OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL MAYOR
November 18,2015
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request of the Commissioner of Planning and Development, I transmit herewith ordinance authorizing an amendment of a previously passed negotiated sale at 1144 North Christiana and 1222 North Rockwell.
Your favorable consideration of this ordinance will be appreciated.
Mayor
Very truly yours,
ORDINANCE
WHEREAS, the City of Chicago ("City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970, and as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, pursuant to ordinance (the "Original Ordinance") adopted by the City Council of the City (the "City Council") on February 5, 2014, and published in the Journal of the Proceedings of the City Council for such date, at pages 74087 through 74093, the City Council authorized the City's sale to L&MC Investments LLC, an Illinois limited liability company (the "Developer"), of the seven vacant parcels of real property commonly known as 1122 N. Christiana Avenue, 1144 N. Christiana Avenue, 1222 N. Rockwell Street, 1226 N. Campbell Avenue, 1754-56 N. Drake Avenue (two (2) parcels), and 3221 W. Crystal Street, Chicago, Illinois (each such parcel, a "Parcel"), and legally described on Exhibit A of the Original Ordinance, which exhibit is attached hereto, for the consideration of One Dollar ($1.00) per Parcel for the development of affordable single-family housing; and
WHEREAS, the City has previously conveyed to the Developer the Parcels commonly known as 1226 N. Campbell Avenue, 1122 N. Christiana Avenue, 1754-56 N. Drake Avenue, and 3221 W. Crystal Street, Chicago, Illinois; and
WHEREAS, the Developer and the City's Department of Planning and Development have proposed (i) to amend Exhibit A of the Original Ordinance by deleting the Parcel located at 1222 N. Rockwell Street (the "Rockwell Parcel") and (ii) to amend the outside date (set forth in the Original Ordinance) by which the Developer must take title to the Parcel located at 1144 N. Christiana Avenue (the "Christiana Parcel"); now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. The foregoing recitals are incorporated herein.
SECTION 2. Exhibit A of the Original Ordinance is amended by deleting the Rockwell
Parcel.
SECTION 3. The transfer of title of the Christiana. Parcel from the City to the Developer must close on or before the date that is eighteen (18) months after the date of publication of this ordinance (the "Outside Closing Date"),, unless the Commissioner in his sole discretion extends the Outside Closing Date.
SECTION 4. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.
SECTION 5. All ordinances, resolutions, motions or orders inconsistent with this ordinance are hereby repealed to the extent of such conflict.
SECTION 6. This ordinance shall take effect upon its passage and approval.
EXHIBIT A
Legal Descriptions and Appraised Fair Market Values
(Subject to Final Title Commitment and Survey):
Parcel 1: appraised fair market value: $48,000
LOT 92 IN S.E. GROSS' FOURTH HUMBOLDT PARK ADDITION TO CHICAGO, BEING A SUBDIVISION OF LOT 7 IN SUPERIOR COURT PARTITION OF THE EAST 1/2 OF SECTION 2, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 1122 N. Christiana Avenue
Chicago, Illinois 60651
Property Index Number: 16-02-408-041-0000
Parcel 2: appraised fair market value: $50,000
LOT 83 IN S.E. GROSS' FOURTH HUMBOLDT PARK ADDITION TO CHICAGO, BEING A SUBDIVISION OF LOT 7 IN SUPERIOR COURT PARTITION OF THE EAST 1/2 OF SECTION 2, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 1144 N. Christiana Avenue
Chicago, Illinois 60651
Property Index Number: 16-02-408-032-0000
Parcel 3: appraised fair market value: $48,000
LOT 1 IN GUBBINS' SUBDIVISION OF LOTS 1, 2, 3 AND 4 IN BLOCK 8 IN HUMBOLDT PARK RESIDENCE ASSOCIATION SUBDIVISION OF THE SOUTHWEST % OF THE NORTHEAST Va OF SECTION 1, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 1222 N. Rockwell Street
Chicago, Illinois 60622
Property Index Number: 16-01-231-022-0000
Parcel 4: appraised fair market value: $54,500
LOT 13 IN BLOCK 6 IN WINSLOW & JACOBSON'S SUBDIVISION OF THE SOUTHEAST 1/4 OF THE NORTHEAST 1/4 OF SECTION 1, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 1226 N. Campbell Avenue
Chicago, Illinois 60622
Property Index Number: 16-01-227-028-0000
Parcels 5 and 6 (the "Drake Parcels"): aggregate appraised fair market value of parcels 5 and 6: $62,500
THAT PART OF LOT 1 LYING BETWEEN THE NORTH LINE OF LOT 2 AND THE SOUTH LINE OF THE RIGHT OF WAY OF CHICAGO PACIFIC RAILROAD CO. AND ALL OF LOT 2 IN BLOCK 18 IN C.B. SIMON'S RESUBDIVISION OF BLOCKS 18 AND 19 OF E. SIMON'S ORIGINAL SUBDIVISION OF THE SOUTHEAST V* OF SECTION 35, TOWNSHIP 40 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 1754-56 N. Drake Avenue
Chicago, Illinois 60647
Property Index Numbers: 13-35-412-015-0000
13-35-412-016-0000
Parcel 7: appraised fair market value: $53,000
LOT 83 IN S.E. GROSS' FIFTH HUMBOLDT PARK ADDITION TO CHICAGO, IN SECTION 2, TOWNSHIP 39 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Address: 3221 W. Crystal Street
Chicago, Illinois 60651
Property Index Number:
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:
. LihJL X.f\>4*l^<^jM~
Check ONE of the following three bom:
Indicate wither the Disclosing Party submitting this EDS is:
fufthe Applici:it
OR
[ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Parly holds an interest:
OR
3. [ ] a legal entity with a right of control (sec Section H.B.I.) State the legal name of Ihe entity in
which the Disclosing Parly holds a right of control:
B Business address of the Disclosing Party:
.ChlZ.ctj.fr j£2 Cao.C 2P
Telephone:
Name of contact person:
Federal Employer Identification No. (if you have one):
F 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):
fe-J Qjp^trucks °{ r\ jiurvx bQl£>tJbr£rM^oh\cM^SdfL
G. Which City agency or department is requesting this EDS?
