OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR
January 13, 2016
TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request of the Commissioner of Planning and Development, I transmit herewith an ordinance amending a previously passed land sale with Windy City Habitat for Humanity.
Your favorable consideration of this ordinance will be appreciated.
Mayor
Very truly yours,
I
ORDINANCE
WHEREAS, the City of Chicago ("City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970, and as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, pursuant to an ordinance adopted on April 22, 2009, and published at pages 58465 through 58537 in the Journal of the Proceedings of the City Council for such date (the "Ordinance"), the City and Windy City Habitat for Humanity, Inc., an Illinois not-for-profit corporation (n/k/a Habitat for Humanity Chicago) ("Developer"), have entered into that certain Agreement for the Sale and Redevelopment of Land (the "Agreement"), dated May 2, 2011, and recorded in the Office of the Recorder of Deeds of Cook County, Illinois (the "Recorder's Office") on May 4,2011, as document no. 1112431047, relating to Developer's construction of up to sixteen (16) single family homes (the "Project") on the vacant parcels of real property commonly known as 11915, 11921-27 and 11933-43 South Union Avenue and 650-658 West 120th Street, Chicago, Illinois,- and which are legally described on Exhibit-A attached hereto (the "City Land"); and
WHEREAS, pursuant to the Ordinance, and in connection with the Agreement, the City has previously conveyed to Developer the real properties commonly known as 11943 S. Union Avenue, 11941 S. Union Avenue, 658 W. 120th Street and 650 W. 120lh Street, Chicago, Illinois, and identified in Exhibit A of this Ordinance as Parcels 8,9, 10 and 11, respectively (together, the "Conveyed Parcels"), by the City's quitclaim deeds, dated March 2, 2012, and July 7, 2015, and recorded with the Recorder's Office on October 10, 2012, and July 7, 2015, respectively, as document nos. 1228439108 and 151881705 7(the portion of the City Land that does not include the Conveyed Parcels, the "Remaining Parcels"); and
WHEREAS, the City has previously issued to Developer two (2) (partial) certificates of completion with respect to Developer's construction of two (2) single family homes; and
WHEREAS, the City and Developer desire to amend the affordability requirements set forth in the Agreement; and
WHEREAS, the Agreement established a procedure for conveying the City Land to Developer pursuant to a series of phased conveyances; and
WHEREAS, in order to facilitate Developer's construction of the balance of the single-family homes on the City Land, Developer has requested that the City convey the Remaining Parcels to it in a single conveyance (i.e., not in phases); and
WHEREAS, Developer also has requested an extension of the date by which Developer must complete construction of the Project; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. The above recitals, and the statements of fact and findings made therein, are incorporated herein and made a material part of this ordinance.
SECTION 2. The Commissioner of the Department of Planning and Development ("Commissioner"") or a designee of the Commissioner is each hereby authorized, with the approval of the City's Corporation Counsel as to form and legality, to negotiate, execute and deliver a first amendment to the Agreement between the City and Developer, in substantially the form attached hereto as Exhibit B and made a part hereof (the "First Amendment"), and such other supporting documents as may be necessary or appropriate to carry out and comply with the provisions of the First Amendment, with such changes, deletions and insertions as shall be approved by the persons executing the First Amendment.
SECTION 3. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.
SECTION 4. All ordinances, resolutions, motions or orders in conflict with this ordinance are hereby repealed to the extent of such conflict.
SECTION 5. This ordinance shall be in full force and effect immediately upon its passage and approval.
