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This record contains private information, which has been redacted from public viewing.
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Type:
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Ordinance
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Status:
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Passed
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Title:
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Zoning Reclassification Map No. 26-E at 720 E 111th St - App No. 18606
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Topic:
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ZONING RECLASSIFICATIONS - Map No. 26-E
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ORDINANCE Be it Ordained by the City Council of the City of Chicago: SECTION 1: That thc Chicago Zoning Ordinance be amended by changing all the Business-Residential-Institutional Planned Development Number 1167, as amended, symbols and indications-shown on Map Number 26-E in the area bounded by: the centerline of East 111th Street; the east line of the 30-foot wide Chicago, Rock Island and Pacific Railroad right-of-way; a line that is 666.93 feet southerly of the centerline of East 103rd Street; the centerline of South Woodlawn Avenue; the centerline of the 100-foot wide South Doty Avenue right-of-way (as occupied); a line that is parallel to and 777.50 feet northerly of the centerline of East 111th Street; an arc with a length of 282.74 feet and a radius of 180 feet; and a line that is perpendicular to the centerline of East 111th Street and approximately 1,388.35 feet east ofthe centerline of South Langley Avenue (as measured along the centerline of East 111th Street), to those of a Business-Residential-Institutional Planned Development Number 1167, as amended, which is hereby established in the area described above subject to such use and bulk regulations as are set forth in the Plan of Development attached hereto and to no others. SECTION 2: This ordinance shall be in force and effect from and after its passage and due publication. ADDRESS: 720 E. 11 1th STREET CA5TM10138127.1 02:31 PM FINAL FOR PUBLICATION FINAL BUSINESS-RESIDENTIAL-INSTITUTIONAL PLANNED DEVELOPMENT NO. I 167, AS AMENDED PLAN OF DEVELOPMENT STATEMENTS Thc area delineated herein as a Business-Residential-Institutional Planned Development Number . 167 (the "Planned Development") consists of approximately 6,017,640 square feet of net site area (approximately 138 acres) of property (the "Property"), together with certain portions of existing adjacent rights of way, as depicted on the attached Planned Development Boundary and Property Line Map. The Planned Development is divided into Subareas (each, a "Subarea," and collectively, the "Subareas") as indicated on the attached Subarea Map. North Pullman 111th, Inc. is thc owner of and, for purposes of this amendment to the Planned Development, the "Applicant" with respect to Subareas B, D, E, F, G, and H. All applicable official reviews, approvals or permits are required to be obtained by the Applicant or its successors, assignees or grantees. These Planned Development Statements do not obligate the City of Chicago ("City") to establish any public rights-of-way, accept or maintain any open space, detention or site buffer areas, construct any public improvements, or finance the construction of any improvements. Any dedication, opening or vacation of streets, alleys or easements or adjustments of rights-of-way or consolidation or re-subdivision of parcels shall require a separate submittal on behalf of the Applicant or its successors, assignees or grantees and approval by the Commissioner of the Department of Transportation ("CDOT") and the City Council ofthe City of Chicago (the "City Council"). Any required City Council approvals must be obtained prior to issuance of any Part II approval. Applicant shall have the right to seek approval in phases for any or all of the foregoing approvals. In connection with planning for any Subarea, adjustments in the location, width and configuration of the rights-of-way illustrated on the Rights-of-Way Adjustment Map may be approved by the Zoning Administrator as a minor change to this Planned Development, provided, such adjustments (a) do not result in a change in the character of this Planned Development in accordance with the requirements of Section 17-13-0611 of the Chicago Zoning Ordinance, (b) are set forth in a plat of subdivision, dedication, opening or vacation, or comparable plat or instrument, as applicable, that has been submitted by Applicant (or its successors, assigns or grantors) for approval by CDOT, the Department and by the City Council at the time of request for such adjustments (and approved by CDOT and the City Council prior to the issuance of any Part II approval), and (c) shall not be deemed to confer any additional bulk, density or other development rights. The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns. All rights granted hereunder to the Applicant shall inure to the benefit of the Applicant's successors and assigns (including any condominium or homeowners' association which may be formed). The requirements of Section 17-8-0400 of the Chicago Zoning Ordinance shall apply to the Property. The Subareas (and, if subsequently designated on any Final Subarea Plan, any subparcels designated thereon), shall be deemed specifically delineated subareas and subparcels for purposes of Section 17-8-0400 ofthe Chicago Zoning Ordinance, provided, however, that for so long as North Pullman 111th, Inc. or any affiliate thereof owns or FINAL FOR PUBLICATION FINAL controls any part of the Property, any application to the City for any such changes or modifications (administrative, legislative or otherwise) must in all cases be authorized by the Applicant (or Applicant's successor, assignee or grantee to such master developer ownership interest) or such affiliate. Where portions of the improvements located on the Property have been submitted to the Illinois Condominium Property Act, the term "owner" shall be deemed to refer solely-to -the condominium association of the -owners of such -portions ofthe improvements and not to the individual unit owners therein. Nothing herein shall prohibit or in any way restrict the alienation, sale or any other transfer of all or any portion of the Property or any rights, interests or obligations therein. The developer making application shall have the burden of establishing to the reasonable satisfaction of the Department that the Applicant's consent has been obtained or irrevocably waived. Upon any alienation, sale or any other transfer of all or any portion ofthe Property or the rights therein (other than a mortgage lien or security interest) and solely with respect to the portion of the Property so transferred, the term "Applicant" shall be deemed amended to apply solely to the transferee thereof (and its beneficiaries if such transferee is a land trust) and the seller or transferor thereof; provided, however, that North Pullman 1 11th, Inc.'s right to authorize changes or modifications to this Planned Development for so long as it owns or controls all or any portion of the Property shall not be deemed amended or transferred to apply to a transferee (or its beneficiaries as aforesaid) unless expressly assigned in a written instrument executed by the original Applicant hereunder. An agreement among different owners of the Property or a covenant binding upon owners of the Property may designate the parties authorized to apply for future amendments, modifications or other changes to this Planned Development and irrevocably waive the Applicant's consent right. 4. This Planned Development consists of these sixteen (16) statements and the following "Design-Exhibits" attached hereto: an Existing Zoning Map, a Planned Development Boundary and Property Line Map (three pages), a Sub Area Map, an overall Site Plan, a final Sub Area Plan and Site Plan (Phase I) for Sub Area B, Elevations - Sub Area B (two pages), Plan of Development Bulk Regulations and Data Table - Sub Area B, and Design Guidelines - Sub Area B, all prepared by ZPD+A Architects and dated December 2, 2015; and a Landscape Plan (Subarea B - Phase I) prepared by Spaceco Inc. and dated November 1 1, 2015. The following Design-Exhibits are incorporated by reference: Bulk Elevations - North Woodlawn/Doty Avenues (Sub Area G), Bulk Axonometrics (Sub Areas A, B, G), Plan of Development Bulk Regulation and Data Tables (including permitted uses) for each of Sub Areas A and C through H (seven pages), all prepared by PappageorgeHaymes Partners dated August 15, 2013; Design Guidelines for Sub Area G, prepared by PappageorgeHaymes dated April 15, 2010; Plan of Development - Bulk Regulations and Data Table Summary, prepared by PappageorgeHaymes dated August 15, 2013; Subarea C Site Plan, prepared by William McDonough Partners dated August 15, 2013; Project Legacy Landscape Plan (two pages), prepared by Norris Design dated August 15, 2013; and Building Elevations and Building Sections Sheet for Sub Area C, both prepared by William McDonough Partners dated August 15, 2013. Full size copies of the Design Exhibits are on file with the Department. him i-Ok KI/BLsUAHUM FINAL The following administrative relief and site plan approval letters are hereby incorporated by reference and made part of this Planned Development (collectively, the "Administrative Approvals"): Administrative Relief request for Subarea A, Phase 1A to Jesse Dodson daled February 25, 2011; Administrative Relief request for Subarea A, Phase 1A to Jesse Dodson dated May 2, 2011; Administrative Relief Request and Site Plan Approval for Subarea A, Phase IB to-David Doigdated-January 25,-2013; and Site-Plan Approval-for Phase IB of Subarea A (South Out Lot - 10834 South Doty Ave.) to David Reifman dated July 25, 2014. References in these Statements to the "Planned Development" shall be deemed to include the aforementioned Design Exhibits and Administrative Approvals. This Planned Development conforms to the intent and purpose of the Chicago Zoning Ordinance and satisfies the established criteria for approval as a Planned Development. In the case of any express conflict between the terms of this Planned Development, and the Chicago Zoning Ordinance, this Planned Development shall apply. Absent an express conflict, the terms of the Chicago Zoning Ordinance shall apply to reviews, determinations and approvals under these Statements and to improvements to the Property. In any instance where a provision of the Planned Development conflicts with the Chicago Building Code, the Building Code shall control. The permitted uses, floor area ratio, building height, setback, parking, bicycle parking and off street loading requirements for each Subarea are set forth in the applicable Plan of Development Bulk Regulations and Data Tables included in the Design Exhibits. For the purposes of calculations or measurements pertaining to the foregoing, the applicable definitions in the Chicago Zoning Ordinance shall apply. Changes in the boundaries of Subareas shall require an amendment to these Statements in accordance with the review and approval procedures in Section 17-13-0602 through Section 17-13-0610 of the Chicago Zoning Ordinance. 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. Off-premise signs are prohibited within the boundary of the Planned Development. For purposes of height measurement, the definitions in the Chicago Zoning Ordinance shall apply. The height of any building or improvement shall also be subject to height limitations established by the Federal Aviation Administration. All ingress and egress shall be subject to the review and approval of CDOT and the Department. Closure of all or any public street or alley during demolition or construction shall be subject to the review and approval of CDOT. All work proposed in the public way must be designed and constructed in accordance with the CDOT Construction Standards for ' Work in the Public Way and in compliance with the Municipal Code of the City of Chicago, and must be designed in accordance with the CDOT Street and Site Plan Design Standards and follow the principles and practices of a Complete Streets design approach. Any dedication, opening, or vacation of public streets, alleys or easements or any adjustment of FINAL the public rights-of-way contained within a particular Part II submittal shall be approved by City Council prior to the issuance of any final Part II approval. In connection with thc Applicant's (or any developer's) submittal of any Site Plans in accordance with Statement 10 below, CDOT shall finally determine what means of ingress and egress are required, what public rights-of-way are required, and what public way improvements must - be constructed as part of any-project in any given Subarea (including any improye_ments required outside of such Subarea, but impacted or integrally related to such Subarea's project and the public improvements associated therewith). Applicant and its successors, assigns and grantees, at such parties' expense, agree to provide traffic impact studies, pay for the services of professional engineering services, and pay for the cost of third party construction inspection services to assist CDOT in its review and approval of Site Plan submissions (which approvals shall be a condition precedent to the Department's issuance of any applicable Part II approval). CDOT must approve the applicable consultant, which shall report to CDOT. Recommended traffic and engineering measures shall be included in the design review process and implemented. A minimum of two percent (2%) of all parking spaces provided pursuant to this Planned Development shall be designated and designed for parking for the handicapped. 