ORDINANCE ) A^t"X?4~T&
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION I. Title 17 ofthe Municipal Code of Chicago, the Chicago Zoning Ordinance, is hereby
amended by changing all ofthe RS-3 Residential Single-Unit (Detached House) District symbols and
indications as shown on Map No. 9-K in the area bounded by
The east west alley north of and parallel to West School Street: A line 245.40 feet west of and parallel to North Karlov Avenue; West School Street; A line 277.4 feet west of and parallel to North Karlov Avenue
to those of a RT-4 Residential Multi-Unit District
SECTION 2. This ordinance shall be in force and effect from and after its passage and due publication.
Common Address of Property:
LUNOiS SURVEYORS. IMC.
PROPERTY ADDRESS: 4121 W SCHOOL STREET CHICAGO, ILLINOIS 60641
FIELD WORK DATE: 1/25/20 1601.2029
BOUNDARY SURVEY COOK COUNTY
REMAINDER OF LOT I 3 (NOT INCLUDED)
STATE OF ILUNOI: COUNT-' OF GRl
W SCHOOL STREET (GC R/W)
FT ±
LOT I 4 AND THE EA5T 7 FEET OF LOT i 3 IN BEL DE YOUNG'S SUBDIVISION CF THE SOUTH 953 75 FEET OF LOT 3 OF COUNTY CLERK'S DIVISION OF THAT PART OF THE SOUTHEAST 1/4 OF SECTION 22. TOWNSHIP -O NORTH RANGE 13. EAST OF THE THIRD PRINCIPAL MERIDIAN. LYING SOUTH OF MILWAUKEE AVENUE IN COOK COUNTY. ILLINOIS
THiS 15 TO CERTIFY THAT TniS PROFESSIONAL SERVICE CONFORMS
TO THE CURRENT ILLINOIS MINIMUM STANDARDS FOR A BOUNDARY . _ _
SURVEY GIVEN UNDER MY .-AND AMD SEAL THIS £th DAY OF JULY "OTAl AR,.A L'F PrV.-'PflR TY i-URVr. >T.D =3?? 20'£ A- 3 "C E JACKSON STREET N MORRIS LSCW50
GRAPHIC SCALE (In Feet) 1 inch = 30' ft.
ILLINOIS PROFESSIONAL LAND SURVEYOR Mo 3403 LICENSE EXPIRES I I/30/201 S EXACTA LAND SURVEYORS L3# 5763
>
O
DATE: 1/25/2016
THE ABOVE SURVEY IS A PROFESSIONAL SERVICE IN COMPLIANCE WITH THE MINIMUM STANDARDS OF THE STATE OF ILLINOIS NO IMPROVEMENTS SHOULD BE MADE ON THE BASIS OF THIS PLAT ALONE PLEASE REFER ALSO TO YOUR DEED. TITLE POLICY AND LOCAL ORDINANCES COPYRIGHT BY EXACTA ILLINOIS SURVEYORS THIS DOCUMENT MAY ONLY BE USED BY THE PARTIES TO WHICH IT IS CERTIFIED PLEASE DIRECT QUESTIONS OR COMMENTS TO EXACTA ILLiNOiS SURVEYORS. INC AT THE NUMBER IN THE BOTTOM RIGHT CORNER
CLIENT NUMBER:
BUYER. SAFFRON CAPITAL LLC
POINTS OF INTEREST NONE VISIBLE
THEcararooGRAM
transforming lives.
SELLER:
>i T A
ILLINOIS SURVEYORS. INC.
LEW 18400S763
www exactachitdyo com p ¦;77.-jr:r).v40io . f 177J) ios-4011
16 cast Jackson Street, Morru. IL 60-150
REPORT OF SURVEY 1601 2C29 This is page 2 of 2 and is not valid without all pages.
LEGAL DESCRIPTION:
LOT 14 AND THE EAST 7 FEET OF LOT 13 IN BEL DE YOUNG'S SUBDIVISION OF THE SOUTH 953.75 FEET OF LOT 3 OF COUNTY CLERK'S DIVISION OF THAT PART OF THE SOUTHEAST 1/4 OF SECTION 22, TOWNSHIP 40 NORTH, RANGE 13, EAST OF THE THIRD PRINCIPAL MERIDIAN, LYING SOUTH OF MILWAUKEE AVENUE, IN COOK COUNTY, ILLINOIS.
JOB SPECIFIC SURVEYOR NOTES:
GENERAL SURVEYOR NOTES:
The Legal Description used to perform this survey was supplied by others.The survey does not determine or imply ownership
This survey only shows improvements found above ground Underground footings, utilities and encroachments are not located on this survey map. 3. If there is a septic tank, well or dram field on this survey, the location of such items was shown to us by others and are not verified.
