 300 N. Elizabeth, LLC and
OR 323 N. Ada, LLC
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name.of the entity in
which the Disclosing Party holds a right of control:
B. Business address of the Disclosing Party: 1040 W. Randolph Street
Chicago, IL 60607 _
Telephone: .312-466-4100. Fax: .312-466-41 OL __. Email: asirnpson@5terllngbay.corn
Name of contact person: Anna Simpson
Federal Employer Identification No. (if you have one):I .
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") lo which this EDS pertains. (Include project number and location of property, if applicable):
Application for planned development for property at 1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W. Carroll Ave., 300-330 N. Elizabeth St.
G. Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A and Contract #
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I
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Party:
Person [X
Publicly registered business corporation [ ]
Privately held business corporation [ ]
Sole proprietorship [ ]
General partnership (Is
Limited partnership
Trust []
] Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation
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:
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 foreign entity?
[X]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 thelegal 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 eacli 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 s'u'b'mit an EDS on ifs own behalf.
Name . Title
_Steiiing Bay Capital Management, LLC- 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
Sterling Bay Capital Partners I, LLC- 1040 W Randolph St., Chicago, IL 60607- 100%
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 . [X ] 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: (1) a not-for-profit entity, oh 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.
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. 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)
[ X] 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 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
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? .
[JYes [ ] No
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 1 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 fiye-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 pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the 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 ofany 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
q. 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 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 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 ofany 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'trie following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the" Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated.Natiorials List, the Denied Persons List, the UnverifiedList^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 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)
[ ] is [X ] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We 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):
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 tp 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 IX] No
NOTE: If you checked "Yes" to Item "D,L, proceed toitems D.2. and D.3. If you checked "No" to , Item D.l v,2procced 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 ofany 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 [ ] 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. Ihe 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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full.disclosure of all such records, including the names ofany and all slaves or slaveholders described in those records:
i
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):
N/A ;
(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 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 ah organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged-arid will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant-the Disclosing Party ritust obtain certifications equal in — form and substance to paragraphs A. l .-through A-.4. above from-all'Subcontractors'before it awards any subcontract arid 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 federallyrfunded, 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 []No
If "Yes," answer the three questions below:
1. Have you developed and do you have on file affirmative action programs pursuant to applicable
. federal regulations? (See 41 CFR Part 60-2.)
[]Yes []Nd
.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 apjplicable filing requircrhents?
[] 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 an explanation:
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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 ofany 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.cityofchicaRO.orfe/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 pr 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.requcst, 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 ofany information submitted in this EDS.
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.l. The Disclosing Parly 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 arid F.2. above arid: will riot, without the prior written consent of the City, use any such contractor/subcontractor that does riot pr6vide;such certifications or that the Disclosirig'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 statefrient must be attached to this EDS.
CERTIFICATION
(Br, LLC .1 Disclo^®J?£rty)
Under penalty of perjury; the person signing below: fl) warrantS'that he/she= is authorized to execute this EDS arid Appcridix A (if applicable')'on behalf of the Disclosirig Party, and (2) warrants that all certifications arid statements contained in this 'EDS and Appendix A(if applicable)are true, accurate and cbmplete°as?bf'tb'e'da^!furaished't6''thc'City. '
^Fulton West$ (Print orjjr
By:_
(Sign here) Andrew' Giobr
(Print or type name of person signing)
Manager of Sterling Bay Capital Management, LLC, manager of Fulton West Manager, LLC (Print or type title of person signing)
Signed and sworn'to before trie on (date) f'uly;8,201r5: ,
at Cootep eouiity, illjhdis (state).
Commission expires.:_
Notary Public.
DIANA TOJune 24. 2016
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 Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related lo the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister, or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section TLB. La., 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 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 bd 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.
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'bc completed by any legal entity whicti has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-0,10, 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? . . •• ::¦ >-!/ '
J 1 ]Ycs [?] No '
• 2. If the Applicant is'a legal enTity'pubMiclyr&aded on any Exchange, ls any offiber or director of the Applicant identified'as a building code scofflaw or problerri iandlord pursuant to Section 2-92-416 of the Municipal Code?
[;]Yes [ ]No ' " ' [J] Not Applicable ;
• : 3. 'Ifyesto:(h)or(2y^ • .
identified 'as^buildihg codefscofflaw or problem landlord and^the address of the building or buildings to!which; the'pertinent code-violations apply. '
FELLING 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.
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:
SEE ATTACHMENT A Commingled Pension Trust Fund (Special Situation Property) of JPMorgan Chase Bank, N.A.
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[ ] 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: 1330 w- Fulton>LLC; 323 N- Ada> LLC; FuIlon West Land>
OR LLC; 300 N. Elizabeth, LLC
[] 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: 270 Park Avenue
New York, NY 10017. • ¦
Telephone: (617)223-4675 Fax: (212)648-2264 Email: steven.c.spinale@ipmorRan.com
Name of contact person: Steven Spinale
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): Application for planned development for property located at 1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W. Carroll Ave.,
300-330 N. Elizabeth Street, Chicago, IL
G. Which City agency or department is requesting this EDS? DPD
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
[ ] Person
[ ] Publicly registered business corporation [ ] Privately held business corporation [ ] Sole proprietorship [ ] General partnership [ ] Limited partnership Ixl Trust
[ ] Limited liability company [ ] Limited liability partnership [ ] 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: formed under the laws of New York State
3. For legal entities not organized in'the State of Illinois: Has the organization registered to do business in the State of Illiriois as a"foreign:entity?'
[ ] Yes [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 below must submit an EDS on its own behalf.