10. Final Subarea Plans were previously approved for Subarea A, as part of establishment of the original Planned Development, and for Subarea C, as part of the amendment to the Planned Development approved on September 11, 2013. Final Subarea Plans shall not be required for Subareas B, D, E, F, G, or H, but development of such subareas shall be subject to Site Plan Review, as set forth in this Statement 10. Prior to the Part II Approval (per Section 17-13-0610 of the Zoning Ordinance), Site Plan Review shall be required for all projects undertaken in furtherance of the Planned Development and, as applicable, the Final Subarea Plan in accordance with Section 17-13-0800 of the Chicago Zoning Ordinance, excluding Site Plan review for (i) the project depicted in Subarea A, which was approved with the original Planned Development and by its related Administrative Approvals, (ii) the project depicted in Subarea C, which was approved as part of the amendment to the Planned Development approved on September 11, 2013, and (iii) the project depicted as Phase I of Subarea B, which is being approved as part of this amendment to the Planned Development. The future expansion ofthe industrial building in Subarea C shall require Site Plan Review and an Administrative Relief submission prior to a Part II approval of the aforementioned expansion project. Review and approval by the Department of Planning and Development is intended to assure that specific development components substantially conform with the Planned Development, including the Plan of Development Bulk Regulations and Data Table and Design Guidelines applicable to such Subarea(s), and to assist the City in monitoring ongoing development. Subarea Site Plan Approval Submittals (per Section 17-13-0800) need only include that portion of the Property for which approval is being sought by the Applicant. If not evidenced on the preliminary plat of subdivision submitted as part of the Final Subarea Plan for the project's subarea (if applicable), or the final approved subdivision plat (if applicable), the Applicant or developer of trie subject project shall provide an exhibit showing lot sizes and boundaries for such project. In addition to the submittal requirements of Section 17-13-0802-B, the Applicant or developer shall also provide a Site Data Table for such project containing, for each Subarea and subparcel, if any, included in such FINAL project: the Gross Site Area; the Net Site Area; the square feet of floor area of each proposed building; the amount of F.A.R. utilized out of the maximum F.A.R. permitted in such Subarea; the height of each building to be constructed and the maximum allowable height permitted under the Design Exhibits applicable to such Subarea; the number of dwelling units to be constructed and the maximum number of dwelling units permitted under the Design Exhibits applicable to such Subarea; the front, rear and side setbacks for each building and the setbacks required under the Design Exhibits applicable to such Subarea; All Residential Open Space, if applicable; The number of parking spaces to be provided and the minimum and maximum number of parking spaces required under the Bulk Regulation Data Table Summary and Design Exhibits, as applicable; and final elevations; elevations must be provided for all of the proposed building facades and building specified. The Site Data Table shall also incorporate a table showing the "green" features to be included in the proposed buildings. The Site Plan shall be subject to review and approval of the Department and such other bureaus, departments or agencies as the Zoning Administrator deems appropriate before issuance of any Part II approval for the subject project. The Site Plan must be in substantial compliance with both the Planned Development and the approved Final Subarea Plan (if applicable). If, after City departmental review, the Zoning Administrator determines that the Site Plan is in substantial compliance with both the Planned Development and the applicable Final Subarea Plan, and if any improvements contemplated by the Site Plan exceed any of the mandatory Planned Development thresholds set forth in Section 17-8-0500 of the Chicago Zoning Ordinance (as applicable to improvements in a C2-3 district, e.g., the Site Plans include 60 dwelling units or more, or buildings 75 feet or more in height), then the Site Plan must then be reviewed by the Chicago Plan Commission, during a public meeting (for which placement on a Chicago Plan Commission Agenda, publication in accordance with Section 17-13-0107-B ofthe Chicago Zoning Ordinance, and posting in accordance with Section 17-13-0107-C of the Chicago Zoning Ordinance shall be required, but for which written notice pursuant to Section 17-13-0107-A of the Chicago Zoning Ordinance shall not be required) but shall not require review and approval by the City Council. If such mandatory thresholds are not met or exceeded, then no Chicago Plan Commission review him rUft ruDLiWinvrc FINAL shall be required, and if, after City departmental review, the Zoning Administrator determines that the Site Plan is otherwise in substantial compliance with both the Planned Development and the applicable Final Subarea Plan, the Site Plan shall then be approved by the Zoning Administrator. Without limiting the foregoing, the first development project within Subarea H may, in the Zoning Administrator's discretion, be presented to the Chicago Plan Commission,during a public meeting (for which placement on a Chicago Plan Commission Agenda shall be required, but for which publication, posting and written notice pursuant to Sections 17-13-0107-A, -B, and -C of the Chicago Zoning Ordinance shall not be required) but shall not require review and approval by the City Council. If, after City departmental review, the Zoning Administrator shall determine that the Site Plan is not in substantial compliance with both the Planned Development and the approved Final Subarea Plan (if applicable), the Zoning Administrator shall advise the Applicant or developer in writing of why the Site Plan does not substantially comply with the Planned Development and/or the Final Subarea Plan (if applicable). In such case, the Applicant or developer shall be given an opportunity to submit revised Site Plans. If the Zoning Administrator finally determines that the Site Plans, as the same may be revised, arc not in substantial compliance with the Planned Development and/or the Final Subarea Plan (if applicable), the Applicant or developer then shall be required to amend this Planned Development and/or the Final Subarea Plan (if applicable) in accordance with the review and approval procedures in Section 17-13-0602 through Section 17-13-0610 of the Chicago Zoning Ordinance in order to obtain approval of such Site Plans. After approval of a Final Subarea Plan (if applicable) and/or Site Plan, such Final Subarea Plans and Site Plans may be changed or modified pursuant to the requirements of Section 13 hereof, if applicable. 11. The improvements on the Property shall be designed, constructed and maintained in substantial compliance with the Design Exhibits attached hereto Parkway and parking lot landscaping shall comply with the landscaping provisions of the Chicago Zoning Ordinance and Chicago Landscape Ordinance, unless specified otherwise in an approved Final Subarea Plan. The Property shall be designed and constructed in accordance with the City of Chicago Regulations for Sewer Construction and Stormwater Management and Stormwater Management Ordinance Manual, latest editions. Any amendment to the City's storm water management requirements which the City adopts thereafter shall apply to the Property or the development thereof. It is the Applicant's intention to adaptively reuse the Brite Line building identified as "Existing Building" in Subarea D on the Site Plan; however, the Applicant reserves the right to demolish such building and to otherwise redevelop Subarea D in conformance with the applicable terms of this Planned Development in the event the Applicant determines that such adaptive reuse is not feasible or desirable. Within Subarea A, a Chicago Transit Authority bus turnaround in a location and of such size and configuration as mutually agreed upon by the Applicant, the Chicago Transit Authority and CDOT has been previously completed. (e) Porches shall be features which are allowed to encroach into any required front yard setback in Subarea F, subject to Site Plan approval. Applicant acknowledges that the City will not maintain or bear the cost of maintaining any landscape or streetscape improvements on any medians to be constructed within the Planned Development. Prior to CDOT approval of engineering drawings for any median-street to be constructed by the Applicani within the Planned Development, the Applicant must demonstrate to the satisfaction of CDOT that sufficient sustainable resources have been committed, and written agreements exist (which provide reasonable protection to the City and, among other things, shall name the City as intended beneficiary, shall grant the City enforcement rights, and shall include or extend indemnification and insurance provisions for the benefit of the City) to provide for the satisfactory maintenance of such medians, which agreements may provide for maintenance costs to be funded through a special service area or special service district, the establishment of which is subject to separate City Council approval. Applicant, at the Applicant's expense, has previously reconstructed S. Woodlawn Avenue from approximately E. I07lh Street to E. 111th Street in accordance with the requirements of Statement 9. The Applicant and each developer of any portion of the Property at the time of a project shall comply with Rules and Regulations for the Maintenance of Stockpiles promulgated by the Commissioner of the Department of Streets and Sanitation, the Commissioner of the Environment and the Commissioner of Buildings under Section 13-32-125 of the Municipal Code of the City of Chicago or any other provision of that Code. The Part II review fee for permits and licenses to be issued for projects in the Planned Development shall be the greater of $0.50 per square foot for the total buildable floor area (i.e., the current rate under Section 17-13-0610 of the Chicago Zoning Ordinance) or the then applicable per square foot charge (or other then applicable charge) at the time of such Part II review. Such fee shall be determined and assessed by the Department at the time of each and every Part II review, shall be applicable to all projects, whether undertaken by the Applicant or another developer, shall be final and binding and must be paid to the Department prior to issuance of any Part II approval. Following Part II review and approval by the Zoning Administrator, the Department shall keep such approved plans and elevations on permanent file and they shall be deemed to be an integral part of this Planned Development. The Applicant acknowledges that it is in the public interest to design, construct and maintain the project in a manner which promotes, enables and maximizes universal access throughout the 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 the highest standard of accessibility. Any interim reviews associated with Site Plan review or Part II reviews, are conditional until final Part II approval. Subject to the other terms and conditions of these Statements, including specifically, but rlfcft- ! U(\ i iK)u.;wnsiU)'- final without limitation, Statement 10's filing, review and approval requirements, the terms, conditions and exhibits of this Planned Development may be modified administratively by the Zoning Administrator upon application and a determination by the Zoning Administrator in accordance with the minor change provisions and standards of Section I 7-13-061 1 ofthe Chicago Zoning Ordinance (provided, however, that Section 17-13-061 1- --- -A.2-arid A.3-shall-be separately tested.on_a-Subarea .basis,.without taking into account.the net site area of or dwelling units permitted in olher Subareas or the Planned Development as a whole) and that such modification, and the improvements contemplated thereby, are consistent with the Planned Development and the applicable Final Subarea Plan. Any such modification shall be reviewed and approved through the minor change provisions of Section 17-13-061 I ofthe Chicago Zoning Ordinance. The Applicant acknowledges that it is in the public interest to design, construct and renovate all buildings in a maimer which provides healthier environments, reduces operating costs and conserves energy and resources. All development in any Subarea shall conform to the City of Chicago's "Sustainable Development Policy Matrix" in effect on the submittal of Site Plans pursuant to this Planned Development; provided, however, that the Zoning Administrator may approve alternative methods of satisfying the "Sustainable Development Policy Matrix." The Applicant has agreed to provide an infiltration trench/bioswale east of the proposed Phase 1 building within Subarea B to provide the equivalent storm water volume control as a 50% Green Roof for the proposed Phase I building and to exceed ASHRAE 90.1-2004 standards by 14%, in satisfaction of the City of Chicago's Sustainable Policy requirements. Unless substantial construction of any new building, as proven by the issuance of building permits and the diligent completion of construction pursuit to such permits for Subarea B or Subarea H has commenced within six (6) years of this amendment to the Planned Development, this Planned Development shall expire upon the sixth anniversary date of the effective date of this amendment to the Planned Development. If this amendment to the Planned Development expires pursuant to the foregoing provision, this amendment to the Planned Development shall expire by separately introduced ordinance, if any, and in such event the zoning of the Property shall revert to Business-Residential-Institutional Planned Development No. 1167, as adopted by the Chicago City Council on September 11, 2013. Such reversion shall not render any building existing at the time to be nonconforming. The six year period described above may be extended for up to one additional year if, before expiration, the Zoning Administrator determines that good cause for an extension is shown. Any open space to be dedicated to the Chicago Park District ("CPD") must meet CPD standards and, where applicable, the park must be designed and constructed to those standards. Any conveyance of open space to the CPD shall be subject to the approval ofthe CPD and a resolution or ordinance issued by the CPD Board of Commissioners must be provided .to the Department to evidence such dedication, conveyance and acceptance. ?MR! SUB AREA B Phase 1 Uses The foMow^ng Cg Motor Vehicle-Related Commercial District uses shall be allowed-"da^ ca7erpostai service; public safety services; utilities and services, minor; Chicago Transit Authority bus turnaround; all animal services excluding stables; artist work or sales space; body art services; business support services excluding day labor employment agencies; employment agencies; communication service establishments; all construction sales and service; drive-through facilities; all eating and drinking establishments including outdoor patio located on a rooftop; all entertainment and spectator sports including outdoor patio located on a rooftop; all financial services excluding payday loan stores and pawn shops; all food and beverage retail sales; liquor stores; liquor sales; gas stations; medical service; office; high technology office; electronic data storage center; parking, non-accessory; personnel service; hair salon, nail salon, massage establishment or barbershop; repair or laundry service, consumer; dry cleaning drop-off or pick-up; coin-operated Laundromat; residential storage warehouse; retail sales, general; all sports and recreation, participant excluding entertainment cabaret; all vehicle sales and service excluding vehicle storage and towing with outdoor storage; hotels; elderly housing; wireless communication facilities excluding freestanding towers. No adult uses are allowed. Site Area Gross 648,718 sf Rights of Way 51,024 sf Net Site Area 597,695 sf Public Open Space 15,167 sf Maximum F.A.R. 1.0 Building Height 100 ft Setbacks Front Oft Side Oft Rear Oft Parking Group M e.g. retail None for first 10,000 square feet then 2.5 spaces per 1,000 square feet Group D e.g. elderly housing 0.33 spaces per a unit Group S e.g. lodging 1 space per 3 lodging rooms Bicycle Parking No use is required to provide more than 50 bicycle parking spaces. Group M e.g. retail 1 per. 5 auto spaces Group D e.g. elderly housing 1 per 4 auto spaces Group S e.g. lodging 1 per 10 auto spaces Off Street Loading Retail 100,000 to 249,999 sf = 4 berths (10 x 50) +250,000 = 1 additional berth (10 x 50) per 200,000 sf above 250,000 sf Lodging 25,000-199,999=1 berth (10 x 50) Multi-Unit 25,000-199,999=1 berth (10 x 25) Plan of Development - Bulk Regulations and Data Sub Area B Applicant: North Pullman IIIth Inc. Address. Ill"1 Street and Doty Avenue Submitted for Administrative Review -11/11/15 Plan Commission- 05/19/16 zpd+a Architects www.2pdarch.com 901 W Jackson, Suite 204
Chicago, IL 60607
P/H II 081901
Design Guidelines
for PD 1167: Sub Area B (IIIth Street Neighborhood Retail District) Updated May 16, 2016
The Design Guidelines are development standards for buildings and public spaces to guide the design and development of any project within the IIIth street neighborhood retail district of Pullman Park. The goal of the guidelines is to provide a framework to achieve a balance between individual expression of each structure and a harmonious connection to not only the community but the history of Pullman as well.