If the Matter is a contract being handled by the City's Department orProcuiement Services, please complete the following.
Specification # and Contract #
Page I of 13
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
Limited liability company [ ] Limited liability partnership [ ] Joint venture f ] Not-for-profit corporation (Is the not-for-profit corporation also a 501(c)(3))?
[]Yes []No [ ] Other (please specify)
I. Indicate the nature of the Disclosing Parly f 1 Person
[ ] Publicly registered business corporation [ ] Privately held business corporation [ ] Sole proprietorship [ ] General partnership [ ] Limited partnership [] Trust
2. For legal entities, the stale (or foreign country) of incorporation or organization, if applicable:
=f(—
3. For legal entities not organized in the Stale of Illinois: Has the organization registered lo do business in the State of Illinois as a foreign entity?
f]Yes []No tfN/A
Is. 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 arc legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titlcholder(s).
If thc.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 n
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. EMimplcs 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 2-1 54-030 of the Municipal Code of f bicago ("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
I «• /I rv-, / . . Disclosing-Party
^ILCaS^ jStLWl^ji^. _
Civ'Coj/> IL lc&lM&. -
SECTION HI -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship." as defined in Chanter 2-! 56 o'"(lie Municipal Code wilh any City elected official in the 12 months before the date this EDS ;s signed?
[ ] Yes
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 ofcach subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Parly has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the toial 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 udmini.Mnim e action on behaif of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (?) 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 Parly 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 (indicale 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
J j not an acceptable response.
'. tfty Crcr^ fzk-hlrnahcb
(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 |(j 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 []No
FURTHER CERTIFICATIONS
1. Pursuant Xo Municipal Code Chapter 1-23, Article I ("Article I'')(wliich the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party . submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some Five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
2. The Disclosing Party and, ifthe Disclosing Party is a legal entity, all of those persons 01 online* identified in Section II.B. 1. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, stale or local unit of government,
have noi. within a five-year period preceding the date of tins EDS, been convicted of a criminal offense, adjudged guilty, or hod a civil judgment rendered against them in connection v. itlr obtaining, attempting lo obtain, or performing a public (federal, state or local) transaction or contract under.a public transaction; a violation of federal or state antitrust statutes; fraud: embezzlement; theft;-forgery; bribery, falsification or destruction of records; making false statements; or receiving stolen property;
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 8.2 b. of lh;s 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 lln's 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 uny 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 Retainer! Parties'"):
any "Affiliated Entity" (meaning ii 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 facihhc-. and equipment; common use of employees; or organization of 3 business entity following the ineligibility of a business entity to do business with federal or state or local govcrmiu-nL including the City, using substantially the same management, ownership. 01 principals us the ineligible entity), with (espeel lo Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by il. or. with the Contractor, is under common control of another person or entity,
any responsible official of the Disclosing Puny, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated EnUty. 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 Pariy. 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, nr. with respect to a Contractor, an Affiliated Entity, or an AlTiiimul Euiiry of a i' oiilraeiorduiing the five years before the date of such Contractor's or A ffiliated Entity's contend 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 office! or employee of the City, the State of Illinois, or any agency of the fedeu! government or of any state or local government in the United States of America, in that oIiicei'¦. or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party ro any such -igreement, or been convicted or adjudged guilty of agreement or collusion among bidders o:' prospective bidders, in restraint of freedom of competition by agreement to hid a fixed price or oiherwise; or
made an admission of such conduct described in a or b. above that is a matter of record, but have not been prosecuted for such conduct, or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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 slate or local government as a result of engaging in or being convicted of (I) bid-rigging in violation of "720 ILCS 503E-3; (2) bid-rotating m violation of 720 ILCS 5/33E-4; or (3 ) any similar offense of any state or of the United Stales of America that contains the same elements as the offense ofhid-rigging or bid-rotating
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the follow ing lists maintained by the Office of foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the. Unverified List, the Entity List and the Debarred List.