EXHIBIT A
LEGAL DESCRIPTION OF CITY LAND
Parcel 1:
LOT 43 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1 /4 OF THE WEST lA OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11915 S. Union, Chicago, Illinois P.I.N.: 25-28-102-009
- - -Parcel 2: -— - - -¦--=¦¦¦¦ -
LOT 40 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST >/2 OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11921 S. Union, Chicago, Illinois P.I.N.: 25-28-102-012
Parcel 3:
LOT 39 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11925 S. Union, Chicago, Illinois P.I.N.: 25-28-102-013
Parcel 4:
LOT 38 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11927 S. Union, Chicago, Illinois P.I.N.: 25-28-102-014
Parcel 5:
LOT 36 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11933 S. Union, Chicago, Illinois P.I.N.: 25-28-102-016
Parcel 6:
THE NORTH V2 OF LOT 34 AND ALL OF LOT 35 IN BLOCK 10 IN WEST PULLMAN, A
- - SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF
SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11935 S. Union, Chicago, Illinois P.I.N.: 25-28-102-017
Parcel 7:
THE SOUTH l/2 OF LOT 34 AND ALL OF LOT 33 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11939 S. Union, Chicago, Illinois P.I.N.: 25-28-102-018
Parcel 8:
LOTS 31 AND 32 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11941 S. Union, Chicago, Illinois P.I.N.: 25-28-102-019
Parcel 9:
THE NORTH 5 FEET OF LOT 28 (EXCEPT THE EAST 27 V2 FEET) AND ALL OF LOTS 29 AND 30 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11943 S. Union, Chicago, Illinois P.I.N.: 25-28-102-020
Parcel 10:
LOTS-25 TO 27 AND-THE SOUTH 20 FEET OF-LOT 28 (EXCEPT-THE-EAST 25 FEET OF SAID LOTS) IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 658 W. 120th Street, Chicago, Illinois P.I.N.: 25-28-102-021
Parcel 11:
THE EAST 25 FEET OF LOTS 25, 26, 27 AND 28 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 650 W. 120th Street, Chicago, Illinois P.I.N.: 25-28-102-022
EXHIBIT B FORM OF FIRST AMENDMENT
[Attached]
THIS INSTRUMENT PREPARED BY, AND AFTER RECORDING, PLEASE RETURN TO: Arthur Dolinsky Senior Counsel City of Chicago
Department of Law, Real Estate Division 121 North LaSalle Street, Room 600 Chicago, Illinois 60602 (312) 744-0200
FIRST AMENDMENT TO AGREEMENT FOR THE SALE AND REDEVELOPMENT
OF LAND - ¦
(The Above Space For Recorder's Use Only)
This FIRST AMENDMENT TO AGREEMENT FOR THE SALE AND
REDEVELOPMENT OF LAND ("First Amendment") is made on or as of the day of
, 20 , by and between the CITY OF CHICAGO, an Illinois municipal corporation and
home rule unit of government ("City"), acting by and through its Department of Planning and Development ("DPP"), as the successor department to the Department of Housing and Economic Development, having its principal offices at City Hall, 121 North LaSalle Street, Chicago, Illinois 60602, and HABITAT FOR HUMANITY CHICAGO (f/k/a Windy City Habitat for Humanity, Inc.), an Illinois not-for-profit corporation ("Developer"), whose offices are located at 2201 S. Halsted Street, Chicago, Illinois 60608. Capitalized terms used in this First Amendment but not defined herein shall have the meaning set forth in the Agreement ("Agreement" is defined below).
RECITALS
WHEREAS, pursuant to an ordinance adopted on April 22, 2009, and published at pages 58465 through 58537 in the Journal of the Proceedings of the City Council for such date (the "Ordinance"), the City and Developer have entered into that certain Agreement for the Sale and Redevelopment of Land (the "Agreement"), dated May 2, 2011, and recorded in the Office of the Recorder of Deeds of Cook County, Illinois (the "Recorder's Office") on May 4,2011, as document no. 1112431047, relating to Developer's construction of up to sixteen (16) single family homes (the "Project") on the vacant parcels of real property commonly known as 11915,11921 -27 and 11933-43 South Union Avenue and 650-658 West 120th Street, Chicago, Illinois, and which are legally described on Exhibit A attached hereto (the "City Land"); and
WHEREAS, pursuant to the Ordinance, and in connection with the Agreement, the City has previously conveyed to Developer the real properties commonly known as 11943 S. Union Avenue, 658 W. 120th Street and 650 W. 120th Street, Chicago, Illinois, and identified in Exhibit A hereto as
Parcels 9, 10 and 11, respectively (together, the "Conveyed Parcels"), by the City's quitclaim deed, dated March 2,2012, and recorded with the Recorder's Office on October 10,2012, as document no. 1228439108 (the portion of the City Land that does not include the Conveyed Parcels, the "Remaining Parcels"); and
WHEREAS, the City has previously issued to Developer a (partial) certificate of completion with respect to Developer's construction of one (1) single family home; and
WHEREAS, the City and Developer desire to amend the affordability requirements set forth in the Agreement; and
WHEREAS, the Agreement established a procedure for conveying the City Land to Developer pursuant to a series of phased conveyances; and
WHEREAS, in order to facilitate Developer's construction of the balance of the single-family homes onthe City Land, Developer has requested that the City convey the Remaining Parcels to it in a single conveyance (i.e., not in phases); and
WHEREAS, Developer also has requested an extension of the date by which Developer must complete construction of the Project;
NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein and in the Agreement, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
SECTION 1. INCORPORATION OF RECITALS.