Orientation:
Buildings located along 111th Street or within the general context of the site, will have their primary elevation oriented to face 111th Street. Buildings located on corners or parking entrances should have their primary elevations oriented to face both 111th Street and the adjacent street or entrance drive.
Massing:
Buildings should be composed of simple volumes, primarily 1 to 2 story retail buildings, plus mid-rise (8 story) Senior Housing and/or Hotel buildings. 1 to 2 story retail occupancies will feature sloped roofs; Mid-rise buildings may be sloped and/or flat roofs.
Retail buildings located along IIIth street will be a minimum of 16' tall and a maximum of 30' tall measured from sidewalk grade to the midpoint of sloped roofs; excluding towers, cupolas and other decorative elements.
Roof massing:
Sloped roofs with a minimum slope of 6:12
Buildings may alternatively feature flat roofs with built up parapets.
Roofs will be designed to screen and conceal all rooftop mounted mechanical equipment.
Lighting:
Lighting will be designed to enhance the building design and storefront, compliment the architecture, and be sufficient for visibility and safety.
Lighting should be stationary and non-animated.
Design Guidelines zpd+a Architects
Sub Area B www.zpdarch.com
901 W Jackson, Suite 204
Applicant: North Pullman IIIth Inc. Chicago, iL60607
Address. lllIh Street and Doty Avenue
Introduced: 12/09/15 P/H ti 081901
Plan Commission: 05/19/16
Masonry Openings:
• Window and door headers in masonry walls should be defined and articulated with stone, cast
stone or special brick coursing such.as soldier or double rowlock header bonds. Jack, segmental,
semi-circular and multi-centered arches are encouraged. Window sills within walls should incorporate stone or precast sills.
Signage:
All signage will be attached to the building or canopy, provided that up to three freestanding multi-tenant signs and up to three free-standing single-tenant signs may be established within Sub Area B. Types of permitted signs include:
o Freestanding pin-mounted letterform
o Freestanding internally illuminated signs (including so-called "lightbox" signs)
o Projecting signs
o Blade signs
o Storefront signs
o Window Signs
o Canopy signs
o Two sided or three-dimensional contextual signs
o Backlit letter metal sign box signs
o Internally illuminated, wall-mounted signs
o Neon signs are permitted only when inset into a metal channel or open-face form with or without an acrylic cover.
Awnings & Canopies:
Awnings and canopies will be compatible in material and construction to the style and character of the building. The color of the awning or canopy should be compatible with the overall color scheme of the facade.
Where feasible, awnings and canopies should be generally aligned with others nearby in order to maintain a sense of visual continuity.
Awnings and canopies should be tailored to the opening of the building and positioned so that distinctive architectural features remain visible.
Design Guidelines zpd+a Architects
Sub Area B www.zpdarch.com
901 W Jackson, Suite 204
Applicant: North Pullman IIIth Inc. Chicago, il 60607
Address: IIIth Street and Doty Avenue
Introduced: 12/09/15 P/H H 081901
Plan Commission: 05/19/1G
CAD 0' i if' *TW.I
H
IV ) s i
Material Transitions:
• Where possible, all transitions between dissimilar wall materials should occur at inside corners.
Storefronts:
Storefronts will be designed using a rhythm created by pilasters, columns, and or piers with trim to frame display windows. Glazing will comprise 50-65% of the storefront wall area.
Aluminum, steel, clad, or aluminum clad wood framed entrances with factory applied finishes in one ofthe accent colors listed elsewhere in this document. A minimum 12" durable storefront base should be incorporated as part of the design to withstand contact with maintenance and snow removal equipment.
Accent Colors:
The colors that are recommended for awnings, aluminum storefronts, brackets, exposed structural elements are listed per the Pantone Matching Systems 8 and are as listed:
o PMS Cool Grey 11 o PMS 626 o PMS Process Black C o PMS 1526
Materials:
Brick-Red finish in an extruded wirecut or velour texture, handmade and/or molded finish. Brick exterior walls will be composed of a blend between modular sized units, 3 5/8" x 2 %" x 7 5/8"; and/or "Quick-Brick" 4" x 16" x 8" nominal sized units. Coursing will be a standard common or header bond. All mortar should be colored mortar to match the brick.
Stone-Buff colored limestone in rock-face, smooth and other textured surfaces.
Precast stone- Fabricated to simulate natural limestone in rock-face, smooth and other textured surfaces.
Roofing: slate, manufactured slate, metal standing seam; or shake type asphalt shingles
Glass- clear insulated, energy efficient glass
Trim-Decorative trim will be cellular PVC, prefinished aluminum and prefinished extruded aluminum panning in traditional brick-mold and casing profiles; accent banding and/or special accent shapes may also include a limited amount of fiber cement siding. EFIS will be allowed at decorative building cornices only.
Design Guidelines Sub Area B
Applicant: North Pullman IIIth lnc
Address: lll,h Street and Doty Avenue
Introduced: 12/09/15 Plan Commission. 05/19/16
zpd+a Architects
www.zpdarch.com
901 W Jackson, Suite 204
Chicago, IL 60607 P/H ft 081901
N PD 1167 7,917,777 sf 181.77 acres
©
Existing Zoning Map
Scale, r = 800-Cr
Applicant: North Pullman 111th Inc.
Address luth Street and Doty Avenue
introduotion Dato ¦ December 0, 201G
Chicago Plan Commission Date May 19, 2016
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Site Plan
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Applicant: North Pullman 111th Inc.
Address I nth Street and Doty Avenue
introduction Date December 9, 2015
Chicago P'an Commission Date May 19, 2016
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Applicant: North Pullman 111th Inc.
Address . tilth Street and Doty Avenue
IntroductionDate December 9, 2015 Chicago Plan Commission Date May 19, 2016
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Planned Development Boundary and Property Line Map -1 of 3
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Applicant: North Pullman 111th Inc.
Address . tilth Street and Doty Avenue
IntroductionDate December 9, 2015
Chicago Plan Commission Dare way 19. 2016 '
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Planned Development Boundary and Property Line Map - Detail - 2 of 3
Scale: 1" = 400'-0"
Applicant: North Pullman 111th Inc.
Address . I llth Street and Doty Avenue
introduction Date December 9, 2015
Chicago Plan Commission Date May 19, 2016
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Planned Development Boundary and Property Line Map - Detail • 3 of 3
Scale- r = 4O0'-0"
Applicant: North Pullman 111th Inc.
Address ¦ Mlth Street and Doty Avenue
introduction Date December 9, 2015 Chicago Plan Commission Date • May 19, 201G
Applicant: NORTH PULLMAN 111TH INC.
Address 111lh Street and Doty Avenue, Chicago IL
Introduced: 12092015 Plan Commiston: 05192016
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Department of Planning and Development city of chicago
MEMORANDUM
TO: Alderman Daniel S. Solis
Chairman, City Council Committee on Zoning
FROM: fotjfo-^ ^ V-iw^- .
Paltricia Scudiero I Chicago Plan Commission
DATE: May 20, 2016
RE: Proposed Amendment to Residential Institutional Business Planned
Development No. 1167 for property generally located at 720 East 111th Street.
On May 19, 2016, the Chicago Plan Commission recommended approval ofthe proposed amendment submitted by North Pullman 111th, Inc. A copy ofthe 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 ofthe 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 LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS 60602
REPORT FINAL TO THE
CHICAGO PLAN COMMISSION FROM
THE DEPARTMENT OF PLANNING AND DEVELOPMENT
MAY 19, 2016
FOR APPROVAL: AMENDMENT TO RESIDENTIAL INSTITUTIONAL
BUSINESS PLANNED DEVELOPMENT NO. 1167
APPLICANT: NORTH PULLMAN 11 1th INC
LOCATION: 720 EAST 111™ 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 submit this report and recommendation on a proposed amendment to Planned Development No. 1167 for your review and recommendation to the Chicago City Council. The application for the amendment to the Chicago Zoning Ordinance was introduced into the City Council on December 9, 2015. Proper legal notice of the public hearing on the application was published in the Chicago Sun Times on May 4, 2016. The Applicant was separately notified of this hearing.