Name Title
JPMorgan Chase Bank, N.A. Trustee
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, stale "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
No person or entity owns more than 7.5%.
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?
IJ Yes DO No
If yes, please identify below the name(s) of such City, elected official(s) and describe such relationship(s): . . SEE ATTACHMENT A
SECTION IV -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects 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 ofany 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 retained or anticipated Address to be retained)
SEE ATTACHMENT A
Relationship to Disclosing Party (subcontractor, attorney, lobbyist, etc.)
Fees (indicate whether paid or estimated.) NOTE: "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
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 ownsT0% or more'of the Disclosing Party been-declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes [ ] No (XJ 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?.
[ ] Yes [ ] No
FURTHER CERTIFICATIONS
t
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
The Disclosing Parly and, if the Disclosing Party is a legal entity, all of those persons or entities
identified in Section II.B. 1. of this EDS: SEE ATTACHMEN T A
are nol 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 five7year 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: SEE ATTACHMENT A
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 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 n ' •
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
i * •
Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, Officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (I) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3)-'any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party rtor any Affiliated Entity is; listed on any of the following-lists maintained by the'Office of Foreign'Assets Control of the U.S. Department of the Treasury orthe Bureau of Industry and Security of the U.S. Department Of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List. !
The Disclosing Party understands and shall comply with the applicable requirements of Chapters
2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Goverrimental'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:
SEE ATTACHMENT 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").
None
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided iri the course of official City business and having a retail value of less than $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is PO 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 "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?
I ] Ycs M No SEE ATTACHMENT A
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 shalLhave a financial interest in his or her own name or in the name of any other person or entity in the purchase ofany 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 []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. SEE ATTACHMENT A
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: 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 arc 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):
Not Applicable ;
(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 ofany 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 ofany 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 the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the'DisclosingParty 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 ,pro .
subcontractors to submit the following information with their bids or in writing at the outset of
negotiations Not Applicable , • .;; ...;, ., ,.
Is the Disclosing Party the Applicant?
I ] Yes [ ] No
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 [ ]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 the applicable filing requirements? ;
[ ] Yes [ ] No 7
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 lo the City's execution ofany 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 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 ofany information submitted in this EDS.
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. 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.
SEE ATTACHMENT A
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 equalin 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 doe's hot provide such certifications or that the Disclosirig 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 staterKent must be attached to this EDS.
CERTIFICATION
Under penalty ofperjury, the person signing below: (1) warrants that he/she is authorized to execute this EDSiand Appendix rA (if applicable) on behalf of the Disclosing Party, and (2) warrants'thatiall. certifications arid statements contained iri this:EDS and'Appendix;A\(if applicable) are true.iaccurate and complete as of the date furnished to .the City.
JPMorgan Chase Bank, N.A. as Trustee for Commingled Pension Trust Fund (Special Situation Property) of JPMorgan (Print or type name of Disclosing Party) Chase Bank, N.A.
(Sign;K|fe) Scott J. Strauss
(Print or type name of person signing)
(Print or type title of person signing)
'ublic.
Signed and sworn to before me on (date) ^ZjjjC^ld^^^^ %d / b
Commission expires
SUSANVANETTENWE'SENFELD p,0.19nf n
Notary Public. State of New York ragi, i^ in u
Qualified in Kings County No. 01WE6121667 My Commission Expires Jan. 31,2017
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner, thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing 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, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, 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?
To the Authorized Representative's knowledge, information and belief after
[ ] Yes fX] No reasonable inquiry
If yes, please identify below (1) the name arid 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.
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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, ihterest 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? '; - ' ¦¦¦
[ ]Yes •; / : ft] No
If the Applicant is a legal entity publicly traded on 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?
• I 1 Yes ' -: [ ]*No -'[X] Not Applicable
If yes to (I) or=(2) above, please identify below the name of the person or legal entity • identified as a building code scofflaw or problem landlord'and'the address of the building or buildings to which the pertinent code violations apply. •
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE. INIjQ, AJSD MADE A PART OF, THE^ASSQCIATED EDS, AND TH AT.THE REPRESENTATIONS MADE IN tlllS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
ATTACHMENT A TO
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
FILED BY
COMMINGLED PENSION TRUST FUND (SPECIAL SITUATION PROPERTY) OF JPMORGAN CHASE BANK, N.A. as TRUSTEE (as a Disclosing Parry holding an interest in the Applicant)
Responses contained in the corresponding EDS and this Attachment A are true, accurate and complete based on the undersigned's ("Authorized Representative") knowledge, information and belief, upon due inquiry by relying on information provided by other employees of the Disclosing Party's Trustee and its affiliates or subsidiaries. The Disclosing Party is a collective investment pension trust fund without any employees that is managed by, and acts solely through, its Trustee as identified in the corresponding EDS, and all responses contained in the corresponding EDS and this Attachment A are based upon these underlying facts.
To the extent certifications in the EDS include "Affiliated Entities" of the Disclosing Party, this Attachment A includes disclosures relating to the Trustee of the Disclosing Party and the Trustee's subsidiary entities. Those sections of this Attachment are in the process of being updated. The Disclosing Party will provide the City of Chicago with an update to this Disclosure Statement if there are any material changes to the matters disclosed herein.