The foregoing recitals constitute an integral part of this First Amendment and are incorporated herein by this reference with the same force and effect as if set forth herein as agreements of the parties.
SECTION 2. HOMEBUYERS.
The eighth recital of the Agreement is amended and restated to read as follows:
"WHEREAS, all the Homes to be constructed by Developer pursuant to this Agreement must be developed and sold to homebuyers (a) for a base sales price (i.e., excluding any upgrades selected by the homebuyer) affordable to a buyer at one hundred percent (100%) of the median income for the Chicago primary metropolitan statistical area ('AMI'), and (b) whose household income at the time of executing a purchase contract for the Home is not more than one hundred twenty percent (120%) AMI (each such homebuyer, a 'Qualified Household')."
SECTION 3. CONVEYANCE OF TITLE
Section 5.3 (Phased Conveyances) of the Agreement is amended to include the following statement at the end of such section: "Notwithstanding the foregoing, pursuant to a written request from Developer, the Department of Planning and Development, in its sole discretion, may elect to convey the Property (or any part thereof) without regard to the phased conveyance procedure set forth above."
SECTION 4. COMMENCEMENT AND COMPLETION DATES.
Section 12 (Commencement and Completion of Project) is amended and restated to read as follows:
"The Developer shall commence construction of the Project no later than the date that is one (1) year and three (3) months after the Ordinance Date (as that term is defined in the Agreement) and shall complete the Project (as evidenced by the issuance of the last Partial Certificate of Completion) no later than March 31, 2018, except as a result of a force majeure; provided, however, that if, for reasons outside the Developer's reasonable control, the Developer requires an extension of the completion date, the Department of Planning and Development, in its sole discretion, may extend the construction completion date, for good cause shown by issuing a written extension letter. The Developer shall give written notice to the City within five (5) days after it commences construction. The Developer shall construct the Project in accordance with the Plans and all Laws and covenants and restrictions of record."
SECTION 5. BASE SALES PRICE FOR HOMES.
A. Sections 5.5.B. (Sales Price) of the Agreement is amended and restated to read as follows:
"Developer affirmatively covenants that it shall sell and convey each Home to a Qualified Household for a base sales price (i.e., excluding any upgrades selected by the homebuyer) affordable to a buyer at one hundred percent (100%) of the median income for the Chicago primary metropolitan statistical area ('AMI'). Upon receipt of a written request from Developer, the Commissioner of Planning and Development shall have discretion to increase the base purchase price, for good cause shown by issuing a written notice to Developer."
B. Section 14.3 (Restrictions on Use) is amended and restated to read as follows:
"The Developer agrees that it shall develop and sell the Homes in accordance with the following provisions:
(a) The Developer shall sell each Home for a base sales price (i.e., excluding any upgrades selected by the homebuyer) affordable to a buyer at one hundred
percent (100%) of AMI, except as that price may be amended in accordance with Section 5.5.
The Developer shall sell each Home to a Qualified Household.
At the closing of each Home, the Developer shall require the homebuyer to execute a First Mortgage and a Second Mortgage.
The Developer acknowledges and agrees that the use and affordability restrictions set forth in this Section 14 constitute material, bargained-for consideration for the City, and that, but for such use and affordability restrictions, the City would not have agreed to convey the City Land to the Developer."