This application is submitted as a mandatory planned development pursuant to section 17-8-0515 Expansion of Existing Development and per the Planned Development requirements. The applicant proposes to amend Subarea B to allow a 10,000 square foot retail development in a phase 1 building.
SITE AND AREA DESCRIPTION
1. PD 1167 and Existing Land Use Map. 2. Photo of existing conditions.
The project consists of Subarea B of Planned Development No. 1167 and consist of approximately 597,000 square feet and is bounded on the north by Subarea A and C of the same planned development and by passive open space, on the east by South Doty Avenue, on the south by 111th Street and on the west by a private drive.
PROJECT DESCRIPTION AND BUILDING DESIGN
The Applicant seeks this amendment to allow development of Subarea B with multiple
commercial buildings consisting of approximately 112,000 square feet, and including a total
of 594 parking spaces. Development of Subarea B is anticipated to take place in multiple
phases, the first of which would consist of an approximately 10,000 square foot multi-tenant
"- retail/restaurant building and approximately 91 surface parking spaces.
The one-story commercial building is clad in a masonry quick brick with stone accents and prefinished metal coping. The base of the building at each tenant space is defined by an aluminum store front with stone or fiber cement accents. A partial mansard roof clad with asphalt roof shingles is located at the two main entry points for the commercial tenants along the north and south facades.
3. Proposed rendering
ACCESS/CIRCULATION
4. Site Plan
The pedestrian access point for the one-story retail building is located along a new sidewalk on East 111th Street. The building floor plan is designed in such a way as to allow access from both the new sidewalk and from the proposed parking lot. Access for vehicle traffic is proposed from two new curb cuts along East 111 Street and South Doty Avenue. The easternmost portion of the retail tenant will allow a future tenant to use a proposed drive through. Loading for the site will occur along the proposed parking lot along the north side ofthe building.
6. Ground Floor Plan LANDSCAPING and SUSTAIN ABILITY
The applicant has agreed to and must comply with the City of Chicago's Landscape Ordinance and the requirements set forth by the City of Chicago Sustainable Matrix.
BULK/USE/DENSITY
Reference attached Bulk and Data Table Exhibit. RECOMMENDATION
The Department of Planning and Development has reviewed the project materials
submitted by the applicant and has concluded that the proposed amendment to Institutional -
Residential Business Planned Development No. 1167 would be appropriate for the site and that the project meets the review criteria for planned developments set forth in the Zoning Ordinance (Section 17-13-0900).
The project complies with the Standards and Guidelines for Planned Developments in the Zoning Ordinance (Section 17-8-0900).
Transportation, Traffic Circulation and Parking.
The pedestrian access point for the one-story retail building is located along a new sidewalk on East 111,h Street. The building floor plan is designed in such a way as to allow access from both the new sidewalk and from the proposed parking lot. Access for vehicle traffic is proposed from two new curb cuts along East 111th street and South Doty Avenue.
Pedestrian Orientation. The proposed project will allow pedestrians to access the site from East 111th Street. The entire street frontage of the building is enlivened by an aluminum storefront window system looking directly onto the street frontage.
Urban and Building Design. The building is design with quality materials and the architecture respects the character of the existing planned development and ofthe surrounding area.
The proposed development is compatible with the character of the surrounding area in terms of uses, density, and building scale.
a. The proposed amended Planned Development would increase the maximum net site area but the Floor Area Ratio (F.A.R.) stipulated by the existing Planned Development for Subarea B would remain at the previously approved maximum F.A.R of 1.0. This project would have similar uses as the surrounding areas, which include commercial, retail and accessory parking. The height of the proposed building at 27'-9" is compatible with buildings in the surrounding area.
Based on the foregoing, it is the recommendation of the Department of Planning and Development that the revised application for a Institutional Residential Business Planned Development No. 1167 be approved and the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be "As-Revised, Passage Recommended"
Department of Planning and Development
PIKl A I » » 1 *» J \ I.
Department of Planning and Development
CITY OF CHICAGO
AMENDMENT TO INSTITUTIONAL RESIDENTIAL BUSINESS PLANNED DEVELOPMENT NO. 1167 720 EAST 111th STREET
WHEREAS, the applicant, North Pullman 111th, inc., proposes to amend institutional Residential Business Planned Development No. 1167. The application for the amendment to the Chicago Zoning Ordinance was introduced into the City Council on December 9, 2015; and
WHEREAS, the applicant proposes to amend Subarea-B of Planned Development No.
1167 to allow development of Subarea B with multiple commercial buildings consisting of a total of approximately 112,000 square feet, and including a total of approximately 594 parking spaces. Development of Sub Area B is anticipated to take place in multiple phases, the first of phase consist of a 10,000 square foot multi-tenant retail/restaurant building and approximately 91 surface parking spaces; and
WHEREAS, proper legal notice of the hearing before the Chicago Plan Commission was published in the Chicago Sun-Times on May 4, 2016. The proposed Zoning Application was considered at a public hearing by this Plan Commission on May 19, 2016. The Applicant was separately notified of this hearing; and
WHEREAS, the Plan Commission has reviewed the applications with respect to the provisions of the Chicago 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 May 19, 2016, a copy of which is attached hereto and made a part hereof; and
WHEREAS, this Plan Commission has fully reviewed the Planned Development application and all information submissions associated with the proposed development, the report and recommendation of the Commissioner of the ¦ Department of Planning and Development, and all other testimony presented at the pubiic hearing held on May 19, 2016, giving due consideration to the Planned Development Standards and Guidelines contained in the Chicago Zoning Ordinance; and
121 NORTH LASALLE STREET, ROOM 1000, CHICAGO ILLINOIS 60602
r'iiN AL
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
THAT the final application dated May 19, 2016 be approved as being in conformance with the provisions, terms and conditions of the corresponding Zoning 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 May 19, 2016; and
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 Chicago Plan Commission regarding the zoning map amendment for an application to amendment Planned Development No. 1167.
Approved: May 19, 2016
RBPD No. 1167, AA
CITY OF CHICAGO
APPLICATION FOR AN AMENDMENTTO THE CHICAGO ZONING ORDINANCE
ADDRESS of the property Applicant is seeking to rezone:
720 E. Ill"'Street
Ward Number that property is located in: 9th Ward
APPLICANT North Pullman 1 I lih. Inc.
ADDRESS 800 Nicollet Mall. 21st Floor
Pec. «?y /5
RECEIVED MAY 1 9 2016
Initial:
ZIP CODE 55402
PHONE (612) 303-7806 EMAIL
CONTACT PERSON Jeffrey W. Shea
NO
X
Is the applicant the owner of the property? YES 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 applicant to proceed.
OWNER
ADDRESS,
CITY
CONTACT PERSON
If the Applicant/Owner ofthe property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY DLA Piper LLP (USl Aitiv. Mariah DtGrino .
ADDRESS 203 N. LaSalle St Ste. 1900 PHONE 312-368-7261
EAS'TM 14166678.1
6. If the applicant is a corporation please provide the names of al! shareholders as disclosed on the Economic Disclosure Statements:
See Economic Disclosure Statements Hied with this Applicalion.
On what date did thc owner acquire legal title to the subject property? _ 2008
Has the present owner previously rezoned this property? If yes, when?
Yes; In 2010. the property was rezoned to Business-Residcntial-Institntional Planned
Development No. 1167. The PD was amended in 2013.
Present Zoning District Dusiness-Residential-Institutional Planned Development No. 1167. as
amended
Proposed Zoning District Business-Residential-Institutional Planned Development No. 1167. as
amended .
Lot size in square feet (or dimensions) Approx. 6.017.640 square feet
Current Use of the Property Commercial, manufacturing and vacant
Reason for rezoning the property To allow development of Sub Area B with commercial uses, as described below.
Describe the proposed use ofthe property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height ofthe proposed building. (BE SPECIFIC)
The Applicant seeks this amendment to allow development of Sub Area B with multiple
commercial buildings consisting of a total of approximately 112,000 square feet, and including a
total of approximately 594 parking, spaces. Development ol" Sub Area B is anticipated to take
' place in multiple phases, the first of which would consist of an approximately 10.000 square loot
multi-tenant retail/restaurant building and. approximately 92 surface parking spaces.
The Affordable Requirements Ordinance (ARO) that requires on-site affordable housing units and/or a financial contribution for residential housing projects with ten or more units that receive a zoning change which, among other triggers, increases the allowable floor area, or, for existing Planned Developments, increases the number of units (see attached fact sheet or visit www.cityofchicago.org/ARO for more information). Is this project subject to the ARO?
YES ... NO X
EAST'vl 14166678 1
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: U.S. Bank, National Association
Check ONE of thc 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 w hich the Disclosing Party holds an interest: North Pullman 111th Inc.
OR
3. [ ] a legal entity with a right of control (see Section ILB.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: 800 Nicollet Mall
Minneapolis, MN 55402
C Telephone 314-335-2529 Fax. 314-335-2568 Email: benjamin.alderton@usbank.
Name of contact person: Benjamin Alderton
Federal Employer Identification No. (if you have one):
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Amendment to Planned Development No. 1167 (Pullman Park) for property located at 720 East 111th Street_(111th and Doty) ]
Which City agency or department is requesting this EDS? Panning and Development
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 11 -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature ofthe Disclosing Person
Publicly registered business corporation Privately held business corporation Sole proprietorship General partnership Limited partnership
Trust
Party:
[ ] 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
[>5 Other (please specify)
National Banking Association
For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
United States
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?
W N/A PLEASE SEE ATTACHMENT "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 SEE ATTACHED LIST
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% ofthe Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
Entity Name: U.S Bank National Association
Carlson, Jennie P. Director Director
Cecere, Andrew Director Director
Ghosy, Jsmas L - Director Director
Davis. Richard K. Director Director
Dolan. Terrance R. Director Director
Elmore, John R Director Direclor
Hernandez, Roland A Drec.or Director
Kotwal, Stiailesh M Director Director
Parker, P.W. (bill) Director Director
Payne, Richard B. Jr, Dlreclor Director
Quinn, Kalher.ne B. Director Director
Rogers, Kathleen A. Director Director
Runnel, Marx G Director Director
Schnucx, Craig U Director Director
Stone, Kent V Direclor Director
von Gillem, Jetlry H. Director Direclor
Davis. Richard K. Chairman, President and Chief Executive Officer Officer
Aneshansel, R chard A. Executive Vice President Officer
Carlson, Jennie P. Executive Vice President Officer
Chosy. James 1_. Executive Vice President. General Counsel and Secretary Officer
Gifford, Craig E. Executive vice President and Controller Officer
Higgins, Christopher P Executive Vice President Officer
Hurd. Amy C Executive Vice Prnsident Officer
Hyatt, John H Executive Vice President Officer
Martin. Barry L Executive Vice President Officer
Petrone, David M Executive Vice President Officer
Rudy, Rex E Executive Vice President Officer
Runkel, Mart. G 1 Executive Vice President and Chief Credit Officer Officer
Stern, John C, Executive Vice President and Treasurer Officer
Witty, Jason A Executive Vice President Officer
Bcdr.arski. Laura F. Senior Vice President and Assistant Secretary Officer
Krush, Matthew B. Vice President and Assistant Secretary Officer
Maiser, Elizabeth E Vice President and Assistant Secretary Officer
Didon, Linda E. Assistant Secretary Officer
Knack, Natasha M Assistant Secretary Officer
Cecere, Andrew Vice Chairman and Chief Operating Officer Officer
Doian. Terranco R Vice Chairman Officer
Elmore, John R. Vice Chairman, Community Banking arid Branch Dolivnry Officer
Kotwal. Shaiiesh M. Vice Chairman, Payment Services Officer
Parker, p VV (Billi Vice Chairman and Chief Risk Office! Officer
Payiifi. Richarc! B Jr. Vice Chairman Otf.cer
QJnr. Katherine B. Executive Vice President, Chief Strategy and Reputation Officer Officer
Rogers. Kathleen A Vice Chairman and Chief financial Officer Officer
Stone, Ken'. V. Vies Chairman, Consumer Banking Sales and Support Officer
vor. G'llcrn. Jcffry Ii. Vice Chairman Officer
Attachment A
- City of Chicago . . .