SECTION V: CERTIFICATIONS
B. FURTHER CERTIFICATIONS
B.2 (a-e) With respect to Section V, paragraph B.2 (a-e), the Authorized Representative certifies based on. the Authorized Representative's knowledge, information, and belief; upon due inquiry, that such statements are accurate with respect to the trustee of the Disclosing Party. Based on the Authorized Representative's knowledge, information, and belief, upon due inquiry, JPMorgan Chase & Co. and/or its subsidiaries (collectively, the "Firm") are defendants or putative defendants in numerous legal proceedings, including private civil litigations and regulatory/government investigations. The litigations range from individual actions involving a single plaintiff to class action lawsuits with potentially millions of class members. Investigations involve both formal and informal proceedings, by both governmental agencies and self-regulatory organizations. These legal proceedings are at varying stages of adjudication, arbitration or investigation, and involve each of the Firm's lines of business and geographies .and a wide variety of claims (including common law tort and contract claims and; statutory antitrust, securities and consumer protection claims), some of which present novel legal theories. Based on current knowledge, the Firm .believes it has asserted meritorious defenses to the claims asserted against it in its currently outstanding legal proceedings, intends to defend itself vigorously in all such matters and does not believe that any pending legal proceeding would have a material effect on the Firm's performance of the services contemplated by the RFP. For further
Page 1 of 3
discussion, please refer to JPMorgan Chase & Co.'s publicly-filed disclosures,
including its most recent Annual Report on Form 10-K and Quarterly Reports on
Form 10-Q filed with the U.S. Securities and Exchange Commission (available at:
). Reference is also made to
a press release issued on May 20, 2015 concerning settlements related to foreign
exchange activities (available at
On May 20, 2015, JPMorgan Chase & Co. entered a plea of guilty to a single
violation of federal antitrust law and is currently awaiting sentencing by the court.
Additional information regarding the plea and resolutions of other investigations
related to the Firm's foreign exchange activities- is available via-May 20, 2015
press release ' (available at
B.3 (a&d) The Authorized Representative certifies on behalf of the Disclosing Party the
• accuracy of the statements contained in Section V,- paragraph B.3 (a '& d) only as
to the Disclosing :Party and its trustee. Based on the Authorized Representative's
knowledge, information, and belief,' upon due; inquiry, JPMorgan Chase & Co;
and/or its;"subsidiaries (collectively, the. "Firm") are' defendants ^or putative '
defendants in numerous legal proceedings, including private civil litigations and
regulatory/government investigations. The litigations range, from individual actions
involving a single plaintiff to class action lawsuits with potentially millions of
class members. Investigations involve both formal and informal proceedings, by
both governmental agencies and self-regulatory organizations. These legal
proceedings are at varying stages of adjudication, arbitration or investigation, and
involve each of'the Firm's lines of .business and'geographies and a wide variety of
•claims (including-common law tort arid contract claims and statutory antitrust,
securities and consumer'protection claims), some of which present novel legal
theories. Based on current knowledge, the Firm believes it has asserted meritorious
defenses' to the claims asserted against it in its currently outstanding legal
proceedings, intends to defend itself vigorously in all such matters and does not
believe that any p'eriding legal proceeding would have a material effect on the
Firm's performance of the: services contemplated by the RFP. For further
discussion, please'refer to JPMorgan Chase & Co.'s publicly-filed disclosures,
including its most recent Annual Report oh Form 10-K and Quarterly Reports on
Form 10-Q filed with the U.S. Securities and Exchange Commission (available at:
). Reference is also made to
a press release issued on May 20, 2015 concerning settlements related to foreign
exchange activities (available at
?ReleaseID=9141 05). Furthermore, with respect to the Living Wage ordinance, the Disclosing Party has not, during the five years before the execution date of this EDS, been determined to have violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance) as it relates to base wages.
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B.3 (b&c)
& B.4 The Disclosing Party has not agreed or colluded with other bidders or prospective bidders as to this transaction, or been a party to any such agreement. Based on the Authorized Representative's knowledge, information, and belief, upon due inquiry, the Disclosing Party has not 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. Based on the Authorized Representative's knowledge, information, and belief, upon due inquiry, the Disclosing Party has not made an admission of such conduct described in B.3 a. or b. above that is a matter of record, and has not been prosecuted for such conduct, except to the extent set forth in the summaries of material legal proceedings involving JPMorgan Chase & Co. or its subsidiaries within the last five years are referenced in JPMorgan Chase & Co.'s Form 10-K, Form 10-Q, and any Form 8-K filing, all as filed with the Securities and Exchange Commission ("SEC") and all available through J.P. Morgan's internet site or through the SEC's internet site (www.sec.gov ) (the "SEC filings") and the public record of each matter identified in the SEC filings. The Authorized Representative certifies based on the Authorized Representative's knowledge, information, and belief, upon due inquiry, none of the foregoing matters would have a material adverse effect on this transaction.
The Authorized Representative certifies on behalf of the Disclosing Party, as to the statements contained in Section VII, paragraph F.l that based on the Authorized
Representative's knowledge, information, and belief, upon due inquiry, diat neither ihe Disclosing Party nor its affiliates are delinquent in paying any fine, fee, tax or other charge owed to the State of Illinois or the City of Chicago except for taxes that are being contested in-good faith by appropriate legal proceeding and possible delinquencies in paying a fine, fee, tax or other charge related to (i) property mortgaged to the Disclosing Party or its affiliates, (ii) property owned by the Disclosing Party or its affiliates and leased to others, (iii) foreclosed property now owned by the Disclosing Party or its affiliates, (iv) property owned or held by the Disclosing Party or its affiliates as a fiduciary or nominee, and (v) fines, fees, taxes or other charges that are being contested in good faith by the Disclosing Party or its affiliates by appropriate legal proceeding. If there arc any outstanding claims that the Disclosing Party is notified of that Disclosing Party was not aware of previously, Disclosing Party will immediately address them.