This survey is exclusively for the use of the parties to whom it is certified
Any additions or deletions to this 2 page survey document are strictly prohibited.
Dimensions are in feet and decimals thereof.
Due to varying construction standards, house dimensions are approximate.
Any FEMA flood zone data contained on this survey is for informational purposes only. Research to obtain such data was performed at www fema gov. 9. All pins marked as set are 5/8 diameter, 18" iron rebar
An examination of the abstract of title was not performed by the signing surveyor to determine which instruments, if any, are affecting this property.
Points of Interest (POTs) are selected above-ground improvements which may be in conflict with boundary, building setback or easement lines, as defined by the parameters of this survey There may be additional POI's which are not shown, not called-out as POI's, or which are otherwise unknown to the surveyor. These POI's may not represent all items of interest to the viewer
Utilities shown on the subject property may or may not indicate the existence of recorded or unrecorded utility easements
The information contained on this survey has been performed exclusively, and is the sole responsibility, of Exacta Surveyors Additional logo or references to third party firms are for informational purposes only
House measurements should not be used for new construction or planning Measurements should be verified prior to such activity
LEGEND:
SURVEYOR'S LEGEND
I BOUNDARY UNE
chain-uk <* wire pence
axaor_wATot ¦no* fttce
OVERHEAD LWE3
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suktace nres- :^a»^ — *¦
WATER 5VM00L5.
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BCMOI MARA CEMTERUNE
CENTRAL ANGLE or DELTA
CONTROL POINT CONCRETE MONUMENT CATCH BA^N ELEVATION PM HYDRANT
pnd or set MONUMENT
GUYW1RE OR ANCHOR MANHOLE
AIR CCHOmcNNS
olocx corner backplow prtventor
BLOCK. BUttONC
B.R.L BUtDIHG RESTRICTION UNE
CALCULATED
curve
COMC. COR.
am
cva
CABLE *V RISER CONCRETE BLOCK. CHMtEY CHAIN UW CENCE CLEAN OUT CONCRETE CORNER
CONCRETE SIDEWALK CONCRETE VALLEY GUTTER CENTER UNE COVERED TORCH CONCRETE SLAB
DRAW HELD DRIVEWAY ELEVATION ENCLOSURE ENTRANCE ELECTRIC METER EDGE OT PAVEMENT EDGE OT WATER ELECTRIC UTwrr DOM HELD
PMD CONCRETE MONUMENT rOUND ORJLL MOLE riNISMen FLOOR POUhO IRON RPC rOUND IRON HPS * CAT POUND IRON ROD POUND IRON ROD * CAT POUND NAIL POUND HAL* asc POUND
POUND PARKER-KALON MAIL 3 POUND PK WAIL * DISK K POUND RAILROAD 9HKC
GARAGE
GAS METER
OENTIPICATION
ILLEGIBLE
INSTRUMENT
INTERSECTION
LENGTH
UCEH3C' - BUSINESS
UCEN9E * - survevrx
MEASURED MAP BOOK
MTTEREDEND SECTION METAL PCHCC NOW RADIAL NOT TO SCALE . ON CONCRETE SLAB ON GROUND
OUTSIDE OT SUBJECT PARCEL
OVERHANG
OVERHEAD UNES
INSIDE OT SUBJECT PARCEL
OmOAL RECOIED BOOK
OPPK3AL RECORD VOLUME
OVERALL
orrscT
PLAT
PLAT BOOK
POW OP CURVATURE
POINT OT COMPOUND CURVATURE
PERMANENT CONTROL POINT
POOL EQUIPMENT
PAGE
POMT OP INTERSECTION PROPESSIONAL LAND SURVEYOR PLANTER
POWT OP BCGtMIING TOW OT COMMENCEMENT PINCHED PIPE
POW OP REVERSE CURVATURE
PERMANENT REFERENCE MONUMENT
PROFESSIONAL SURVEYOR
AMD MAPPER
PORir OF TANGENCY
RAOnjS or RACIAL
RECORD
RIGHT OT WAY SURVEY SETBACK UNE SURVEY CLOSURE UNE SCREEN
SCO SIRC 3* tO SQPT
ESMT iEjCE IRR.E
R.oe
S WE 5 WME
SECTION SEPTIC TANK SEWER
SET GLUE DISC SET IRON ROD » CAP SET MAR i DOC SQUARE PECT STORY
SURVEY TIE UNE SEWER VALVE SIDEWALK. SEAWALL
TEMPORARY BENCHMARK TELEPHONE rACUTICa TOT OT BANK TOWNSHIP
TYPICAL
utility riser witness corner water pilter wooden pence water mctekwalvc box water valve vinyl pence
ACCE5S EASEMENT ANCHOR EASEMENT CANAL MAINTENANCE ESMT COUNTY UTILITY ESMT DRAINAGE EASEMENT DRAINAGE AND UTILITY ESMT EASEMENT
INGRESS/EGRESS ESMT. IRRIGATION EASEMENT LIMITED ACCESS ESMT LANDSCAPE BUrrtR ESMT LANDSCAPE ESMT. LAKE DR LANDSCAPE MAINTENANCE EASEMENT MAINTEHEHCE EASEMENT PUBLIC UT1UTY CASEMENT KOOr OVERHANG ESMT SIDEWALK CASEMENT STORM WATER MANAGEMENT ESMT TECHNOLOGICAL UTILITY ESMT UTILITY CASEMENT