Economic Disclosure Statement and Affidavit
Statement Regarding Registration as Foreign Entity
U.S. Bank;-operates branches in the State of Illinois under the authority of its national bank charter and Is therefore not required to register as a foreign corporation with the State.
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None," NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
f/
SECTION III BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of tbe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
-tt, rue e&sr if oofu wt'Up&t*,
[]Ycs NNo /if^po&/Awy
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 thc nature of the relationship, and thc 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 lhc disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees ("indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
: . (Add sheets if necessary)
Jp^Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities, SECTION V - CERTIFICATIONS
A. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more ofthe Disclosing Party been, declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes [ ] No V] No person directly or indirectly owns 10% or more ofthe
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?
[]Yes []No
B, FURTHER CERTIFICATIONS
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-Porty 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 ofthe 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 tlie City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below,
Page 4 of 13
2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section ILB.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;
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; u 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 ofthe offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
3. The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls thc Disclosing Party, is controlled by tbe 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 ofthe Disclosing Party, any Contractor or any Affiliated Entity,
u.Mi'r« .-¦ *>i \ ec-ii >j «t Iv* 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:
... a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to..
bribe, a public officer or employee of the City, the State of Illinois, or any agency ofthe federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with otiier bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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(l) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any ofthe following lists maintained by the Office of Foreign Assets Control ofthe U.S. Department ofthe 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 tbe 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) ofthe Municipal Code.
If the Disclosing Party is unable to certify to any ofthe above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
t.
Page 6 of 13
Attachment B
Gty of Chicago Economic Disclosure Statement and Affidavit
Statement Regarding Further Certifications
U.S Bank National Association itself is a mortgage lender. U.S. Bank National Assqciajipn is also one of the largest corporate trustees in the United States and in such capacity is trustee of numerous mortgage-backed securitization trusts that each hold multiple real property mortgages. From time to time, mortgage borrowers in Chicago default on payment of real estate taxes or otherwise fail to comply with City of Chicago's requirements with respect to certain mortgaged properties. This can result in legal action against the borrower by the City of Chicago, which legal action may name U.S. Bank National Association as the mortgage holder (either in its individual capacity or in its capacity as a trustee). As of December 22, 2014, U.S. Bank National Association was aware of outstanding claims against it (individually or in its capacity as trustee) totaling $154,040.89 wherein the City of Chicago or one ,of its departments or divisions (including the Department of Buildings and the Department of Streets and Sanitation) is the creditor. The vast majority of this amount is related to properties, that U.S. Bank National Association holds in trust and for which it does'not do the servicing. U.S. Bank National Association, both in its individual capacity and in its capacity as a trustee meets periodically with various City officials to address these claims.
If thc 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 ofthe 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 ofthe 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. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
is [ ] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
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 ofthe 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 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "Nodc," 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 ofthe Municipal Code have the.same meanings when used in this Part D.
In accordance with Section 2-156-110 ofthe 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? m ^ 0f CfJfL Iwt&pM,
C]Yes ^No fiFI*^ tot,/owey
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 ot 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.J., provide thc names and business addresses ofthe City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGAPJDING 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 thc Matter voidable by the City. J
r 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
f>. ¦ 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:
A'Trnr./tM^T^ At\\p pm {frrfys
. pftn-p jtrtUs &4qH ¦ = .
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 ofthe City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING * ^ ^Ut>&>
1. List below the names of all persons or entities registered under thc federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of thc 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 cone] usively 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 thc 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
Attachment C
City of Chicago Economic Disclosure Statement and Affidavit
Statement Regarding Slavery Era Business
U.S. Bank National Association was formed from the following major banks: (1) Star Bank, National Association (Cincinnati, Ohio) changed its name to Firstar Bank, National Association (Cincinnati, Ohio) effective February 1999; (2) Mercantile Bank National Association (St. Louis, Missouri) merged into Firstar Bank, National Association (Cincinnati. Ohio) effective April 2000; (3) United States National Bank of Oregon (Portland, Oregon) merged with First Bank, National Association under the title U.S. Bank National Association effective August 1997; (4) U.S. Bank National Association merged into Firstar Bank, National Association, and the succeeding bank, changed its name to U.S. Bank National Association effective August 2001 These banks acquired through mergers and acquisitions numerous smaller banks. There are five hundred and forty-two U.S. Bank National Association predecessors. Thirty-five predecessors were founded before the abolition of slavery in December 1865. Thirteen of the pre-1866 predecessors were established in southern slave-holding states and territories, including Kansas, Kentucky, Missouri'and Tennessee
In reviewing historical records held in various external repositories in accordance with the research requirements as set forth in the City of Chicago Office of the Corporation Counsel opinion letter dated April 29, 2004 (attached hereto), U.S. Bank National Association has identified external records of its predecessors which necessitate disclosure. The conveyance records, while showing no record of direct ownership of enslaved individuals did contain records of founders and/or directors of-predecessor banks owning enslaved individuals; as well as a record.where an, enslaved individual was the collateral for a loan. Specifically^the first president of predecessor Marion National Bank of Lebanon,' Kentucky (founded 'in 1656), Benedict Spalding, owned two enslaved individuals in 1850. In 1860 someone with a similar name "Benidict Spalding" is also listed as having owned fourteen enslaved individuals. ln,addition, certain members of the Marion National Bank of Lebanon's board of directors (called "commissioners") owned approximately forty-seven enslaved individuals in total (the records include abbreviated names, which we conclude may be references to commissioners). The first president of predecessor First National Bank of Clarksville, Tennessee (founded in 1865), S.F. Beaumont, owned one enslaved individual in 1860. The first president of predecessor St. Louis Building and Savings Association, Missouri (formed.in 1857), Marshall Brotherton, owned ten enslaved individuals in 1850 and four enslaved individuals in 1860. Merchants Bank (founded in 1857) and Bank of St. Louis .(founded in 1857), both predecessors, along with a group of other St. Louis firms, issued a mortgage to Charles McLaran that was secured by his property, which included an unspecified number of enslaved individuals. However, the 1860 Federal Census Slave Schedule for St. Louis provided that Charles McLaran owned thirteen enslaved individuals.
The above is only a summary. U.S. Bank National Association has previously provided the City ot Chicago with supporting attachments.
U.S. Bancorp, the parent company of U.S. Bank National Association, was founded after the slavery era and has no separate assets or activities that pre-date the 20th century. As such, it has no disclosure separate from that of the bank.
April 29, 2004
Ot) of Oiicap.o Hiclurd M. Daley, Maynr
OtparloifntorLa?'
MaiaS. Gtorjcs Corporation Counsel
Cil/Hslt, Room 600 121 North LiSalitSlirct Chiraxo, Illinois 60602 (3I2)*7«^900 (}!2) 7-M-S538 (FAX) ¦ (312) 744-2963 (ITr)
http;//mv(v.ri.chi.U.u(
Hon.Edward M. Burke
Chairman, City Council Committee on Finance City Hall, Room 302 121 North LaSalle Street Chicago Illinois 60602
Rc: Question, regarding Economic Disclosure Statement and Affidavit, Part VI ("Ccitificalion Regarding Slavery Era Business") and Resolution pending before the Joint Committee on Finance and Human Relations
Dear A lderman Burke:
In a letter dated April 26,2004, you indicated Lhat a special committee of the City Council, consisting ofthe combined. Committee on Finance and the Committee on Human Relations, currently has under consideration a resolution that raises certain issues regarding mleipretation of Section 2-92-585 ofthe Chicago Municipal Code, tlie Business, Corporate and Slavery Era Insurance Ordinance. That ordinance requires every city contractor to "complete an affidavit verifying that the contractor has searched any and all records ofthe company or any predecessor company regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era. The names of any slaves or slaveholders described in those records must be disclosed in thc affidavit." (Emphasis supplied)
The affidavit requirement of Section 2-92-585 has been incorporated into the standard Economic Disclosure Statement ("EDS") completed by city contractors as Part VL entitled "Slavery CctliCcalion." Hie EDS requires an entity contracting with the city to verify that it has "searched any and all records of the Undersigned and any and all predecessor entities for records of investment-; or profits from slavery, the slave industry, or shareholder insurance policies." (Emphasis supplied) The EDS form then requires the contracting entity to disclose the results of that search.
You have asked specifically whether it is "reasonable to interpret the language 'records of tlie undersigned and any and all predecessor euuues' to mean [the contracting entity's] records and the records of ils predecessor entities." For the reasons that follow, it is thc opinion of this office that the answer is in the
m
Hon. Edward M. Burke April 29, 2O04 Page 2
affirmative. A search required for proper compliance with and disclosure under Section 2-92-585 must include all known records ofthe contracting entity and each of its predecessor entities, to which records thc contracting entity has or can obtain access.
Neither the ordinance nor any Illinois decision defines a "predecessor" entity of a city contractor. Underlie general rules of statutory construction, the word should be given its ordinary meaning. Black's Law Dictionary' defines "predecessor" as "one who goes or has gone before; the correlative of
'successor' Applied to a body politic or corporate, io the same sense as
'ancestor' is applied to a natural person." This simple analogy indicates that every known antecedent entity of a city contractor — acquired entities, components of earlier mergers, entities acquired by and subsumed into a prior entity thai became a predecessor of a contracting entity — should be treated as a predecessor. Tliis is especially appropriate when one considers the preamble to the ordinance adding Section 2-92-385 to the Chicago Municipal Code. Tlie fifth paragraph ofthe preamble (found at page 94891 ofthe Journal of Proceedings of tho City Council of October 2, 2002) refers to records located in thc archives of current insurance firms, documenting slave insurance policies "issued by a predecessor insurance linn; the sixth paragraph (id.) refers to "insurers and businesses whose successors remain in existence today." Thus tlie City Council recognized that, as the American economy has expanded and become more complex, modem business may include different business disciplines (insurers and other businesses).
