OFFICE OF THE MAYOR
CITY OF CHICAGO
RAHM EMANUEL
MAYOR
April 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 ordinances authorizing the sale of city-owned property.
Your favorable consideration of these ordinances will be appreciated.
Mayor
Very truly yours,
ORDINANCE
WHEREAS, the City of Chicago ("City") is a home rule unit of government by virtue of the provisions of the Constitution of the State of Illinois of 1970, and, as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, the City is the owner of the vacant parcels of property located at 5200-02 5205, 5207 and 5209 South Ashland Avenue, Chicago, Illinois, which are legally described on Exhibit A attached hereto ("Properties"), and which Properties are located in the 47th/Ashland Redevelopment Project Area ("Area") established pursuant to ordinances adopted by the City Council on March 27, 2002, and published in the Journal of Proceedings of the City Council for such date at pages 81473 through 81652; and
WHEREAS, the City, acting through its Department of Planning and Development ("DPD"), has proposed to sell the Properties through a sealed bid auction pursuant to Chapter 2-158 of the Municipal Code of the City of Chicago; and
WHEREAS, the Commissioner of DPD caused to be published a public notice advertising the City's intent to sell the Properties through a sealed bid auction, and such advertisements appeared in the Chicago Sun-Times, a newspaper of general circulation, on December 7, 2015, December 14, 2015 and December 21, 2015; and
WHEREAS, the sealed bid received in response to the aforesaid public notice was opened in a public meeting before a certified court reporter and DPD received one conforming sealed bid from Access Community Health Network, 600 West Fulton Avenue, Suite # 200, Chicago, Illinois 60661 in the amount of Fifty Thousand and No/100 Dollars ($50,000.00); and
WHEREAS, DPD has recommended that the sealed bid of Access Community Health Network, the sole and highest bidder, be accepted by the City Council; and
WHEREAS, pursuant to Resolution No. 16-020-21 adopted on March 17, 2016, by the Plan Commission of the City of Chicago (the "Commission"), the Commission approved the sale of the Properties; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. The City Council hereby accepts the bid of Access Community Health Network, 600 West Fulton Avenue, Suite # 200, Chicago, Illinois 60661, ("Grantee"), and approves the sale of the Properties to the Grantee in the amount of Fifty Thousand and No/100 Dollars ($50,000.00).
SECTION 2. The Mayor or his proxy is authorized to execute, and the City Clerk or Deputy City Clerk is authorized to attest, a quitclaim deed conveying the Property to the Grantee, or to a land trust of which the Grantee is the sole beneficiary, or to a business entity of which the Grantee is the sole controlling party. Such deed shall include a covenant obligating the Grantee to use the Properties only for a use consistent with the land uses permitted under the redevelopment plan for the Area. Grantee's acceptance of the City's deed shall constitute Grantee's agreement to such covenant.
SECTION 3. DPD is authorized to deliver the deed to the Grantee upon receipt of the balance of the purchase price in accordance with its standard procedures. In the event that the closing has not occurred within three months from the passage of this ordinance through no
fault of the City, DPD may cancel the sale upon written notice to the Grantee, retain the Grantee's deposit check as liquidated damages, and again offer the Properties for sale.
SECTION 4. If any provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such provision shall not affect any of the other provisions of this ordinance.
SECTION 5. All ordinances, resolutions, motions or orders inconsistent with this ordinance are hereby repealed or amended to the extent of such conflict.
SECTION 6. This ordinance shall take effect upon its passage and approval.
/
EXHIBIT A
Purchaser:
Purchaser's Address: Purchase Amount: • Appraised Value:
Access Community Health Network
600 West Fulton Avenue #200, Chicago, Illinois 60661
$50,000.00
$23,000.00
Legal Description (Subject to Title Commitment and Survey):
Lot 1 (Except that part taken and condemned for the widening of Ashland Avenue) And Lot 2 (Except that part taken and condemned for the widening of Ashland Avenue) In Block 8, In Orvis's Subdivision of The Northeast % of The Southeast % of Section 7, Township 38 North, Range 14, East of the Third Principal Meridian, in Cook County, Illinois.