ELECTRONIC SIGNATURE:
In ord^i to "Electronically Sign" all ot the PCrs sent by STARS, you must use a hash calculator A
free online rash calculator :s available at http //www.filcformat info/tool/md5sum.htm To E!ec:ronc3iiy Sign any su/vey PDF 1 Savo tho PDF orto ycur computer 2 Use rnu orime tool at http //www,fileformat.info/tool/md5sum.hr.rn :o browse for the saved PDF o.-i your compute; 3 Seiect the Hash Metnod as SHA 4 Cic.< Submit
Your PDF s slectroncaily s gr-ed if in o; the characters ir the SHA-1 code subm rted oy STARS matches the code which :s produced by the hash
calculator If they match exactly, your PDF n electronically sgned II the codes do ret matc'i exactly, you" PD- is not a-jt^ertx
PRINTING INSTRUCTIONS:
While viowing the survey in Adobe Reader, soloa the "Print" button under the "Filo" tab
Select a pnnterwith legal sized paper
Under" Pint Range", dick seloct the "All" togglo
Under the "Pago Handling" section, select the number of copies that you would like to pnnt
Under the "Page Scaling" selection drop down menu, select "None"
Unchecic thc "Auto Rota to and Center" checkbox
Check the "Choose Paper size by PDF' chockbox
Click OK to pnnt
TO PUNT IN BLACK + WWTE:
Ir the main print screen, c.ioose "Properties"
Choose "Quality" from the options
Change from "Auto Color" or "Full Color" to 'Gray Scale"
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OFFER VALID ONLY FOR THE BUYERS LISTED ON THE FIRST PAGE OF THIS SURVEY:
ANY FUTURE SURVEYING SERVICES j ON THIS PROPERTY
, .iija'issPEna'ii>c!K«6w tefe:'5!ES3£diii«;i:s
• isaieEiiSa .
www.exactachicago.com P: (773) 305-4010 • F: (773) 305-4011 316 East Jackson Street, Morns, IL 60450
September 7, 2016
Honorable Daniel S. Solis Chairman, Committee on Zoning 121 North LaSalle Street Room 304
Chicago, Illinois 60602
Dear Committee Members:
The undersigned, Tyler Manic, being first duly sworn on oath, deposes and states the following:
That the undersigned certifies that he has complied with the requirements of Section 17-13-0107 of the Chicago Zoning Ordinance by sending written notice to such property owners who appear to be the owners of the property within the subject area not solely owned by the applicant, and to the owners of all property within 250 feet in each direction of the lot luie of the subject property, exclusive of public roads, streets, alleys and other public ways, or a total distance limited to 400 feet. Said "written notice" was sent by First Class U.S. Mail, no more than 30 days before filing the application.
The undersigned certifies that the notice contained the address of the property sought to be rezoned; a statement of intended use of said property; the name and address of the applicant; the name and address of the owners; and a statement that the applicant intends to file an application for a change in zoning on approximately September 7, 2016.
The undersigned certifies that the applicant has made a bonafide effort to determine the addresses of the parties to be notified under Section 17-13-0107of the Chicago Zoning Ordinance and that the accompanying list of names and addresses of surrounding property owners within 250 feet of the subject site is a complete list containing the names and addresses of the people required to be
served.
Tyler Manic
Attorney for Applicant and Owner
SCHAINI BANKS
SCHAIN BANKS KENNY & SCHWARTZ LTD
70 W. Madison Street Suite 5300 Chicago, IL 60602
Main 312.345.5700 Fax 312.345.5701 www.schainbanks.com
Dear Sir/Madam:
In accordance with the Amendment to the Zoning Code enacted by the City Council, Section 17-13-0107-A of the Chicago Zoning Ordinance, please be advised that on or about September 7, 2016, the undersigned, will file an application for a change in zoning for the property located 4124 West School Street from a RS-3 Residential Single-Unit (Detached House) District to a RT-4 Residential Two-Flat, Townhouse and Multi-Unit District.