The appropriate extent ofthe mandated records search can also be discerned from tbe preamble. Thc final paragraph of the preamble (p. 91892) contains a finding ofthe City Council that entities "doing business with the City of Chicago shall take any and all steps in goodfaith to disclose any records within their possession or knowledge relating to investments or profits from the slave industry including insurance policies.." (Emphasis supplied) In order to implement this statement ofthe Council's intent, a contracting entity may not ignore records that are archived outside thc entity's possession (e.g. in a museum, university library, historical society or trade association). To ignore deliberately the existence of such known records could not possible constitute a "good faith" effort to take "any and all steps" lo document the contractor's history. The breadth of the City Council's desired disclosure also led this department, in the-revision of the EDS necessary to implement Section 2-92-585, to change tlie ordinance's disjunctive in the reference to "any 3nd all records ofthe [contracting] company or its predecessors" lo a conjunctive in the EDS ("any and all records of
Hon- Edward M. Burke April 29,2004 Page 3
thc [contracting entity] and any and all predecessor entities").
Should you need additional assistance, please do not hesitate to contact
mc.
Very truly yours,
MARA S. GEORGES Corporation Counsel
Thc 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) ofthe Internal Revenue Code of 1986; or (ii) it.is an organization described in section. 501(c)(4) ofthe Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If thc Disclosing Party is thc Applicant, thc 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 thc duration of thc Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If thc Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit thc following information with their bids or in writing at the outset of
negotiations' ffttffcT f&emxy ftis>WSr>
Is the Disclosing Party the Applicant?
f]Ycs ^ 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, thc Director of the Office of Federal Contract Compliance Programs, or thc Equal Employment Opportunity Commission all reports due under tbe applicable filing requirements?
[ ] Yes [ ] No
Have you participated in any previous contracts or subcontracts subject to thc equal opportunity clause?
[ ] Y es [ ] 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:
A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between tlie Applicant and thc City in connection with thc 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 al! statutes, ordinances, and regulations on which this EDS is based.
fi. 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 ord inances and a training program is available on line at www.citYofchicaKo.orfi/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 contractor 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 incarcerationand an award to the City of treble "damages.
It is.the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all ofthe information provided on this EDS and any attachments to this EDS may be made available to thc 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 thc 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 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period,
.: : ¦• * i j c_„*: -! i z/. .-.-j.", „ *.,?,._:„; s
ai, itijuiicu.uy v_/jjajnci aiiu ljcuuuii i-un-uii; \ji ilk* .uuuii^i(jai v^uue.
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, thc Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by thc U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F. 1. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf ofthe Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
U.S. Bank, National Association
(Print or type name of Disclosing Party)
X^tSign here)
(Print or type name of person signing) (P'rint or type title of person signing)
Signed and sworn to before me on (date)
at by. V^-ovS Cmmty, ^xs^ox^ (stale).
V^i^Q^CrV^ "q)- y>C- Notary Public.
Commission expires:
Pase 12 of 13
REBECCA L SEITZ Notary Public-Notary Seal State ot Missouri, Saint Louis City Commission # 15223866 My Commission Expires Aug 26, 2019
U.S. BANK NATIONAL ASSOCIATION ASSISTANT SECRETARY'S CERTIFICATE
I, Natasha M. Knack, an Assistant Secretary of U.S. Bank National Association, hereby certify that the following is a true and exact extract from the Bylaws of U.S. Bank National Association, a national banking association organized under tlie laws ofthe United States (thc "Association").
ARTICLE VI. CONVEYANCES, CONTRACTS, ETC.
All transfers and conveyances of real estate, mortgages, and transfers, endorsements or assignments of slock, bonds, notes, debentures or otiier negotiable instruments, securities or personal property shall be signed by any elected or appointed officer.
All checks, drafts, certificates of deposit and all funds ofthe Association held in its own or in a fiduciary capacity may be paid out by an order, draft or check bearing the manual or facsimile signature of any elected or appointed officer ofthe Association.
All mortgage satisfactions, releases, all types of loon agreements, all routine transactional documents of thc Association, and all other instruments not specifically provided for, whether to be executed in a fiduciary capacity or otherwise, may be signed oh behalf of tlie Association by any elected or appointed officer thereof.
The Secretary or any Assistant Secretary of the Association or other proper officer may execute and certify that required action or authority has been given or has taken place by resolution of the Board under this Bylaw without the necessity of further action by the Board.
I further certify that Stephen Michael Begany, Assistant Vice President, is a duly appointed and qualified officer of the Association authorized to act under Article VI of the Bylaws of the: Association and that such authority is in full force and effect as of the date hereof and has not been modified, amended or revoked.
IN WITNESS WHEREOF, 1 have set my hand this 30th day of November, 2015. (No corporate seal)
Natasha Knack, Assistant Secretary
Individual
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.lhc Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in thc 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 ofthe date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrodier or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers ofthe Disclosing Party listed in Section ILB.l.a., if the Disclosing Party is a corporation; all partners ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of tlie Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members ofthe Disclosing Party, if the Disclosing Party is a limited liability company, (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7,5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
r 1 yes oNo Tl ^' f*Sr OF 06^ J^«AJ^k±f
[]Yes ^No /trjML ixjuwutzy
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 ofthe 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
BULLDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is fo 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 ofthe Municipal
Code?
[ ]Ycs
2. If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of die Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
C lYes
3. If yes to (1) or (2) above, please identify below the name ofthe person or legal entity
identified as a building code scofflaw or problem 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.
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: Pullman Transformation Inc.
Check ONE ofthe following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[ ] the Applicant
OR
P<] 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: North Pullman 111th Inc.
OR
3. [ ] a legal entity with a right of control (see Section ILB.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control:
Business address ofthe Disclosing Party: 800 Nicollet Mall
Minneapolis, MN 55402
C Telephone 314-335-2529 Fax. 314-335-2568 Email benjamin.alderton@usbank.co
Name of contact person: Benjamin Alderton
Federal Employer Identification No. (if you have one): _
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Amendment to Planned Development No. 1167 (Pullman Park) for property located at 720 East 111th Street (111th and Doty)
Which City agency or department is requesting this EDS? Plan"in9 and Development
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature ofthe Disclosing P [ ] Person
[ ] Publicly registered business corporation tyQ Privately held business corporation [ ] Sole proprietorship [ j General partnership [ ] Limited partnership [ ] 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)
For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
Deofiv/tt&'i t).s-t\-.
For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
[]Yes t#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 tbe 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 on EDS on its own behalf.
Name Title
indirect beneficial interest (including ownership) in excess of 7.5% ofthe Disclosing Party. Examples of such an interest iuclude shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
Entity Name: Pullman Iransforrratiori, Inc.
Dolan. Terrance R Director Director
Giise, Stephanie M Director Director
Dolan. Terrance R - ¦ President and Treasurer - Officer - --- -
Glover, Lisa Senior Vice President Officer
Kaish. Matthew B. Senior Vice President and Assistant Secretary Officer
Scnbner, Brett E Vice President Officer
Bednarski, Laura F. Senicr Vice Presided! and Secretary Officer
Shea, Jeffrey W. Vicu President and Treasurer Officer
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
OS • fl/ME-. AM llo hWs P 9lbi ti/C6/I.fr A/Jp/ r /oo'/o
. MtiHtrffbUS; MAI .>&/6X-
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?
rjYes [&No ^-T^HW^'i *(your k^v\^c} ctr^d^
If yes, please identify below thename(s) of such City elected official(s) and^desenbe 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 ofthe relationship, and tbe 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 otiier than: (1) a not-for-profit entity, oq 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 Parly must either ask thc 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.
{^sr,jL-.£L£cr\k)ta^ tc£- /7o cv^/jptter. su/i?, ^o arjuf^-y »ao -
, QjjS'i^Dl).. $LUQfy MP frl/Q 5~ .
(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.
l
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 ^Kj 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 to Municipal Code Chapter 1-23, Article I ("Article I")(which thc 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(ij) 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, thc 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 ILB.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 ofthe 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 die City or by the federal government, any state, or any olher 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, oris, 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 ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization ot a responsible oiticiaj ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either tbe 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 thc five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
a bribed or attempted to.bribe, or been convicted .or adjudged guilty.of bribery or attempting to.
bribe, a public officer or employee ofthe City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b.- above that is a matter of record, but have not been prosecuted for such conduct; or
violated thc 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 of any state or of the United States of America that contains thc same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security ofthe 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 tbe 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 Pari B (Further Certifications), the Disclosing Party must explain below:
/jqaj£ ;
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 ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees ofthe Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none").
None
9. To the best ofthe 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 ofthe City recipient. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is [yi is not
a "financial institution" as defined in Section 2-32-455(b) ofthe 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 ofthe 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 ofthe Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in
Op^tjn,, 0-7.1-A^.'ifhA nf thp Munirinnl (~*.-mj.p'\ ic s nrpri-atnnr IpnHpr tiMtrjin thp rp f» cs n 1 ni rr nf flmnfpr
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 ofthe 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? ~ r^ ^fCf oj£_ £UWl,(LV6fr,
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 tbe 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 ofthe 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 thc Matter involve a City Property Sale? []Yes t)$[o
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 thc 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 au 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 thc Matter voidable by the City.
X 1- The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Parly and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during thc 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 thc 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 thc following constitutes full disclosure of all such records, including thc 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 ofthe City arc not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1, List below thc names of all persons or entities registered under thc federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf ofthe 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 thc 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. Thc 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 federai 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 thc end of each calendar quarter in which there occurs auy 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) ofthe Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A,4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration ofthe Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require thc Applicant and all proposed subcontractors to submit the following information with their bids or in writing at thc outset of
negotiations- f^jeoT IS N*T f^e^AuN ]£/JvW3>
Is the Disclosing Party thc Applicant?
[] Yes
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (Sec 41 CFR Part 60-2.)
[ ] Yes [ ] No
Have you filed with the Joint Reporting Committee, the Director of thc Office of Federal Contract Compliance Programs, or thc Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[]Yes []No
Have you participated in any previous contracts or subcontracts subject to thc 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 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 ail 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.cityofchicaAo.orK/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 ofthe information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
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 thc City takes action.on the Matter. If the Matter is a contract being handled by tbe City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required 'oy Chapter t-2j and Section 2-ij4-0'2O.oi the fviuincipui Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.). The Disclosing Parry is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor ate the Disclosing Pan\ or its Affiliated Entities delinquent in paying any fine, foe. 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- Parry 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 Panics List System ("EPLS") maintained by tbe U. S. General Services Administration.
F.3 if ihe Disclosing Party is the Applicant, the Disclosing Party will obtain from any cor. tr a ;tors/sub contractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F. 1. and F.2. above and will not, without the prior written consent ofthe Citv use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason 10 believe has not provided or cannot provide truthful certifications.
NOTE; If the Disclosing Pany 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: (]) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of tbe date furnished to thc City. ¦
Pullman Transformation, Inc.
(Print or type name of Disclosing Party)
(Print cr type name of person signing)
D i rector
(Prim or type title of person signing )
/
/
T —
Signed and swprr; .to Betore :ne 0n (Q.te) >v y4 ><.
at '!y -. . •''W/ .County. l./¦'/(./ 1_ (stat
C orr.iii j s si on expires: / /4/ /A
JULIE BIERMAN Notary Public-Notary Seal State ot Missouri. St Louis County
Commission # 14563966 Mv Commission Expires Jan 6, 2018
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 dale 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 (I) all executive officers ofthe Disclosing Party listed in Sectiorj ILB.l.a., if the Disclosing Party is a corporation; all partners ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the D isclosing 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 ofthe 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 thc 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 m*3T^ oOrC KWLfb&k,
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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 ouly 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 tp 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 ofthe Municipal
Code?