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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/ if applicable:
323 N. ADA, LLC ¦
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[?] 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: _.
OR
3. [] a legal entity with a right of control (sec 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: 1040 W. Randolph Street
Chicago,,IL 60607 •
Telephone: 312-466-41,00 Fax: ,312-466-4101 ... Email: asirripson@sterlingbay.com
Name of contact person: Anna Simpson
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):
Application for planned development for property at 1300-1,344 W. Fulton St., 301-329 N .Ada St., 1301-1345 W Carroll Ave., 300-330 N. Elizabeth St. '
G. Which City agency or department is requesting this EDS? DPD ,
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A and Contract #
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SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
Person
Publicly registered business corporation
Privately held business corporation
Sole proprietorship
General partnership
Limited partnership
Trust
[X ] Limited liability company
[ ] Limited liability partnership
[ ] 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: Delaware '
3. For legal entities not organized in the State of Illinois: Has the organization registered to do busirieVs in the State Of Illinois as a foreign entity?
[X]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 ail members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
FULTON WEST VENTURE, LLC - Managing 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
Fulton West Venture, LLC- 1040 W. Randolph Street, Chicago, IL 60607- 100%
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 [ X] 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: (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;-
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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 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 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, Article I ("Article I")(which the Applicant should consult for defined terms'(e.g., "doing business") and legal requirements), if the Disclosing Party submitting) thi's;EDS is the-Applicarit:and is doing business with the City, then the DisclosihgiParty ¦ certifies as follows: (i)-neither the Applicant nor any Controlling person is currently iridictedor 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; arid (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.
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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, attemptingto obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
arc not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, 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 O ther 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").
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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 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 ofany 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 ireedoirri of competition by agreement to bid a fixed :price or otherwise; or ¦
made an admission of such conduct described in a. or b. aboveviolatedthe•provisions^6f Municipal Code Sectiofi'2-92-6'10 (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 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 br 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;anyof thcfollowing list's ¦¦'>•
maintained by the Office of'Foreign Assets Control of the- U.S. Department of the Treasury or the
Bureau of Industry and Security o'f the U.S.'Departmeht of Commerce or their successors: the Specially
Designated'Nationals List, the Denied Persons List, the Unverified List, the Entity List and the
Debarred List'. ¦ ''
1 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. '"' :; •' "
7. If the Disclosing Party & 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 the City recipient.
N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is ¦ [ X] is not
a "financial, institution" as defined in Section 2-32-455(b) of the M unicipal 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): 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.
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 ' '". [X]No
NOTE: If you checked "Yes" to Item D.l., proceed tp Items D.2. and D.3. If you checked "No" to Item D.I., proceed to.^art 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?
[ ] Yes [ ] 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 t ( 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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: 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 Apt of 1995 who have made.lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
N/A
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, 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 ofany agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not-engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party iriust obtain certifications equal in fonn 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.Applipant 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 []No
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 [ ] 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 the applicable filing requirement's?
[ ] Yes T ] No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes []No
If you checked "No" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII — ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between 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 oh
line at www.yq^ 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 Mattenand/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/of 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.
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.l. The Disclosing Party is not delinquent in the payment ofany 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 Disclosirig Party is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit theirsubcoritractors 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. arid F.2. above and will not, without the prior writtert'eonsent of the City;, use any-such cb'htractof/siibcoritractor 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 iriust 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 anil Appendix A (if applicable) on behalf of the Disclosing Party, and:(2)'warrants that all certifications arid statementscontained in this EDS and Appendix A:(if applicable) are true, accurate and coriiplete as of the date furnished to the City. '
323 N. Ada, Liafeg^"' jg- .
(Print or^^nk\^^^>6^^^^x^)^
(Sign here)
Andrew Gloor '• ' ' . : :
(Print or type name of person signing)
Manager of Sterling Bay Capital Management, LLC, manager of Fulton West Manager, LLC, managing member of Fulton West Venture, LLC, the sole member of 323 N. Ada, LLC (Print or type title of person, signing)
Signed and sworn to before me on (date) . July 8,2015 , j
at ' Cook ... County, -Illinois, (state).
Commission expires:^
Notary Public.
DIANA TOKAT OFFICIAL SEAL Notaiy Public, Slaiool Illinois My Commission Expires June 24, 2018 "
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 Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing 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^ stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, 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 [ X ] No
If yes, please identify below (1) the name and title of such person, (2) the name ofthe legal entity to which such person is connected; (3) the name and title of the elected city official'or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
Page 13 of 13
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 ownershipjnterest 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 iri the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a buijding codescojfflaw'oipj-bjbjem.landlprd.pursuanttoS'ec.tion 2-92-416. of the.Municipal
"'''coder "':" t " '"
[ ] Yes'" ' ' ' '"¦ [„]No . -l ' •
If the Applicant is a legal entity publicly traded on ariy 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?
[ J Yes , ' [ ] No [ ?]• Not Applicable
'3. If yes to (1) or (2) above, please identify belOw the riarrie of-the person or legal entity : ¦ identified as aJbuildirig code s^MaW'Or'problem:landlbFd''an.d the address of the buildingor buildings to which the pertinent code violations apply.
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.
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: FULTON WEST LAND, LLC
Check ONE of the following three boxes:,
Indicate whether the Disclosing Party submitting this EDS is:
\k] 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:
OR
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control: .