The owner of the property and the applicant of the Zoning Amendment Application is Saffron Capital Partners, LLC located at 1844 North Hoyne, Chicago, IL 60647.
The applicant is requesting a zoning amendment from a RS-3 Residential Single-Unit (Detached House) District to a RT-4 Residential Two-Flat, Townhouse and Multi-Unit District to allow for ground floor residential unit in an existing two storv building containing two residential dwelling units and two parking spaces. The appliccint proposes a third dwelling unit that would be located on the ground floor with an additional parking space.
I am the duly authorized attorney for the applicant. My address is 70 West Madison, Suite 5300, Chicago, Illinois 60602. My telephone number is (312) 345-5700.
PLEASE NOTE THAT THE APPLICANT IS NOT SEEKING TO PURCHASE OR REZONE YOUR PROPERTY. THE APPLICANT IS REQUIRED BY LAW TO SEND YOU THIS NOTICE BECAUSE YOU OWN PROPERTY LOCATED WITHIN 250 FEET OF THE SUBJECT PROPERTY.
Verv trulv vours,
J - J J
Tyler Manic Attorney for Applicant and Owner
CITY OF CHICAGO
APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE
ADDRESS of the properly Applicant is seeking to rezone:
4124 West School Street
Ward Number that property is located in: 30
APPLICANT Saffron Capital Partners, LLC
ADDRESS 1844 N. Hoyne CITY Chicago
STATE Illinois ZIP CODE 60647 PHONE 773-209-4785
EMAIL mitirpatel@gmail.com CON TACT PERSON Mitir Patel
Is the applicant the owner of the property? YES X NO
If the applicant is not the owner of the properly, please provide the following information regarding the owner and attach written authorization from the owner allowing the application to proceed.
OWNER Same as Applicant
ADDRESS CITY
STATE ZIP CODE PHONE
EMAIL CONTACT PERSON
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
ATTORNEY Tyler Manic of Schain, Banks, Kenny & Schwartz, Ltd.
ADDRESS 70 W Madison St Suite 5300
CITY Chicago STATE _JL ZIP CODE 60602
PHONE 312/345-5700 FAX 312/345-5701 EMAIL tmanic@schainbanks.com
If the applicant is a corporation please provide the names of all shareholders as disclosed on the Economic Disclosure Statements.
Cem Karsan
On what date did the owner acquire legal title to the subject property?.
Mas the present owner previously rezoned this property? If yes. when?
No
Present Zoning District RS-3 Proposed Zoning District RT-4
Lot size in square feet (or dimensions) 32 x 124.88 = 3.996.2 square feet
Current Use of the property Existing two dwelling unit building
Reason for rezoning the property To allow for ground floor residential unit in an existing two story building containing two residential dwelling units and two parking spaces. The applicant proposes a third dwelling unit that would be located on the ground Poor with an additional parking space.
Describe the proposed use ofthe property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building. (BE SPECIFIC)
To allow for ground floor residential unit in an existing two story building containing two residential dwelling units and two parking spaces. The applicant proposes a third dwelling unit that would be located on the ground floor with an additional parking space.
The Affordable Requirements Ordinance (ARO) requires on-site affordable housing units and/or a financial contribution for residential housing projects with ten or more units that receive a zoning change which, among other triggers, increases the allowable floor area, or. for existing Planned Developments, increases the number of units (see attached fact sheet or visit www.cityofchicago.org/ARO for more information). Is this project subject to the ARO?
YES
COUNTY OF COOK STATE OF ILLINOIS
I, \ ^\ | /C PA^7c°^— , being first duly sworn on oath, states that all ofthe above
statements and the statements contained in the documents submitted herewith are true and correct.