C. Exhibit 1 (Base Prices) of the Agreement is deleted in its entirety.
SECTION 6. CITY HIRING PLAN. The Agreement is amended to.include Section 33 (City Hiring Plan), which reads as follows:
"(i) The City is subject to the June 16, 2014 'City of Chicago Hiring Plan' (as amended, the '2014 City Hiring Plan') entered in Shakman v. Democratic Organization of Cook County, Case No 69 C 2145 (United States District Court for the Northern District of Illinois). Among other things, the 2014 City Hiring Plan prohibits the City from hiring persons as governmental employees in non-exempt positions on the basis of political reasons or factors.
(ii) Developer is aware that City policy prohibits City employees from directing any
individual to apply for a position with Developer, either as an employee or as a subcontractor, and
from directing Developer to hire an individual as an employee or as a subcontractor. Accordingly,
Developer must follow its own hiring and contracting procedures, without being influenced by City
employees. Any and all personnel provided by Developer under this Agreement are employees or
subcontractors of Developer, not employees of the City of Chicago. This Agreement is not intended
to and does not constitute, create, give rise to, or otherwise recognize an employer-employee
relationship of any kind between the City and any personnel provided by Developer.
(iii) Developer will not condition, base, or knowingly prejudice or affect any term or aspect
to the employment of any personnel provided under this Agreement, or offer employment to any
individual to provide services under this Agreement, based upon or because of any political reason or
factor, including, without limitation, any individual's political affiliation, membership in a political
organization or party, political support or activity, political financial contributions, promises of such
political support, activity or financial contributions, or such individual's political sponsorship or
recommendation. For purposes of this Agreement, a political organization or party is an identifiable
group or entity that has as its primary purpose the support of or opposition to candidates for elected
public office. Individual political activities are the activities of individual persons in support of or in
opposition to political organizations or parties or candidates for elected public office.
(iv) In the event of any communication to Developer by a City employee or City official in violation of subparagraph (ii) above, or advocating a violation of subparagraph (iii) above, Developer will, as soon as is reasonably practicable, report such communication to the Hiring Oversight Section of the City's Office of the Inspector General (the 'OIG'), and also to the head of the relevant City Department utilizing services provided under this Agreement. Developer will also cooperate with any inquiries by the OIG."
SECTION 7. RECORDING COSTS. Developer shall pay to record this First Amendment and other documents incidental thereto.
SECTION 8. FULL FORCE AND EFFECT. Except as amended hereby, the Agreement shall continue in full force and effect as the binding obligations of the City and Developer.
SECTION 9. COUNTERPARTS. This First Amendment may be executed in any number of
counterparts, each of which shall be deemed an original and all of which, taken together, shall
- constitute a single, integrated instrument. - i ¦ -
(Signature Page Follows)
IN WITNESS WHEREOF, the parties have caused this First Amendment to be executed on or as of the date first above written.
CITY OF CHICAGO, an Illinois municipal corporation, acting by and through its Department of Planning and Development
By:
David L. Reifman, Commissioner
Department of Pl anning and Development
HABITAT FOR HUMANITY CHICAGO (f/k/a Windy City Habitat for Humanity, Inc.), an Illinois not-for-profit corporation
By:_ Name: Its:
STATE OF ILLINOIS COUNTY OF COOK
)
) SS. )
I, the undersigned, a Notary Public in and for said County, in the State aforesaid, do hereby certify that David L. Reifman, the Commissioner of the Department of Planning and Development of the City of Chicago, an Illinois municipal corporation, personally known to me to be the same person whose name is subscribed to the foregoing instrument, appeared before me this day in person and, being first duly sworn by me, acknowledged that, as said Commissioner, he signed and delivered the foregoing instrument pursuant to authority given by the City of Chicago as his free and voluntary act and as the free and voluntary act and deed of said municipal corporation, for the uses and purposes therein set forth.
GIVEN under my notarial seal this day of . 20 .
NOTARY PUBLIC
STATE OF ILLINOIS )
) SS.
COUNTY OF COOK )
I, the undersigned, a notary public in and for said County, in the State aforesaid, do hereby certify
that , personally known to me to be the
of Habitat for Humanity Chicago, an Illinois not-for-profit corporation and the same person whose name is subscribed to the foregoing instrument, appeared before me this day in person and, being first duly sworn by me, acknowledged that s/he signed and delivered the foregoing instrument as her/his free and voluntary act and the free and voluntary act of said company for the uses and purposes therein set forth.