Addresses: 5200-02 South Ashland Avenue
Chicago, Illinois 60609
Property Index Numbers: 20-07-415-024/025-0000
Lot 3 In Taylor's Subdivision of the Southwest % of the Northwest % of the Southwest % of Section 8, Township 38 North, Range 14, East of the Third Principal Meridian, in Cook County, Illinois, except that part of said Lot 3 conveyed to the City of Chicago by Deed recorded October 16, 1928 as Document Number 9436901.
Addresses: 5205 South Ashland Avenue
Chicago, Illinois 60609
Property Index Number: 20-08-308-003-0000
Lot 4 In Taylor's Subdivision of the Southwest % of the Northwest % of the Southwest % of Section 8, Township 38 North, Range 14, East of the Third Principal Meridian (Except that part of the Said Lot lying West of a Line 50 Feet East of And Parallel With The West Line of Said Section 8), in Cook County, Illinois.
Addresses: 5207 South Ashland Avenue
Chicago, Illinois 60609
Property Index Number: 20-08-308-004-0000
Lot 5 (Except Street) In Taylor's Subdivision of the Southwest Vi of the Northwest % of the Southwest % of Section 8, Township 38 North, Range 14, East of the Third Principal Meridian in Cook County, Illinois.
5209 South Ashland Avenue Chicago, Illinois 60609
Property Index Number:
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT , AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
A. Legal name of the Disclosing Parly submitting (bis EDS. Include d/b/a/ if applicable;
Check ONE of the following fltrcc boxes;
Indicate whether the Disclosing Party submitting this EDS Is:
\)rf\t Applicant
OR
[ ] a legal entity holding a direct or Indirect interest in (he 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.13.1.) State the legal name of the entity in
which the Disclosing Party holds a right of control!. . ........., ^ L
13. Business address of the Disclosing Parly: _ _ —
Telephone; t; .Email:,, &
Name of contact pcrsotw
B. Federal Employer Identification No. (if you have one): - ¦
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which (his EDS pertains. (Include project number and location of property, if applicable):
. .<*tft-£e/H ft;/* n-e&loo-oZ ^
Which City ageney or department is requesting this BDS7_
If (he Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification il ..... $ j' ajid Contract 11 - ... . =
Page I of 13
SECTION 11 - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate (be nature of (he Disclosing Party:
[ J Person r j Limited liability company
f J Publicly registered business corporation [ j Limited liability partnership
I) Privately held business corporation [j Joiivt venture
[ ) Sole propric(orship [^WoT-for-profil corporation
f ] General partnership (Is the noljor^roftt corporation also a 501(c)(3))?
f) Limited partnership [TYcs f]No
f J Trust rj Other (please specify)
For legal entities, the state (or foreign country) of incorporation or organization, if applicable;
MH^Pj^ _ _
For legal entities not organized in the State of Illinois: Has (he organization registered to do business in (he State of Illinois as a foreign entity?
UYcs [jNo [^N/A
13. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. Lis( below (he 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 (here arc no such members, write "no members." For trusts, estates or other similar entities, list below the legal lideholder(s).
If (he 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 o(her person or entity (hat controls (he day-to-day management of the Disclosing Party, NOTE: Each legal entity Hstcd'bclow must submK on BDS on i(s own behalf.
Name Tide
Alte-^Jt^kfa^^
^^.^^^.e^L^ Pa&AJ~ jd£Q Mo^ Jtit^J^
Qkd^
±*aj?i CrA-uXUf "cA«jr jJte#4%%
2. Please provide (he following information concerning each porson or en(ily having awect % 0°^ - - asA* indireel beneficial in(ercs( (including ownership) in excess of 7.5% of (he Disclosing Party. Examples \)f jfMrllA^^0 of such an in(cres( include shares in a corporation, partnership interest in a partnership or joint venture,
r >o Page 2 of 13
ro«i
1% a/A/A £V*t/*HMO - {/Name
til*
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 (he Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information, from any applicant which is reasonably intended (o achieve full disclosure.
Business Address Percentage In(cres( in (he
Disclosing Parly
SECTION HI -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "busincss'rclattonship," as defined in Chapter 2-156 of (he Municipal Code, with any City elected official in (he 12 tnotUhs before the date this BDS is signed?