B. Business address of the Disclosing Party: 1040 W. RANDOLPH STREET
• . CHICAGO, IL 60607 ¦ :_
Telephone: 312-466-4100 Fax: 312-466-4101 Email: asimpson@sterlingbay.com
Name of contact person: Anna Simpson
Federal Employer Identification No. (if you have one): . T
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):
Application for planned development for property located at 1300-1344 W. Fulton St., 301-329 N. Ada
St., 1301-1345 W. Carroll Ave., 300-330 N. Elizabeth St. ...
G. Which City agency or department is requesting this EDS? DPD ... _J;.„.,J
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A . and Contract # N/A
Page 1 of 13
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Party:
Person [X]
Publicly registered business corporation [ ]
Privately held business corporation [ ]
Sole proprietorship [ ]
General partnership (Is
Limited partnership
Trust [ ]
Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation .t
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;, 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 foreign entity? ' :
[XYes []No []N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below the full names and titles of alt executive officers and all directors of the entity. NOTE: For not-for-profit'cofporatio'ns, also list below all members; if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each'legal entity listed below must submit'ah EDS o"h its own" behalf.'.
Name Title
FULTON WEST VENTURE, LLC - MANAGING 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
FULTON WEST VENTURE, LLC- 1040 W. RANDOLPH ST., CHICAGO, IL 60607- 100%
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 W 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 tp 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 retained or anticipated Address to be retained)
Relationship to Disclosing Party Fees (indicate whether
(subcontractor, attorney, paid or estimated.) NOTE:
lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
(Add sheets if necessary)
[ XCheck 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 directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[X] No [ ] 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?
[ ] Yes
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 1 supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, within a five-year period preceding the date of this EDS, been convicted 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 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 Disclosirig Party, nor any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the 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 hid a fixed price or otherwise; or
made ah 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 Muriicip'arCdde Section 2-92-610 (Living Wage'Ordinance).
Neither the Disclosirig Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any uriit 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-the United States Of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither trie -Disclosing Party nor ariy Affiliated Entity is listed on any of the followirig lists
maintained by the Office of Foreign Assets Control of the UJ}. Department of the'Treasury or the
Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially
Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the
Debarred List. ' ' '•
The Disclosirig 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.
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 the City recipient.
N/A ' ' ¦ : _ ,
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Parly (check one)
[ ] is Dfl 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):
N/A
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: Docs any officiaTor employee" of the City have a financial interest in his or her own name or in the name ofany other person or entity in the M atter?
[ ] Yes y 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 of this Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ j No
If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such 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.
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): N/A
(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 lo influence or attempt to influence an officer or employee.of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosirig Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
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 Par'ty'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 [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 []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 the applicable filing requirements?
[] Yes ''" [ JNo •
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 ofany contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and arc 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 .ci ty of chi c a go. Orfe/E t h i cs< 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 ofany information submitted in this EDS.
The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS lip 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.l. The Disclosing Party is not delinquent in the payment ofany 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 Parly 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 th,e 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/subco.ntractors-,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 priorwritten consent of the ¦ City, use any such contractor/subcontractor that does not provide such certifications or. that the Disclosing Party has reason Jo 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.3above, an explanatory statement must be'attached to this EDS.
CERTIFICATION
Under 'pcnally 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 Disclosirig Party, and (2) warran ts 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. • • '
FULTON WEST LAND, LLC
(Print or type name of Disclosing Party) By-
SCOTT GOODMAN
(Print or type name of person signing)
Manager of Sterling Bay Capital Management, LLC, the Manager of Fulton West Manager, LLC, Managing Member of (Print or type title of person signing) Fulton West Venture, LLC, the Sole Member of Fulton West Land, LLC
Signed'and sworn lo before me on (date) $PV£ftA^ , U)\^>t
at C^OOVC- County, UlfrjOli (state).
ANNA'SIMPSON
''I S"S^t''-iii li :Noi(iiv"i"ii(
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 Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner Uiereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or. nephew, grandparent,, grandchild, father-in-law, mother-in-law, son-in-law,.daughter-in-law, stepfather or stepmother,.stepson or stepdaughter, stepbrother or stepsister or halfrbrother orhalfsister
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, 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 LX] 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;'^) the name and title of the elected city official or department head to whom such person has a familiaPrelationship, and (4) the precise nature of such familial relationship.
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 (h) 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.
1. 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? :::r:...~— - •¦ —-; = ¦¦ ¦ ¦ ¦¦
t ]Ycs ;: [v] No
• •¦-2. If the Applicant is a legaTentity publicly traded on any exen'ange; is" any officer or director of the Applicant identified as a building code'sedfflaw or problem ''landlord1pursuant to'Sectiori 2^92-416 of the Municipal Code?
[ ] Yes- ' [ ]No [v] Not Applicable
-3. If yes to (1) or (2) above, please identify below the name of the person or legal entity
' identified as a building code scofflaw or problem landlord ahdiihe address of the building Or buildings to which the pertinent code violations apply. ' . • .
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.
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:
1330 W. FULTON, LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[?] 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:
OR
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control:. .' .. ..
B. Business address of the Disclosing Party: 1040 W. Randolph Street
Chicago, IL 60607 .
Telephone:.312-466-4100. ,,; Fax:312-466-4101 • '- Email: aslmp6on@sterlingbay.com
Name of contact person: Anna Simpson ' '
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):
Application for planned development for property at 1300r1344 W. Fulton St., 301 -329 N. Ada St., 1301-1345 W. Carroll Ave., 300-330 N. Elizabeth St.
G. Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A 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 Party:
Person [X
Publicly registered business corporation [ ]
Privately held business corporation [ ]
Sole proprietorship [ ]
General partnership (Is
Limited partnership
Trust [ ]
] Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation
the not-for-profit corporation also a 501(c)(3))?
[JYes ... [JNo
Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
Delaware _^
3. For legaLentities not organized in the State of Illinois: Has the organization registered to do
business in the State of liiihbis as a foreign entity?
[X ] Yes [ ] No [ ] N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List belpw4he_Tu.ll 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 ientity listed below must submit an EDS. on its own behalf.
Name . Title
FULTON WEST VENTURE, LLC - Managing 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
Fulton West Venture, LLC- 1040 W. Randolph Street, Chicago, IL 60607- 100%
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 [X]No
If yes, please identify below the namc(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: (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.
Schuyler, Roche & Crisham 180 N. Stetson Ave., Suite 3700 Attorney Estimated $25,000
Chicago, IL 60601
(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 of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes [y] No [ ] 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?
L ] Yes [JNo -
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
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:
a.- 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;
b. 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;
c. , 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 indirecdy: 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); withrespect to Contractors, the term Affiliated Entity means a person pr 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-Statc-of-Iilinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such
agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or
prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or
otherwise; or ' '":
made an admission -of such conduct described in a. or b. above''that is a matter of record, but have not been prosecuted for such conduct; or
violated tne'provisioris of Municipal-Code Section 2-92-610-('Living Wage Ordinance),
Neither the Disclosing Party; Affiliated Entity dr Contractor,' brahy of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a-Tesult 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 tiie^Dis'cidsirig Party nor any AffiliatedEntity is listedk'on any of the following lists maintained by the'Officeof Foreign Assets Cohtrbl-Of the U.S: Deparunent of the Treasury or the Bureau of Industry and Security of the 'U.S. Department Of Commerce Or their successors: theSpecially Designated Nationals List, me'Dehied'Pefsbns List, the Unverified liist.Hhe Entity List and the Debarred'List. '
The DisclosihgParty understands andshall 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'rhust 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 the City recipient.
N/A ' ' ¦ . - • - ;
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is [ X] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined iri 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):
N/A . '
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 interestin his or her own name or in the name ofany other person or
entity in.the Matter? . (
[] Yes '.' .[ X] 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, ho City elected official or employee shall have a financial interest in his or her ownhame 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?
[]Ycs []No
If you checked "Yes" to Item D. 1., 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 o_f Jnrterest
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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: 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):
N/A . ' ....... .
(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 ofany agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that cither: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged'and will not engage in "Lobbying Activities".
5; If'the Disclosirig-Party is the Applicant,- the-DiscIosing-P-arty-must-obtain-certifications equal inform and substance to paragraphs A; 1. through AA above frbm all subcontractors before .itawards any subcontract and1 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.
J3. 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 [ J 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 the. applicable filing requirements'? • -!
[J Yes [JNo
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[JYes [JNo
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 ofany 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.cityofeh'icago? oiiff/E thics. 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.
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. 1. The Disclosing Party is nol 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 UvS. 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 Disclosirig 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 ih'F:T. and F.'2. above and will riot, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosirig Party has 'reason'to believe'has not provided or cannot provide truth 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 beattached'to this EDS.
CERTIFICATION
Under penalty of perjury, tlie person signing below:l'(l) warrarits"that he/she is authorized to execute this EDS and Appendix A (if appiicabTe)-oribehalf of the Disclosing Party, arid (2) warrants that all certifications and statem'erits' contained in this EDS and Appendix A (if applicable) 'are true, accurate and cornplete as of the date'furnished''td the Ci'tyV - -
(Print orj$f-i§ rijjj_$^f'Discld. By:.
'(Sign here)
Andrew Gloor
(Print or type name of person signing)
Manager of Sterling Bay Capital Management, LLC, manager of Fulton West Manager, LLC, the managing member of Fulton West Venture, LLC, sole Member of 1330 W. Fulton, LLC (Print or type title of person signing)
Signed arid sworn to before rheori' (date) July 8f 2015
at. Cook Counte ; ffiiiVprsf"(state).
Commission expires:
. Notary Public.
DIANA TOKAT OfFiCIAt-SEAL NoiaryPublM^'SlflJool Illinois My ClviiiiiiiosioiiiOxpiics . Juno 2«. 2018
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 whedier such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing 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, stepbrother or stepsister or half-brother or half-sister,
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B. 1 .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 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 [ X ] 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.
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 onjy aT^ 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 laridlori^pursuaht to_Secti6ri"2-92-416 of tHe Municipal Code?-- ¦ -~ "~"~'
[ j Yes [?JNo
If the Applicantisa legal entity publicly'traded on any exchaMge,-isariy officer or director of
the Appiicarit identified as a b pursuant to Section
2-92-416 of the Municipal Code?
[ JYes [JNo ' [?] Not Applicable
If yes to (1) or (2) above, please identify below the name of the person or legal entity identified as a-building code scofflaw or problem landlord and the address of the building or buildings to which thepertinent code violations apply.
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.
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:
300 N. ELIZABETH, LLC '
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[?] 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!
OR
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control: .....
B. Business address of the Disclosing Party: 1040 W. Randolph Street
Chicago, IL 60607
Telephone: 312-466-4100 ¦ Fax: 312-466-4101 ¦ . Email: ,asimpsoh@sterlingbay.cbm :
Name of contact person: Anna Simpson
Federal Employer Identification No. (if you have one):j. - ____ ]' . __.