GIVEN under my notarial seal this day of , 20 .
NOTARY PUBLIC
(sub) EXHIBIT A to First Amendment
LEGAL DESCRIPTION OF CITY LAND
Parcel 1:
LOT 43 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 OF THE WEST !/2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11915 S. Union, Chicago, Illinois P.I.N.: 25-28-102-009
Parcel 2:
LOT 40 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V* OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11921 S. Union, Chicago, Illinois P.I.N.: 25-28-102-012
Parcel 3:
LOT 39 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST 14 OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11925 S. Union, Chicago, Illinois . P.I.N.: 25-28-102-013
Parcel 4:
LOT 38 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST '/2 OF THE NORTHEAST 1/4 AND THE NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11927 S. Union, Chicago, Illinois P.I.N.: 25-28-102-014
Parcel 5:
LOT 36 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11933 S. Union, Chicago, Illinois P.I.N.: 25-28-102-016
Parcel 6:
THE NORTH VrOF LOT 34 AND ALL OF LOT .35 IN BLOCK 10 IN WEST PULLMAN, A
SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1IA OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11935 S. Union, Chicago, Illinois P.I.N.: 25-28-102-017
Parcel 7:
THE SOUTH V2 OF LOT 34 AND ALL OF LOT 33 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1IA AND THE WEST Vi OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11939 S. Union, Chicago, Illinois P.I.N.: 25-28-102-018
Parcel 8:
LOTS 31 AND 32 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION OF THE NORTHWEST 1/4 AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11941 S. Union, Chicago, Illinois P.I.N.: 25-28-102-019
Parcel 9:
THE NORTH 5 FEET OF LOT 28 (EXCEPT THE EAST 27 V2 FEET) AND ALL OF LOTS 29 AND, 30 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 11943 S. Union, Chicago, Illinois P.I.N.: 25-28-102-020
Parcel 10:
LOTS 25 TO 27 AND THE SOUTH 20 FEET OF LOT 28 (EXCEPT THE EAST 25 FEET OF SAID LOTS) IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE NORTHWEST 11A AND THE WEST V2 OF THE NORTHEAST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 658 W. 120th Street, Chicago, Illinois P.I.N.: 25-28-102-021
Parcel 11:
THE EAST 25 FEET OF LOTS 25, 26, 27 AND 28 IN BLOCK 10 IN WEST PULLMAN, A SUBDIVISION IN THE WEST V2 OF THE NORTHEAST 1/4 AND NORTHWEST 1/4 OF SECTION 28, TOWNSHIP 37 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY, ILLINOIS.
Commonly known as: 650 W. 120th Street, Chicago, Illinois P.I.N.: 25-28-102-022
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:
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is: 1. [*fthe Applicant OR
2. [ ] a legal entity "holding a" direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest:
OR
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in
which the Disclosing Party holds a right of control:
B. Business address of the Disclosing Party: -J-^Oj % fa| ^Vtd. St- ^l^-5(
Telephone: 6l> <5l/-*> O^Wax: 3lp- 5\j> O^t Email: . pArkSfg, KitWfCiw Aft). I'rj
Name of contact person: JlAiUfW"" f&'k-S
E. Federal Employer Identification No. (if you have one): L_
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):
Which City agency or department is requesting this EDS? Qtj;y,i,i'h>u»-1~ 0^ iT^rin^ t PC jc\o^-ru<4~
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
Page 1 of 13
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY 1. Indicate the nature of the Disclosing Party:
Person [ ] Limited liability company
Publicly registered business corporation [ ] Limited liability partnership
Privately held business corporation [ ] Joint venture
Sole proprietorship [ J^-^Tot-for-profit corporation
General partnership (Is the not-for-profit corporation also a 501(c)(3))?
Limited partnership [Jf*fes [ ] No
Trust [ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incoiporation or organization, if applicable:
JMlYlo i3. 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?