If yes, ploasc identify below the name(s) of such City elected offioial(s) and doscribe such relationship^):
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Parly musl disclose (he name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or en(ity whom (he Disclosing Party has retained or expects (o retain in connection with the Mn((er, as well as the na(urc of (be rclau'onship, and (he total amount of (he fees paid or es(lma(ed lo bo paid. Tho Disclosing Parly Is not required lo disclose employees who arc paid solely through (he Disclosing Parly's regular payroll.
"Lobbyist" means any person or entity who undertakes (o influence any legislative or admims(rative action on behalf of any person or entity other than: (I) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Parly is uncertain whether a disclosure is required under this Section, the Disclosing Party must cither ask (he Ci(y whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Pecs (indicate whether
rclained or anticipated Address (subcontractor, attorney, paid or estimated.) NO TE:
to be retained) lobbyist, etc.) ' "hourly rate" or "t.b.'d." is
, , . r> i not an acceptable response.
/te-L;«4
(Add sheets if necessary)
[tf&heck hero if (he 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 tho Disclosing Parly been declared m arrearage on any child support obligations by any Illinois court of oompetcnt jurisdictionV
person directly or indirectly owns 10% or more of the Disclosing Parly.
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?
[ J Yes I
B. FURTHER CERTIFICATIONS
J. Pursuant to Municipal Code Chapter L23, Article I ("Article I")(whlch the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting (his EDS is (he Applicant and is doing business with (he City, then the Disclosing Parly certifies as follows: (i) neither the Applioam* 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, (heft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of (he City or any sister agency; and (ii) the Applicant understands and acknowledges (ha( compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies (o 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 entitles 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 offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting (o obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or slate antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification ordcslruollon of records; making false statements; or receiving stolen properly;
arc not presently indiclcd for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of (he offenses set forlh 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, slate or local) terminated for cause or default; and
c. have not, within a five-year period preceding tho 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 stale, or any other unit of local government.
3. The certifications In subparts 3, 4 and 5 concern:.
(he Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by (he Disclosing Party in connection with tho Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
j any "Affilia(cd Entity" (meaning a person or entity thai, directly or indirectly: controls (he Disclosing Party, is controlled by the Disolosiug Party, or is, with (he 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 n business entity following the ineligibility of a business entity lo do business with federal or sta(c or local government, including (he Ci(y, using substantially (he same management, ownership, or principals as (he ineligible entity); with respect (o Contractors, (he (crm Affiliated Entity means a person or entity (hat 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 (he Disclosing Party, any Con(ractor or any Affiliated Entity or any other official, agent or employee of (he Disclosing Parly, any Con(rac(or or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Parly, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 13
Neither the Disclosing Party, ;ior any Contractor, nor any Affiliated Entity of cither the Disclosing Party or any Contractor nor any Agents have, during the five years before the date lhi6 EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before (he date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted (o bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a publio officer or employee of (he City, (he S(a(e of Illinois, or any agency of the federal government or of any state or local government in (he United Slates of America, in tha( officer's or employee's official capacity;
agreed or colluded wilh 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 (o bid a fixed price or otherwise; or
made an admission of snob conduc( described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated (he provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Bulky or Contractor, or any of their employees, officials, agents or partners, is barred from contracting wilh 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-ro(a(ing 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 (he offense of bid-rigging or bid-rotating.
Neither (he Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by (he Office of Foreign Assets Control of (he U.S. Department of the Treasury or (he Bureau of Industry and Security of (he U.S. Department of Commerce or (heir successors: the Specially Designated Nationals Lis(, (he Denied Persons List, (he Unverified List, (ho Entity List and (he Debarred Lis(.
The Disclosing Parly understands and shall comply with (he applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental E(hics) of (he Municipal Code.
Page 6 of 13
7. If (he Disclosing Parly is unable (o certify lo any of (he above statements in this Pari B (Further Certifications), (he Disclosing Party must explain below:
If (he letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party cerlified to the above statements. .
8. To (lie best of the Disclosing Party's knowledge after reasonable inquiry, (he following is a complete list of all current employees of (he Disclosing Party who were, at any time during (he 12-mojilh period preceding the execution date of (his EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indica(c with "N/A" or "none").