For Office Use Only
Date of Introduction:
File Number:
Ward:
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I -- GENERAL INFORMATION
A. Legal name ofthe Disclosing Party submitting this EDS. Include d/b/a/ if applicable: Saffron Capital Partners, LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
f/ the Applicant /Owner
OR
[ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which thc Disclosing Party holds an interest:
OR
3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name ofthe entity in
which the Disclosing Party holds a right of control:
B. Business address ofthe Disclosing Party: 1844 North Hoyne
Chicago, IL 60647
Telephone: (773) 209-4785 Fax: Email: mitirpatel@gmail.com
Name of contact person: Mitir Patel
Federal Employer Identification No. (if you have one):
Brief description of contract, transaction or other undertaking (referred to below as thc "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Zoning Amendment for property located at 4124 West School, Chicago, Illinois
G. Which City agency or department is requesting this EDS? DPD
If the Matter is a contract being handled by thc 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
Limited liability company Limited liability partnership Joint venture
Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[ ] Yes [ ] No
1. Indicate the nature of the Disclosing Party Person
| | Other (please specify)
Publicly registered business corporation Privately held business corporation Sole proprietorship General partnership Limited partnership Trust
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Delaware
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
[]Yes []No I/|N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
1. List below the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name Title Cem Karsan President
Mitir Patel Vice-President
2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% of the Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
Page 2 of 13
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
Name Business Address Percentage Interest in the
Disclosing Party
Cem Karsan 1844 N. Hoyne, Chicago, IL 60647 100%
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?
[]Yes [/No
If yes, please identify below the name(s) of such City elected official(s) and describe such rclationship(s):
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.
Page 3 of 13
Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether
retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:
to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
Tyler Manic 70 W Madison, #5300, Chicago, IL 60602 Attorney Estimated $10,000
(Add sheets if necessary)
[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
[ ] Yes [ ] No \/\ No person directly or indirectly owns 10% or more of the
Disclosing Party.
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?
[]Yes []No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if thc 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 thc City. NOTE: If Article I applies to the Applicant, thc permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
Page 4 of 13
The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section Il.B.l. of this EDS:
are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
have not, within a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;
have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section 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 thc 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 thc Contractor, is under common control of another person or entity;
• any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization 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 thc Disclosing Party or any Contractor nor any Agents have, during the five years before thc date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in thc United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control ofthe U.S. Department of thc Treasury or the Bureau of Industry and Security of thc U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, thc Unverified List, the Entity List and the Debarred List.
The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
N/A
Page 6 of 13
If the letters "NA," thc 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 thc City of Chicago (if none, indicate with "N/A" or "none"). N/A
9. To the best of thc Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
N/A
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is \/\ is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then thc Disclosing Party pledges:
"We arc not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss ofthe privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) ofthe Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):
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If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
Any words or terms that arc defined in Chapter 2-156 of thc 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 thc 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/J 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 thc purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit ofthe City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within thc meaning of this Part D.
Does the Matter involve a City Property Sale? []Yes f/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 thc nature of such interest:
Name Business Address Nature of Interest
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in 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 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 thc 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) ofthe Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of thc Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".
If the Disclosing Party is the Applicant, thc Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for 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 thc outset of negotiations.
Is thc Disclosing Party the Applicant?
[ ] Yes [ ] No
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[JYes []No
Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or thc Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[ ] Yes [ ] No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes [ ] No
If you checked "No" to question 1. or 2. above, please provide an explanation:
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SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
The Disclosing Party understands and agrees that:
The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between thc Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and are material inducements to the City's execution of any contract or taking other action with respect to thc Matter. Thc Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cityofchicago.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow thc 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 thc public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify thc accuracy of any information submitted in this EDS.
The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to thc time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.
The Disclosing Party represents and warrants that:
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F.l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are thc Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party is thc 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 thc City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If thc Disclosing Party cannot certify as to any ofthe 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.
Saffron Capital Partners, LLC
(Print or type name of Disclosing Party)
Mitir Patel
(Print or type name of person signing) Vice-President
(Print or type title of person signing)
Signed and sworn to before me on (date) ?>/Z<\ /-Z-Q\ L>
at C€>&*L County, I Lu NAqiS (state).
Notary Public.
Commission expires: J
OFFICIAL SEAL CHRISTIAN LEONARD
NOTARY PUBUC - STATE OF ILLINOIS MY COMMISSION EXPIRES-.02/09/20
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section Ii.B.l.a., if thc Disclosing Party is a corporation; all partners of thc 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 [/] No
If yes, please identify below (1) the name and title of such person, (2) the name ofthe legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) thc precise nature of such familial relationship.
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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (u) the Applicant, anil (b) any legal entity wliicli li:is u direct ownership interest in thc Applieant exceeding 7.5 percent (an "Owner"). It i.s not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is thc Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-97.-416 of the. Municipal Code?
[ ]Yes ryTNo
If thc Applicant is ti legal entity publicly traded on any exchange, is any officer or director of (he Applicant identified as a building code scofflaw or problem landlord pursuant to Section 2-^2-416 of the Mun icipal Cone?
[ ]Yes [ ]No "f/] Not Applicable
If yes to (I) or (2) above, please identify below the name ofthe person or legal entity identified as a building code scofflaw or problem landlord and the address ofthe building or buildings to which the pertinent code violations appiy.
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 CERTD7ICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.