[JYes []No Hi^/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
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
SECTION II. DISCLOSURE OF OWNERSHIP INTERESTS, PART Bl
Last Name First Name Title
Anderson Doug Director and Vice President
Avery Cameron Director and Secretary
Fercho Kristy Director, President, and Board Chair
Jozwiak Jeff Director
Marszalek Daniel Director
McGuire Sean Director and Treasurer
Meloy Elizabeth Director
Miazga Michael Director and Vice President
Mover Robert Director and Vice President
Parks" Jennifer Assistant Secretary and Executive Director
Pfeffer Michael Director
Rowsell Kristi Director
Saville Shelby Director
Walker Wesley Director
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
(YOm
SECTION III -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
.Has the...Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
[ ] Yes [jrfo
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 Parly must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
y.t mIrWI
(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
- A. COURT-ORDERED CHILD SUPPORT COMPLIANCE - - - -
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10%-or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] 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
B. FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article 1 ("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
Estimated X X X X X X X X X X X
Paid
Fees $319,200.00 $236,000.00 $56,080.00 $267,040.00 $96,000.00 $63,320.00 $15,200.00 $94,400.00 o o d o o IN rv t/v $40,000.00 $8,000.00 pro bono pro bono
Relationship Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Subcontractor Architect Attorney
to to OJ — < 4605 N Elston, Chicago, IL 60630 5911 N. Elston, Chicago, IL 60646 11442 S. King Dr., Chicago, IL 60628 1133 Four Seasons Ln, Bolingbrook, IL 60440 832 W. 85th St., Chicago, IL 60620 137 E. Joliet St., Schererville, IN 46375 1025 N. 27th St., Melrose Park, IL 60160 i 18 W. 100 West 22nd St., Oakbrook Terrace, 60108 \ 3740 W. Irving Park Rd., Chicago, IL 60618 i 20604 Burl Court, Joliet, IL 60433 I 4044 N. Lincoln Avenue, Chicago, IL 60618 ! 1017 W Webster Ave, Chicago, IL 60614 : 222 N LaSalle St #800, Chicago, IL 60601 ;
Retained or Anticipated to be retained Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Anticipated Retained Retained
Name Dunleavy Construction Dunleavy Concrete M.S Masonry, Inc. Agua Plumbing Spurlock & Son Inc. Modern Heating & Cooling Inc. Wally's Precision Machining MSM Inc. DuSable Construction Co. Inc. Home Energy Control Inc. Peterson Environmental Kennedy Architecture LLC Gould & Ratner LLP
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities dentified in Section II.B.l. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, within a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
have not, within a fiVe^ycaT'pcfiod preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership;.identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any stale 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
'"~c. made an admission" of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
If the Disclosing 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 of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none").
IfvOrVL^
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-monlh period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally"avairable~tb_City"empI6ye'es or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than S20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
t^vorvc-
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is [-iffs 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. Wc further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
Page 7 of 13
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.
In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter?
[ ] Yes [jrfio
NOTE: If you checked_^Yes''to ItemD.l., proceed to Items D.2and D.3. If_you.checked-"No" to -Item D.l., proceed to PartE.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale?
[ ] Yes [ ] No
If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
The Disclosing Party verifies that the Disclosing Parly has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
SECTION VI -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is 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 the duration of the Matter and must make such certifications promptly available to the City upon request.
¦— B.-CERTIFICATION REGARDING EQUAL-EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
[]Yes [JNo If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes [ ] No
Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[ ] Yes [ ] No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ J 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.cityofchicaeo.orR/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing
Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a
contract being handled by the City's Department of Procurement Services, the Disclosing Party must
update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of
Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified
offenses), the information provided herein regarding eligibility must be kept current for a longer period,
as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing 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 tax.es .
F.2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the'Disclosing Party;"cahridf ceTfify as to any of the items in F.L, F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.
'Mm'&r Pad
PS
(Print or^typc name of Disclosing Party) By:
(Print or type name of person signing) (Print or type title of person signing)
Signed and sworn to before me on (date) ) 7^- ^ - \c3>
at __^> g>Y—- County, \\ . (state).
Notary Public.
Commission expircs:_
"OFFICIAL SEAL MICHAELSCOTT
Notary Public - State ' My Commission Expires Aufjuat
Page 12 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section Il.B. 1 .a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
[ ] Yes
If yes, please identify below (I) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
2. If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of the Applicant identified as a building code scofflaw or problem landlord pursuant to. Section 2-92-416 of the Municipal Code?
[ ]Yes [ ]No I jrfot 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 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.