_,—
9. To (he best of the Disclosing Party's knowledge after reasonable inquiry, (he following is a complete list of all gifts (hat (he Disclosing Party has given or caused (o be given, at any time during the 12-monlli period preceding (he 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" docs no( includo: (i) anything made generally available to City employees or (o (he gcnoral 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 (o any gift listed below, please also list (ho name of the City recipient.
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
J. The Disclosing Party certifies (hat the Disclosing Party (check one)
I) is [ftsnoi
a "financial ins(i(u(ion" as defined in Section 2-32-455(b) of the Municipal Code.
2. If (he Disclosing Parly IS a financial institution, (hen (he Disclosing Party pledges:
"We are no( 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 (he Municipal Code. We undcrstaud (hn( becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with (he City."
If the Disclosing Par(y is unable to make (his pledge because it or any of i(s affiliates (as defined in Section 2-32-455(b) of (he Municipal Code) is a predatory lender within (he meaning of Chapter 2-3 2 ofilhe l^jmicipal 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 f^No
NOTE: If you checked "Yes" to Item D.L, proceed to Items D.2. and D.3. If you checked "No" to Item D.L, proceed to Part E.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power docs not constitute a financial interest within the meaning of this Part D.
Does the Matter involve a City Property Sale7
[ ] 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 sucli interest:
Name. Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check cither 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to (his EDS all information required by paragraph 2. Failure to
Page 8 of 13
comply with these disclosurc.rcquircmcnls may make any contract entered into with the City in connection wit)} the Matter voidable by the City.
The Disclosing Parly verifies that the Disclosing Parly 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 (he slavery era (including insurance policies issued to slaveholders (hat provided coverage for damage to or injury or death of (heir slaves), and the Disclosing Parly has found no such records.
2. The Disclosing Party verifies that, as a result of conducting (he search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Patty verifies (hat (he following constitutes full disclosure of all such records, including (he names of any and all slaves or slaveholders described In (hose records:
3 ik : ::::::.:r**
SECTION VI« CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
NOTE: If the Matter is federally funded, complete this Section VI. ir the Matter Is not federally funded, proceed (o Section VII. For purposes of this Section VI, tax credits allocated by the Cily and proceeds of debl obligations of the City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
J. List below (he names of all persons or entities registered under (he federal Lobbying Disclosure Act of 1995 who have made lobbying con(ac(s on behalf of (he Disclosing Party with rospect (o (he Matter: (Add sheets if necessary):
7V7A- ^ ——
(If no explanation appears or begins on (he lines above, or if (he letters "NA" or if (he word "None" appear, it will be conclusively presumed (hat the Disclosing Parly means that NO persons or entities registered under (lie Lobbying Disclosure Act of 1995 have made lobbying conlacls on behalf of the Disclosing Party with respect to the Matter.)
2. The Disclosing Parly has not spent and will no( expend any federally appropriated funds (o pay any person or entity listed in Paragraph A. 1. above for bis or her lobbying activilies or (o pay any person or entity lo influence or allcmpl lo influence an officer or employee of any agency, as dofincd by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection wilh the award of any federally funded contract, making any federally funded giant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Pago 9 of 13
The Disclosing Party will submit an updated ccilifioalion at the end of each calendar quarter in which 1hcrc occurs any event that materially affects the accuraoy of (he statements and information set forth in paragraphs A.l. and A.2. above.
The Disclosing Party certifies (ha( cither: (i) i( is not an organization described in section 501(c)(4) of the Internal Revenue Code of IS>86; or (ii) it is an organization described in scotion 501(c)(4) of (he Internal Revenue Code of 19B6 but has not engaged and will «o( engage in "Lobbying Ac(ivi(ics".
If (he Disclosing Party is (he Applicant, the Disclosing Parly mus( obtain certifications equal in form and substance (o paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and (ho Disclosing Party must maintain all such subcontractors' certifications for (ho duration of the Matter and must make such certifications promptly available to the City upon request.
13. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If (he Matter is federally funded, federal regulations require the Applicant and all proposed subcojrtractors (o submit (he following information wilh (heir bids or in writing a( the outset of negotiations.