[ ]Yes
2. Tf thc 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
3, If yes to (1) or (2) above, please identify below'the name ofthe person or legal entity
identified as a building code scofflaw or problem landlord and the address ofthe 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 ofthe Disclosing Party submitting this EDS. Include d/b/a/ if applicable: North Pullman 111th Inc.
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[XI 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 ILB.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: 800 Nicollet Mall
Minneapolis, MN 55402
Telephone: 314-335-2529 Fax. 314-335-2568 Email: benjamin.alderton@usbank.co
Name of contact person: Benjamin Alderton
Federal Employer Identification No. (if you have one):
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Amendment to Planned Development No. 1167 (Pullman Park) for property located at 720 East 111 th Street (111 th and Doty)
Which City agency or department is requesting this EDS? Plannin9 and Development
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature ofthe Disclosing Party:
[ ] Person [ ] Limited liability company
[ ] Publicly registered business corporation [ ] Limited liability partnership
\$ Privately held business corporation [ ] Joint venture
[] Sole proprietorship [] Not-for-profit corporation
[ ] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
[] Limited partnership [ ] Yes [ } No
[ ] Trust [ J Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
3. For legal entities nol organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
[]Yes [3 No £4 N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
I. List below the full names and titles of all executive officers and all directors ofthe 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 otiier similar entities, list below the legal titlcholder(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
2. Please nrovide thc 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
Entity Name: North Pullman 111th Inc.
Dolan. Terrance R. Director ' Director
Grise, Stephanie M Director Direclor
Shea, Jeffrey W Director Director
Dolan, Terrance R. President and Treasurer Officer
Grise. S'.ephanie M Vice President Officer
Scribner, Brett E Vice President Officer
Shea, Jeffrey W. Vice President Officer
Bedford, Atyn L. Assistant Secretary Officer
Bidon, Linda E. Assistant Secrotary Officer
Krjsh, Matthew B. Assistant Secretary Officer
Maiser, Elizabeth E Assistant Secretary Officer
Bednarski, Laura P. Secretary Officwr
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None.'" NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in tbe
Disclosing Party
Mlkitir.Arx.JS, Mk\
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
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If yes, please identify below thc 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 subcontractorattorney, 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 thc nature ofthe relationship, and the total amount of thc fees paid or estimated to be paid. The Disclosing Party is.not required to disclose employees who are paid solely through thc 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 Parly must cither 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.
ffrx^/r P/.ackja',//, /lo c.AK£>h}P&L*r ^a/rr. /coo ArrdtM.y >j/0/o ao - esf,^
(Add sheets if necessary)
[ ] Check here if tlie 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 ofthe 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 and 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 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,1 !forgery, perjury, dishonesty or deceit against an officer or employee ofthe City or any sister agency; and-(ii) tlie 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 thc 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 ILB.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 offeDse, 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 properly;
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any ofthe offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding thc 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.
Thc certifications in subparts 3, A and 5 concern:
the Disclosing Party;
any "Contractor'1 (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 tlie Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of thc Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Parly, nor any Contractor, nor any Affiliated Entity of 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 Contraclor 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 ofthe City, tlie State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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 or ofthe United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any ofthe following lists maintained by the Office of Foreign Assets Control ofthe U.S. Department ofthe Treasury or the Bureau of Industry and Security ofthe 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.
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.
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 ofthe 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, ofthe 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, ofthe 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. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is [y\ 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
Qprtinn O-IO-d^^fhA nfth.P IVTljnipir-.nl Cnr1.^ a r.rpHatnn; IsnHpr %3,-ir!-. in tUe> mAoninn nf Hiantor
V v 11 2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terras that are defined in Chapter 2-156 ofthe Municipal Code havethe.same meanings when used in this Part D.
In accordance with Section 2-156-110 ofthe Municipal Code: Does any official or employee
of the City have a financial interest in his orher own name or in the name of any other person or
entity in the Matter? ^ Tb "WrSfet 0(-oO(Z- KVwlr-tzpGg.
NOTE; If you checked "Yes" to Item D.l., proceed to Items D.2. andD.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 tlie City's eminent domain power does not constitute a financial interest within tlie meaning of this PartD,
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 thc City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. Thc 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.
V 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 pr profits from slavery or slaveholder insurance policies during tlie 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 tlie 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
fnnded, 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. , .
f^ecr ft N*7 ?&>e*k\X\ f^»££>
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all persons or entities registered under thc federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of tbe 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 thc 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 fedeial law, a member of Congress, an officer or employee of Congress, or anerriployee 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 thc accuracy ofthe statements and information set forth in paragraphs A.l. and A.2, above.
The Disclosing Party certifies that either: (i) it is not an organization described in section -591(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 thc Disclosing Party must maintain all such subcontractors' certifications for the duration of thc Matter and must make such certifications promptly available to the City upon request.
13. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require the Applicant and all proposed
subcontractors to submit the following information with their bids or in writing at the- outset of
negotiations. ffo^^t K NOl f&>£Is the Disclosing Party the Applicant?
b<(Yes [ 1 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
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes [ ] No
If you checked "No" to question 1. or 2. above, please provide an explanation:
Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and are material inducements to the City's execution
¦ of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cttvofchicago.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 tlie 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 Cily 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 die 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 tlie City in connection with the public release of information contained in this EDS and also authorizes the City to verify tlie 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 tlie Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
Thc Disclosing Party represents and warrants that:
Page 11 of 13
F.i. The Disclosing Party is not delinquent in ihe payment, of any tax administered by ihi Illinois Department of S.ev enue, nor are the Disclosing Party or its Affiliated Entities dciinquent in paying any tine, fee, rax o; other charge owed to die 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 permn 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 Parry is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors-hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without thc prior written consent ofthe. City, use any such contractor/subcontractor that does not provide such certifications oi 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. 1... F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants thai he/she is authorized to execute this EDS and Appendix A tif applicable) on behalf ofthe Disclosing Party, and (2) warrants thai all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
North Pullman 11 lth Inc.
(Print or type name of Disclosing Party)
(Sign here)
v:
(Print or type name of person signing)
Vice President (Print or type title of person signing)
at > ...
(state). Notaiy Public.
Signed and ;:\vorn to before me on. (da.te)\>,./ ,-f. ^O /fe
';,y,-:ir ¦ Xouii'ly, y
l ommission expires:_
JULIE BIERMAN Notary Public-Notary Seal State of Missouri, St Louis County Commission # 14563966
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 ofthe date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as-spouse or domestic partner or as any ofthe following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers ofthe Disclosing Party listed in Section TLB. La., if the Disclosing Party is a corporation; all partners ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members ofthe Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers ofthe 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?
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 thc 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
APPENDLX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is fo be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in thc Applicant exceeding 7.5 percent (an "Owner"). It Is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 ofthe Municipal Code'/
[ ]Yes p^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 M unicipal Code?
[JYes [ ]No h/] Not Applicable
3. If yes to (1) or (2) above, please identify below the name ofthe person or legal entity
identified as a building code scofflaw or problem 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 APPENDLX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OFTHE 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: U.S. Bancorp
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
Applicani in which the Disclosing Party holds an interest: North Pullman 111th Inc.
OR
3. [ ] a legal entity with a right of control (see Section ILB.l.) State the legal name of the entity in
which thc Disclosing Party holds a right of control:
B. Business address of the Disclosing Party: 800 Nicollet Mall
Minneapolis, MN 55402
C Telephone 314-335-2529 Fax. 314-335-2568 Email benjamin.alderton@usbank.
Name of contact person: Benjamin Alderton
Federal Employer Identification No. (if you have one):
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Amendment to Planned Development No. 1167 (Pullman Park) for property located at 720 East 111th Street (111th and Doty)
Which City agency or department is requesting this EDS? Plannin9 and Development
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of thc Disclosing Party:
[ ] Person [ ] Limited liability company
[}§ Publicly registered business corporation [ ] Limited liability partnership
[ ] Privately held business corporation [ ] Joint venture
[ ] Sole proprietorship [ ] Not-for-profit corporation
[ ] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
[ ] Limited partnership [ ] Yes [ ] No
[ ] Trust [ ] Other (please specify)
2. For legal entities, thc 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?
[]Yes fed 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 titlcholder(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
Please see attached
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
Name Title ¦-¦¦ ;. ' .' ' . . Title Role
Davis, Richard K. Director, Chairman ofthe Board Director
Baker, Douglas M. Jr. Director Director
Baxter, Warner L. Director , Director
Casper, Marc N. Director Director
Collins, Arthur D. Jr Director Director
Harris, Kimberly J. Director Director
Hernandez, Roland A. Director Director
Johnson, Joel W. Director- — - - - - - Director
Kirtley, Olivia F. Director Director
Lynch, Karen S. Director Director
O'Maley, David B Director Director
Owens, O'dell M. Director Director
Schnuck, Craig D. Director Director
Stokes, Patrick T. Director Director
Wine, Scott W Director Director
Woo Ho, Doreen Director Director
Davis, Richard K Chairman and Chief Executive Officer Officer
Carlson, Jennie P. Executive Vice President Officer
Chosy, James L. Executive Vice President, General Counsel and Secretary Officer
Gifford, Craig E. Executive Vice President and Controller Officer
Oldshue, Paul F. Executive Vice President Officer
Runkel, Mark G. Executive Vice President and Chief Credit Officer Officer
Somers, Timothy W. Executive Vice President Officer
Stern, John C. Executive Vice President and Treasurer Officer
Bednarski, Laura F. Senior Vice President and Assistant Secretary Officer
Bradley, John A. Senior Vice President Officer
Burke, Deborah M Senior Vice President Officer
Canon, Karen J. Senior Vice President Officer
Flagstad, Lynn D. Senior Vice President Officer
Good, Daniel Senior Vice President Officer
Martin, John W. Senior Vice President Officer
McCarver, Jeannie L Senior Vice President Officer
Raffetto, Richard A. Senior Vice President Officer
Shaheen, Christopher T Senior Vice President Officer
Spiller, Daniel H. Senior Vice President Officer
Wippler, Luke R Senior Vice President Officer
Becker, Elizabeth L. Vice President Officer
Fenske, Scott A. Vice President Officer
Griner, Robert E Vice President Officer
Holden, Stacie M Vice President Officer
Krush, Matthew B. Vice President and Assistant Secretary Officer
MacMillan, Kevin M Vice President and Associate General Counsel Officer
Nikolai, James T Vice President Officer
Shea, Jeffrey W. Vice President Officer
Tessmer, Joseph M. Vice President Officer
Cecere, Andrew President & Chief Operating Officer Officer
Dolan, Terrance R. Vice Chairman Officer
Elmore, John R. Vice Chairman Officer
Godridge, Leslie V. Vice Chairman Officer
Kelligrew, James B. Vice Chairman Officer
Kotwal, Shailesh M. Vice Chairman, Payment Services Officer
Parker, P.W. (Bill) Vice Chairman and Chief Risk Officer Officer
Payne, Richard B Jr. Vice Chairman Officer
Quinn, Katherine B. Executive Vice President, Chief Strategy and Reputation Officer Officer
Rogers, Kathleen A. Vice Chairman and Chief Financial Officer Officer
Stone, Kent V. Vice Chairman Officer
von Giller'n, Jeffry H. Vice Chairman Officer
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in thc
Disclosing Party
None -
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
[ ] Yes [X) No * To the best of our knowledge, after due inquiry
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 ofthe relationship, and thc 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 Partv must either ask the Citv whether disclosure is reauired or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
(Add sheets if necessary)
[)i 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 M No person directly or indirectly owns 10% or more ofthe
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 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 ILB.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 ofthe 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.procceding, or in any criminal or.civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
any responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
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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 ofthe City, the State of Illinois, or any agency of the federal -government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
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 or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither thc Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control ofthe U.S. Department of the Treasury or the Bureau of Industry and Security ofthe U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), thc Disclosing Party must explain below:
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 ofthe Disclosing Party's knowledge after reasonable inquiry, thc 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 ofthe 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, ofthe 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 ofthe City recipient. None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
M is [ ] is not * by nature of its status as a "bank holding company"
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 ofthe 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
Q.o.-ti.-.;-. O-IO-J^.'M nf th.-* Mun^rtol n^Ar.\ ,c o nroHotnrelAidor 117! thin tho main Mir. nffho^r
2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 ofthe Municipal Code: Does any official or employee ofthe 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 * To the best of our knowledge, after due inquiry
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 [Xj No
If you checked "Yes" to Item D.l., provide the names and business addresses ofthe City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with thc 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.