Brief description of contract, transaction or other undertaking (referred lo below as the "Matter") to which this EDS pertains. (Include project number aridlocation of property, if applicable):
Application for planned development for property at 1-300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W. Carroll Ave., 300-330 N. Elizabeth St.
G. Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # N/A 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 Party:
Person [X
Publicly registered business corporation [ ]
Privately held business corporation [ ]
Sole proprietorship [ ]
General partnership (Is
Limited partnership
Trust [ ]
] Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation
the not-for-profit corporation also a 501(c)(3))?
[ ] Yes [JNo
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 foreign entity?
[X] Yes []No []N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below .the full names and titles of all exec.utive.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, limitedjiability company, limited.liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf
Name Title
FULTON WEST VENTURE, LLC - Managing 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 1.3
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 lo achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
Fulton West Venture, LLC- 1040 W. Randolph Street, Chicago, IL 60607- 100%
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 .[ X] 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 arc 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 pari 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 retained or anticipated Address to be retained)
Relationship to Disclosing Party (subcontractor, attorney, lobbyist, etc.)
Fees (indicate whether paid or estimated.) NOTE: "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 1.0% or 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 owns 10% or more of the
Disclosing Party.
If "Yes'"'has the person entered iilto«a-'€ouA4approved- agreement-for payment of all'support owed and is the person in compliance with that agreement?
r ] Yes • ' [.] No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined' terrtis (e-.gv"doirig:business") and legal -requirements), if the Disclosirig Party submitting this EDS -isithe' Applicant arid is doing busirt'es's-with the City? then the Disclosing. Party i certifies as follows: (i)'neither the Applicant nOr ariy controlling person is'currently indicted of 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 ari 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
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
slate, or any other unit of local government. . ,
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited 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 lo 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, iri'restraint of freedom of competition b*y agreement to bid a fixed price or
otherwise; dr ' " • -•.<¦
Ci 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 Municipal Code Section 2-92-610 (Living Wage Ordinance). •
Neither the Disclosing Party, Affiliated Entity 'or Crintractbr','or any of their employees, officials, agents or partners, is barred from contracting with any unit of stafe'ior 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 *thVtf isclosing P'arty nor any Affiliated Entity is listed on' any of the following lists 1
maintained by theOffice of Foreign Assets' Control of the'U.S. Department of the Treasury orthe
Bureau of Industry and Security of the U.Si Department 'Of Commerce or their successors: the Specially
Designated 'Nationals List, the Denied Persons List. the Unverified List, the Entity List and the
Debarred List.' •.¦•'' '
6: The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56' (Inspector General) and2-156 (GovernmentalEthics):Of the Municipal C6de.; :
7. 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-monlh 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,fpIease also list the name of the City recipient.
n/a i ... ," • ¦
C. CERTIFICATION OF STATUSES FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one) .
[ ] is [ X] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We 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):
N/A ' ' ...
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?
[ ] Yes [ X] No '
NOTE: If you checked "Yes" to Item D.l., proceed toitems D.2. and D.3. If you checked "No" to Item D.l., proceed to Part E!
Unless soid pursuant'tb'a process of competitive^biddirig, "or otherwise permitted, ho 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 []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 eitherT. 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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION; VI -- CERTIFICATIONS FOR FEDERALLY-FUNDED MATTERS
NOTE. 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):
N/A '
(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 of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) itis not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
5. If the Disclosmg-Party is the-Applicantrthe-Disclosing-P-arty must obtairi-certifications equal-in
form and substance to paragraphs'A. l.through-A.4. above from all subcontractors before it awards any subcontract arid the: Disclosing Party must-maintain alt 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, federaLrcgulations .require the Applicant and all .proposed subcontractors to submit the following information'w"itn their bids or ih'writihg at the outsetof negotiations.
Is the Disclosing Party the Applicant?
[ ] Yes [ ] No
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 [ ] No
Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Corrimissiori all reports due under the applicable filing requirements?
[ ] Yes [ ]No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[] Yes I j 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 ofany 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 ww'wYcitydfciu^^ 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 oh 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.
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. 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.
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 listedby 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-Disclosihg-Party-will obtain-fronuany contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those inJF.T. arid1 F;2. above and will not; without the prior written consent of the City, use any such contractor/subcbritracfor that does not provide such certifications or that the Disclosirig Party haVrea'sbn to'believe has not provided-"or' ca'nridt 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 slatemehf;rriust be attached to this'EDS. ' -
CERTIFICATION
Un'der'penalty of perjury, the p'ersori signing below: (1) warrants that he/she is authorized ;to execute
this EDS arid'Appendix A (if applicable) on behalf of the Disclosing Party, and;(2) warrants 'Ihat.alF-
certification's and statehients Contained in this EDS and'Appendix A (if applicable) are true, accurate,
and complete asi of-the date furnished to the City. . . u :
• (Sigh-here)-' Andrew Gloor
(Print or type name of person signing)
Manager of Sterling Bay Capital Management, LLC, Manager of Fulton West Manager, LLC, Managing Member of Fulton West Venture, LLC, Sole Member of 300 N. Elizabeth, LLC (Print or type title of person signing)
Signed and sworn to before me on (date) July 8.2015 at Cook Cdunly, Illinois
Notary Public.
u
Commission expires:_
DIANA TOKAT'
'%W3f7Vi OFFICIAL SEAL *
I Noiaiy Public. Stale ot Illinois
¦^h'-^yp My Comni'lsslon Expiios i Juried, 20IB
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.S percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing 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; sbn-in4aw, 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 lLB.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 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 . [X]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.
