RESOLUTION CLASS 6(B) REAL ESTATE TAX INCENTIVE FOR THE BENEFIT OF 3410 W LAKE LLC, AN ILLINOIS LIMITED LIABILITY COMPANY, AND REAL ESTATE LOCATED GENERALLY AT 3410 WEST LAKE STREET IN CHICAGO, ILLINOIS PURSUANT TO COOK COUNTY, ILLINOIS TAX INCENTIVE ORDINANCE, CLASSIFICATION SYSTEM FOR ASSESSMENT
WHEREAS, the Cook County Board of Commissioners has enacted the Cook County Tax Incentive Ordinance, Classification System for Assessment, as amended from time to time (the "County Ordinance"), which provides for, among other things, real estate tax incentives to property owners who build, rehabilitate, enhance and occupy property which is located within Cook County, Illinois and which is used primarily for industrial purposes; and
WHEREAS, the City of Chicago (the "City"), consistent with the County Ordinance, wishes to induce industry to locate and expand in the City by supporting financial incentives in the form of property tax relief; and
WHEREAS, 3410 W Lake LLC, an Illinois limited liability company (the "Applicant"), owns certain real estate located generally at 3410 West Lake Street, Chicago, Illinois 60624, as further described on Exhibit A hereto (the "Subject Property"); and
WHEREAS, the Applicant purchased the Subject Property, which contained an approximately 13,250 square foot industrial building that had been totally vacant for more than two years prior to the purchase date, and substantially rehabilitated the building; and
WHEREAS, the Applicant has leased the entire Subject Property to its affiliate, Why Not Iron, Inc., an Illinois corporation, to operate a metal fabricating business which manufactures, fabricates and installs custom designed architectural and structural metal work; and
WHEREAS, the redevelopment objective of the City in connection with the Subject Property is to support the City's goal of encouraging retention of the Applicant's operations within the City, creating new jobs and attracting investment; and
WHEREAS, the Applicant has filed an eligibility application for a Class 6(b) tax incentive under the County Ordinance with ,the Office of the Assessor of Cook County (the "Assessor"); and
WHEREAS, the Subject Property is located within (i) the City of Chicago Enterprise Zone No. 5 (created pursuant to the Illinois Enterprise Zone Act, 20 ILCS 665/1 et seq., as amended, and pursuant to an ordinance enacted by the City Council of the City, as amended),and (ii) the Chicago/Central Park Redevelopment Project Area (created pursuant to the Illinois Tax Increment Allocation Redevelopment Act, 65 ILCS 5/11-74.4-1 et. see-., as amended, and pursuant to an ordinance enacted by the City Council of the City), and the purposes of Enterprise Zones and Redevelopment Project Areas are also to provide certain incentives in order"to stimulate economic activity and to revitalize depressed areas; and|1010|
WHEREAS, it is the responsibility of the Assessor to determine that an application for a Class 6(b) classification or renewal of a Class 6(b) classification is eligible pursuant to the County Ordinance; and
WHEREAS, the County Ordinance requires that, in connection with the filing of a Class 6(b) eligibility application with the Assessor, the applicant must obtain from the municipality in which such real estate that is proposed for Class 6(b) designation is located a resolution - expressly stating, among other things, that the municipality has determined that the incentive provided by Class 6(b) is necessary for development to occur on such real estate and that the municipality supports and consents to the Class 6(b) classification by the Assessor; and
WHEREAS, the intended use of the Subject Property will provide significant present and future employment; and
WHEREAS, notwithstanding the Class 6(b) status of the Subject Property, the redevelopment and utilization thereof will generate significant new revenues to the City in the form of additional real estate taxes and other tax revenues; now, therefore,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1: That the City determines that the incentive provided by Class 6(b) is necessary for the development to occur on the Subject Property.
SECTION 2: That the City supports and consents to the Class 6(b) classification by the Assessor with respect to the Subject Property.
SECTION 3: That the Economic Disclosure Statement, as defined in the County Ordinance, has been received and filed by the City.
SECTION 4: That the Clerk of the City of Chicago is authorized to and shall send a certified copy of this resolution to the Assessor, and a certified copy of this resolution may be included with the Class 6(b) eligibility application filed with the Assessor by the Applicant, as applicant, in accordance with the County Ordinance.
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EXHIBIT A
Legal Description of Subject Property:
LOTS 16, 17, 18, 19 AND 20 IN BLOCK 1 IN WARD'S SUBDIVISION OF THE EAST Va OF THE WEST I/2 OF THE SOUTHEAST Va OF SECTION 11, TOWNSHIP 39 NORTH, RANGE 13, LYING NORTH OF LAKE STREET EXCEPT THE EAST 33 FEET AND THE NORTH 395 FEET LYING SOUTH OF THE RAILROAD RIGHT OF WAY, IN COOK COUNTY, ILLINOIS.