Is the Disclosing Party the 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? (See 41 CFR Pari 60-2.)
[JYcs {}No
Have you filed wi(h (he Joint Reporting Committee, the Director of (he Office of Federal Con(ract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under (he applicable filing requirements?
[JYcs fJNo
Have you participated in any previous contracts or subcontracts subject (o the equal opportunity clause?
[} Yes (] No
If you checked "No" (o question J. or 2. above, please provide an explanation:
Page 10 of 13
SECTION.VII.- ACKNOWLEDGMENTS, CONTRACT INCORPORATION,
COMPLIANCE, PENALTIES, DISCLOSURE - >' " '1. - •
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 Parly understands that it musl comply with all statutes, ordinances, and regulations on which this BDS 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-wwv/.cityofchicago.orA/Blhics. 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 Parly must comply fully with tho 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 (he contract or agreement (if not rescinded or void), a( law, or in equity, including terminating the Disclosing Parly's participation in the MaUcr and/or declining to allow (he Disclosing Party to participate in other transactions with (he City. Remedies at Jaw for a false s(atemcn( of material fac( may include incarceration and an award to the City of treble damages.
K is the City's policy to make this document available to the public on its Internet site and/or upon requost. Some or all of (he information provided on (his EDS and any attachments to this EDS may be made available lo (he public on (he Internet, in response (o a Freedom of Information Act request, or otherwise. By completing and signing this EDS, (he Disclosing Parly waives and releases any possible lights or claims which it may have against (he Cily in connection with the public release of information contained in (his EDS and also authorizes (be Cily to verify (he accuracy of any information submitted in this EDS.
E. The information provided in (his EDS must be kept current. In the event of ohanges, the Disclosing
Parly must supplement (his EDS up to (he time the Cily lakes action on the Matter. If (he Matter is a
contract being handled by the City's Dcpartmcnl of Procurement Services, the Disclosing Party must
update (his EDS as the contract requires. NOTE: Wilh respect to Matters subject to Article I of
Chapter 1-23 of (he Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified
offenses), (he 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 (he Municipal Code.
The Disclosing Party represents and warrants that:
Page 11 of 13
F. 1. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Parly 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 (he Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by (he 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 (he 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 (he 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.
(Sign here) (Print or type name of person signing) of person signing)
f_ (state).
Signed^md sworn to before mc at L&ilAO- County,
Notary Public. Commission expires:_
OFFICIAL SEAL MICHAEL HOLMAN
NOTARY PUBLIC - STATE OF ILLINOIS MY COMMISSION EXWRES:OM>2/20
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 lo be completed only by (a) (lie 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 oily an Indirect ownership interest in (he Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether suoh Disclosing Party or any "Applicable Party or any Spouse or Domestic Partner (hereof currently lias a "familial relationship" with any elected city official or department head. A ''familial relationship" exists if, as of the date this EDS is sighed, (he Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner (hereof is related to (he mayor, any alderman, the cily clerk, the cily treasurer or any city department head as spouse or domestic partner or as any of (he 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, stepfaiher or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (I) all executive officers of the Disclosing Party lislcd in Section II.B.l.a., if (he Disclosing Party is a corporation; all paitncrs of the Disclosing Patty, if (he Disclosing Parly is a general partnership; all general partners and limited partners of (he Disclosing Party, if the Disclosing Party is a limited partnership; alt managers, managing members and members of (he Disclosing Parly, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Psrly; and (3) any person having more than a 7.5 percent ownership interest in (lie Disclosing Parly. "Principal officers" means flic president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
Docs the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner (hereof currently have a "familial relationship" with an elected city official or department head?
[ JYes
If yes, please identify below (1) the name and title of such person, (2) (he name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head (o whom such person has a familial relationship, and (4) (he precise nature of such familial relationship.
(sUhi
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is (o be completed only by (a) (he 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 indu-ect 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?. . • . .
t ]Ycs
2. If tho Applicant is a legal entity publicly traded on any exchange, is any officer or director of ihc Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
[ JYes i^f^ f/fNot Applicable
3. If yes to (1) or (2) above, please identity below (he 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.
tint __
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.