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 riot to be coriipleted'by anyiegal entity'which has brtly ari'indirecrownership interest iii
the Applicant. v -
1. Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuantto Section' 2-92-416 ofthe Municipal
" "Code?""" ''' ' '"; ;""" ', * J -— •••. ' •
[ ] Yes' =¦ • [^]No
i ;2. - If the Applicant is "a-legal entity publicly.-traded on 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 ofthe Municipal Code?
[• ] Yes : - ,[.: ]¦ No Not Applicable
3; If yes to (-1) or(2)above, pleaseridendfyibelovy the name.of the person or legal-entity:
identified as. a building code scofflaw or.problem landlprdand the address of the building or
buildings to, which the pertinentxode violations apply. •• .,
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REfMeNCE INtO, AND MADE A PAkT OF/THE ASSOCIATED EDS, AND THAT THE kEPRESENTATibNS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATE PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
(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.
Application for planned development for property located at 1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W.
This recertification is being submitted in connection withcarroii Ave., 300-330 n. Elizabeth st. [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 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.
GLOOR HOLDINGS, LLC TJate: // f t^} j 2Qlf
(Print or type legal name ol(pi^closing Party) By:
(sign here)
Print or type name of signatory:
ANDREW GLOOR
Title of signatory:
MANAGING MEMBER
Signed and sworn to before me on [date]
fft/CYY ,at f.flO[iL County,
Notary Public.
Commission expires: Q UC(LSf Qt 36 ft
Vcr. 11-01-05
(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.
Application for removal of restrictive use covenant against
. , . ,. . property located al 1330 W: Pulton St., Chicago, 300 N.
This recertification is being submitted in connection with wi^th, (-hi™^ ™a m n aa*, rhimgn [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 the date of this recertification, and (3) reaffirms its acknowledgments.
(sign here)
fulton west manager, llc Date: February 5, 2016
Print or type name of signatory:
ANDREW GLOOR
Title of signatory:
Manager of Sterling Bay Capital Management, LLC, Manager ofFulton West Manager, LLC
Signed and swom to before me on [date] February 5,2016 by
Mr«r» ft'Oftf at fflfl|l County, UUnflL* [state].
Notary Public.
Commission expires: QlftlJLSi- Qtd6 ft .
Vcr. 11-01-05
(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.
Application for planned development for properly located at 1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W.
(Print or type legal name 0 By
This recertification is being submitted in connection withcarroii Ave., 300-330 n. Elizabeth si. [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 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.
Date:
closing Party)
323 N. ADA, LLC
(sign here)
Print or type name of signatory: ANDREW GLOOR
Title of signatory:
Manager of Sterling Bay Capital Management, LLC, the Manager of Fulton West Manager, LLC, Managing Memher of Fnllnn West Venture. T.T.C, Sole Member of 323 N. Ada, LLC
Signed and sworn to before me on [date] ^
rMr^ fP/QT/Y , at t0O[L County,
-r_-'by
UUnfr^ [state].
Notary Public.
Commission expires: Qlftllffi Qt 36
Vcr. 11-01-05
(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.
Application for planned development for property located al 1300-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W.
This recertification is being submitted in connection withcarroii Ave., 300-330 n. Elizabeth st. [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.
FULTON WEST VENTURE, LLC
(Print or type legal name 0 By:
(sign here)
Print or type name of signatory: ANDREW GLOOR
Title of signatory:
Manager of Sterling Bay Capital Management, LLC, Manager of Fulton West Manager, LLC, Managing Member of Fulton West Venture, LLC
Signed and sworn to before me on [date]
fP/QT/Y , at f,f3fl[t. County,
,by
TtT/nfl^ [state].
Notary Public.
Commission expires: Q.liCULSl" Qt^6 fl •
Vcr. 11-01-05
(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.
Application for planned development for property located at 1300-1344 W. Fulton St., 301 -329 N. Ada St., 1301 -1345 W.
This recertification is being submitted in connection withcarroii Ave., 300-330 n. Elizabeth st. [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 the date of this recertification, and (3) reaffirms its acknowledgments.
1330 W.FULTON, LLC Date: \l/ L*> j 2Q\$
(Print or type legal name OAp^|closing Party)
By:
(sign here)
Print or type name of signatory: ANDREW GLOOR
Title of signatory:
Manager of Sterling Bay Capital Management, LLC, the Manager of Fulton West Manager, LLC, Managing Member of Fulton West Venture, LLC, sole Member of 1330 W. Fulton, LLC
Signed and sworn to before me on [date]
Mr<^ (QIOC/Y at [00(1, County,.
-t-r?by
UI l r\bi± [state].
Notary Public.
Commission expires: Q tMlSf Qt^6 ft
Vcr. 11-01-05
(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.
Application for planned development for property located at 130(1-1344 W. Fulton St., 301-329 N. Ada St., 1301-1345 W.
This recertification is being submitted in connection withcarroii Ave., 300-330 n. Elizabeth st. [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 the date of this recertification, and (3) reaffirms its acknowledgments.
300N. ELIZABETH, LLC Date: /// V$ j 2Qlf
(Print or type legal name oKpiljclosing Party) By
(sign here)
Print or type name of signatory: ANDREW GLOOR
Title of signatory:
Manager of Sterling Bay Capital Management, LLC, the Manager of Fulton West Manager, LLC, Managing Member of Fulton West Venture, LLC, Sole Member of 300 N. Elizabeth, LLC
Signed and sworn to before me on [date] ^
, at P.flfllL County, Notary Public.
-r-r'by
JiLlQliA_ [state].
Commission expires: QuQ(lM~ Qt3)6 fl
Vcr. 11-01-05
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