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of tlie Municipal Code.
1. If (he Disclosing Party is unable to certify to any of the above statements in this Pan B (Further Certifications), (he Disclosing Party must explain below:
Paged of 13
Ifthe letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
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").
=—IT/fl
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. Eor purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than S20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
==—irj^==z=zz====i
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is ^Lis 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."
Ifthe Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None." or no response appears on the line's 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 2-156-1 10 of the Municipal Code: Docs any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in.the.Matter? ?
[ ] Yes tfKo
NOTE: If you checked "Yes" to Item D.l., proceed to liems D.2. and D.3. If you checked "No" to Item D 1proceed 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 thai fi) 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 (he City's eminent domain power does not .constitute a financial interest within the meaning of this Pari D.
Does the Matter involve a City Property Sale?
[ J Yes [ ] No
If you checked "Yes" to Item D.l., provide, the names and business addresses of the Cilv 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 cither I. or 2. below. Ifthe 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 m connection with the Matter voidable by the City.
V_ I. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage lo ot' injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI ~ CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: Ifthe Matter is federally funded, complete this Section VI. Ifthe Matter is not federally funded, proceed to Section VU. 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
I. List below the names of all persons or entities registered under the federal Lobbying • Disclosure Act of 1095 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 ha ve uii.de 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 (¦ applicable federal law. a member of Congress, an officer or employee, of Congress, or an employee of 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
3. The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
4 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 19S6 but has not engaged and will not engage in "Lobbying Activities".
5. Ifthe 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 Ihe Disclosing Party must maintain all such subcontractors' certifications for the duration of the Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
Ifthe Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
If "Yes," answer the three questions below:
[ 1 No
1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[1 Yes
2. 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?
[JYes
3. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
I i Yes [1 No
you checked "No" to question t. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION. COMPLIANCE, PENALTIES, DISCLOSURE
Tlie Disclosing Party understands and agrees that:
The certificalions, disclosures, and acknowledgments contained in this EDS will become pan of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement. City assistance, or other City action, and are material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cilyofchicago.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.
Ifthe 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), atlaw, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow Ihe Disclosing Party to participate in other transactions with the City. Remedies a( 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 he made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing aiid signing this EDS, tl.e Disclosing Parly waives and releases any possible rights or claims which it mayhiive against the City in connection with the public release of information contained in this EDS mid also authorizes the City to verify the accuracy of any information submitted in this EDS.
E. The information provided in this EDS must be kept current In the event of changes, the Disclosing
Party must supplement this EDS up to the time the City takes action on the Matter. Ifthe Matter is a
contract'being handled by the City's Deportment 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 of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Parly or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, oui is not limited to, all water charges, sewer charges, license fees, parking tickets, properly taxes or sales taxes.
F.2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated Fintilies will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parlies Lisl 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 Ihe Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: Ifthe Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1). warrantsthat he/she is authorized to exccuie Ihis EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished lo the City.
(Print or type nimie of Disclosing Pa "
By:.
(Sign here)
C^\rO
(Print or lype name of person signing)
ty\^r\b^r
(Print or type title of person signing)
SignecLand sworn to before me on (date)*r\isxf TfVf^r If^.eO^i^S
at V f^OVC County; ~Tl (stale).
Aq. V .YQIM l V r\_QCLj^ Notary Public.
Commission expires: f fffY3/U fy^j.
NUMMONONEZ
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 Parmer 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 Parry" means (!) all executive officers of the Disclosing Party listed in Section U.B.I.a., ifthe Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership: all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, ifthe Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means ihe 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?
[ j Yes [
If yes, please identify below (1) the name and title of such person, (2) the name of ihe 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 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?
[ JYes
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?
[ ]Yes [ ]No l^Not Applicable
If yes to (1) or (2) above, please identify below the name of the person or legal entit\ 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 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.