X 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:
this regard. The operating bank that the Disclosing Party holds, U.S. Bank National Association, has disclosed its slavery era business history on its EDS regarding this Matter.
SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VL If the Matter is hot federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations ofthe City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING * Project is not federally funded
1. List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf ofthe 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 poiaun \ji i^uiiLjr tu luiiui/iii/u ui aiLi'iupi uO iUi.iUuiiCC an Oiiicci* or employee oi any agency, as ociiiicu oy 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 thc accuracy ofthe statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of 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 Party must maintain all such subcontractors' certifications for thc 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? * Pro-'ect is not federail>' m"ded
[ ] Yes K| 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
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 thc 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.
-D; It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on thc Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 ofthe Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. The Disclosing Parly is not delinquent in the payment of any tax administered by lhe Illinois Department of Revenue, nor are rhe Disclosing Party or its Affiliated Entities delinquent in paying any tine, 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 lo use, any facility listed by the U.S. E.P.A. on thc federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If thc Disclosing Party is the Applicant, thc 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. I. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that thc Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants lhal he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as ofthe date furnished to the City.
(Print or type^name of Disclosing Party)
(Print or type name of person signing) (Print or type title of person signing)
Signed and sworn to before me on (date) I'Af^iL. £~ 2>o\ W , at J1/ziOMrlUCL__ County, rMn n&SQ-ffl (state).
ffl$^/ttTft7/7frf ""S^^Wotary Public.
( v f /
Commission expires: d\ (31 I 2.(37J3 ¦
$/$?^ NATASHA MARiE KNACK | NOTARY PUBLIC • MINNESOTA » ?' ^ias^ M, Commtssior Expsw Jan. 3i, 2020 |
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 ofthe date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, 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 ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe 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 * To the best of our knowledge, after due inquiry
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.
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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 interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
[ ]Yes [x]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 ofthe Municipal Code?
[ ] Yes [ ] No [X] Not Applicable
3. If yes to (1) or (2) above, please identify below the name ofthe person or legal entity
identified as a building code scofflaw or problem 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.
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I-- GENERAL INFORMATION
A. Legal name of the Disclosing Party-submitting this-EDS. Include d b;a/ if applicable: Chicago Neighborhood Initiatives, Inc.
Check ONE of the following three boxes:
Indicate whether thc 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 ofthe
Applicant in which thc Disclosing Party holds an interest:
OR
[ ] a legal entity with a right of control (sec Section ILB.l.) State the legal name ofthe entity in
which the Disclosing Party holds a right of control:
[X] the proposed transferee and developer of the property that is the subject of the Matter.
Business address of the Disclosing Party:
1000 E. 111th Street
Chicago, Illinois 60628
Telephone: (773) 341-2063 Fax: Email: amarks@cnigroup.org
Name of contact person: Angelica Marks
Federal Employer Identification No. (if you have'one):
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Amendment to Planned Developer No. 1167 (Pullman Park) for property located at 720 East 111th Street (111th and Doty)
G. Which City agency or department is requesting this EDS'7 Planning and Development
If thc Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification H and Contract #
Page I of 13
SECTION 11 -
- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing P;; [ ] Person
[ ] Publicly registered business corporation [ J Privately held business corporation [ ] Sole proprietorship [ ] General partnership [ ] Limited partnership [J Trust
[ J Limited liability company [ ] Limited liability partnership [ J Joint venture [x| Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
IX Yes [ ] No
[ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:' Illinois
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in thc Stale of Illinois as a foreign entity?
[ ] Yes [ ] No [ ] N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below thc full names and titles of all executive officers and all directors of thc 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 titlcholder(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 ofthe Disclosing Parly. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title
No Members ¦
See attached list of Directors
David Doiq. President
Jennifer Bransfield, Assistant Secretary
2. Please provide thc 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 simitar entity. If none, state '"None.'' NOTE: Pursuant to Section 2-1 54-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
None - - - — - -
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 ofthe Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
f ] Yes y 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 thc nature ofthe 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 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 lo Disclosing Pany 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.
DLA Piper 203 N LaSalle Street, Suite 1900 Attorney $15,000 (est.)
Chicago, Illinois 60601
ZPD+A 901 W Jackson, Suite 204 Architect $10,000 (est.)
Chicago, Illinois 60607
(Add sheets if necessary)
v.
f ] 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 thc City must remain in compliance with their child support obligations throughout thc 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 [X.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 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, thehVihe'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 eve'r-bech 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 anofficer 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:
arc 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 offenseradjudged guilty,- or-had- a civil judgment rendered against them in-conncction 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 ofthe offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding thc 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 thc date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any , state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
¦ any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties"):
any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with thc Disclosing Parly, 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 ihe Cily, using substantially thc same management, ownership, or principals as thc ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
• any responsible official ofthe Disclosing Party, any Contraclor or any Affiliated Entity or any other official, agent or employee of the Disclosing Parry, any Contraclor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity oi either the Disclosing Party or any Contractor nor any Agents have, during the five years before the dale this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before ihe dale of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matler:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee ofthe City, the Stale of Illinois, or any agency of the federal government or of any slate 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 lhal is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local 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 LLCS 5/33E-4; or (3) any similar offense of any state or of thc United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign 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: thc Specially Designated Nationals List, the Denied Persons List, thc Unverified List, the Entity List and the Debarred List.
The Disclosing Party understands and shall comply with thc applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) ofthe Municipal Code.
If lhe Disclosing Parly is unable to certify to any ofthe above statements in this Part B (Further Certifications), thc Disclosing Party must explain below:
None
Page 6 of 13
If thc letters "NA," the word "None," or no response appears on ihe lines above, it will be conclusively presumed that thc Disclosing Party certified to the above statements.
8. To thc best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees ofthe Disclosing Parly 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 thc best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a
complete lisi of all gifts that the Disclosing Party has given or caused to be given, at any time during the
1 2-month period preceding the execution date of this EDS, to an employee, or elected or appointed
official, ofthe City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything
made generally available to City employees or to ihe general public, or (ii) food or drink provided in (he
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 thc name ofthe City recipient.
None
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) ofthe 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 ofthe Municipal Code. Wc understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe privilege of doing business with the City."
If thc Disclosing Party is unable lo make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) ofthe Municipal Code) is a predatory lender within the meaning of Chapter 2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If thc letters "NA." thc word "None," or no response appears on the lines above, it w ill 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 ofthe Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 ofthe Municipal Code: Does any official or employee of thc City have a financial interest in his or her own name or in the name of any other person or entity in the Matler?
[JYes [XNo
NOTE: If you checked "Yes" to Item D.l., proceed to Hems 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 thc purchase of any property that (i) belongs to thc 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 lhc City's eminent domain power docs not constitute a financial interest within thc meaning of this Part D.
Does thc Matter involve a City Property Sale?
[ ] Yes [ ] No
If you checked "Yes" to Item D.l., provide the names and business addresses ofthe City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial iiueresi in the Matter will be acquired by any Cily official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 1. or 2. below. If thc Disclosing Party checks 2., lhc Disclosing Partv 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 thc Matter voidable by the City.
X 1. The Disclosing Partv verifies that the Disclosing Partv has searched anv 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 thc 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 thc 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 ofthe City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all persons or entities registered under thc federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf ofthe Disclosing Parly with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matler.)
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 thc accuracy ofthe statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies lhat either: (i) it is not an organization described in section 501(c)(4) of ihe Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is thc Applicani, 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 ofthe Matler and must make such certifications promptly available to the Cily upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If lhe Mailer is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids of in writing al the outset of negotiations.
Is the Disclosing Party thc 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 requirements?
[ ] Yes [ ] No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity-clause?
[ ] Yes [ ] No
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Page 10 of 13
SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
Thc 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 of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cityofchicago.org/Ethics . and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with lhe 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 tenninating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all ofthe information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify thc accuracy of any information submitted in this EDS.
The information provided in this EDS must be kept current, fn the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility musl be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 ofthe Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. Thc Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor arc 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, thc 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 Parly will obtain from any contractors/subcontractors hired or to be hired in connection with thc Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent ofthe City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If thc Disclosing Parly cannot certify as to any of the items in F.L, F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (inapplicable) are true, accurate and complete as ofthe date furnished to the City.
Chicago Neighborhood Initiatives, Inc.
(Print or type name of Disclosing Party)
(Sign here)
By:
David Doig
(Print or type name of person signing)
President
(Print or type title of person signing)
Signed and sworn to before mc onjdate) hidY 0% 20((a at dO/Oytr County, '/*//ssf*l
Notary Public.
Commission expires: Qtttf-. ( £., '2-Q .
Page 12 of 13
OFFICIAL SEAL MARIA G MEDUGA Notary Public -.State.of Mimas My Commission Expires Oct 12, 2013
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to he completed by any legal entity which has only an indirect ownership interest iti 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 ofthe dale 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 ofthe following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brolher or half-sister.
"Applicable Party" means (1) all executive officers ofthe Disclosing Party listed in Section II.B.La., if the Disclosing Parly is a corporation; all partners ofthe Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited panners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members ofthe Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the'Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
[ ] Yes fXJ 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 ofthe elected city official or department head to whom such person has a familial relationship, and (4) the precise nalure 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.
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 ofthe Municipal Code?
[ ]Yes [X]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'scoffiaw or problem landlord pursuant to Section 2-92-416 of the . Municipal Code?
[ JYes [ ]No [x] 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 and the address-of the building or buildings to which thc 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 FART.-iOF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATIONi MAI^E UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
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