Permanent Real Estate Tax Index Number (PIN) for the Subject Property:
16-11-410-037-0000
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: 3410 W. Lake LLC
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
1. the 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 LI.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: 4425 W. Klnzle ^
. Chicago, IL 60624 '
0 ~ , , 773-379-0700 _. 773-379-0707 „ ., officemanager@ ,
Telephone: Fax: Email: whyriotiroTi.com
Name of contact person: Sean R- Kelly
i
Federal Employer Identification No. (if you have one): .
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Application for Class 6B-\ Status for property at 3410 W. Lake, Chicago
PIN 16-11-410-037
Which City agency or department is requesting this EDS? Dept. of Planning $ Development
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
Specification # and Contract #
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SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Party:
' ] Person §J Limited liability company
' ] Publicly registered business corporation [] Limited liability partnership
\ ] Privately held business corporation [ ] Joint venture
] Sole proprietorship [ ] Not-for-profit corporation
] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
] Limited partnership [ ] Yes ' [ ] No
] Trust [ ] Other (please specify)
2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois
3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as;a foreign entity?
[ ] Yes [ ] No • [] N/A
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY: . •
1. List below the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If 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'
Sean R. Kelly, Manager
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,'
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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 2-154-03O 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
Sean R. Kelly, 4425 W. Kinzie, Chicago 60624 100%
SECTION ni - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
Has the Disclosing Party had a "business relationship,n 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 fx] No
If yes, please identify below the name(s) of such City elected ofGcial(s) and.describe such relationship(s):
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTUS
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.
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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 "tb.d." is
not. an acceptable response.
Law Offices of Terrence Kennedy, Jr. - 180 N. LaSalle, #2650, Chicago,"IL 60601 Attorney for Class 6B application - $3,000
(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
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 mdirectly 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 [x] 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 I ("Article I")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a.continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
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2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section JJ.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, of found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.'
3. The certifications in subparts 3, 4 and 5 concern:
the Disclosing Party;
any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls 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 of 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").
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Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter: -
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials,, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 LLCS 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:
Not Applicable
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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.
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").
None
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the . 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name of the City recipient.
None
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION. .
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is jx] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the City."
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in 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):
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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 are defined in Chapter 2-156 of the Municipal Code have the same meanings when iised 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 hrj No
NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D.I., proceed to Part E.
Unless sold pursuant to a process of competitiye^bidding, or otherwise permitted, no City elected official^r 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 &c]No
If you checked "Yes" to Item D.I., 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.
i
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
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 me 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 qot federally funded, proceed to Section VH. 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):
None
(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.
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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?
W Yes []No
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[]Yes [x]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 H No
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[]Yes 50 No
If you checked "No" to question 1. or 2. above, please provide an explanation:
This application does not involve performing work for the government.
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SECTION VII — ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTB2S, 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.cityofchicago.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N.
Sedgwick St., Suite 500, Chicago, LL 60610, (312) 744-9660. The Disclosing Party must comply fully
with the applicable ordinances. " • _ _
X;7~If me~Cityli.eterm provided in this EDS is false, incomplete or inaccurate/
any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contractor agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Parry's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
D. It is the City's policy to make this document available to the public on its Internet site and/or upon
request. Some or all of the information provided on this EDS and any attachments to this EDS may be
made available to the public on 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:
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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 Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party-is the Applicant, 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. 1. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.I., 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.
3410 W Lake LLC (Print or type/flame of Disclosing Party)
By:
Sean R. Kelly
(Print or type name of person signing)
Manager
(Print or type title of person signing)
Signed and sworn to before me on (date) \ \ \ \ \ \ $
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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 me 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 Parry" 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 pr domestic partner or as any of the foUpwing, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, fiVher-in-law, mother-in-law, son-in-law, dmigjhter-ih-law, stepfather, or stepmother, stepson or stepd^u^ter/stepbroiher or stepsister or half-brother or half-sister.
• "Ar^hcableParty" means jjlj all. executive officers of the Disclosing Parry .hsted in Section ILB.La., if the .Disclosing Party is a whporatipn; auparmefs of the Disclosing Party, if the Disclosing Party is a general parmership; 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 lhe Disclosing Party, if the Disclosing Party is a limited liability company; (2) all rjrincipal 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 "fiamilial relationship" with an elected city official or department head?
[ ]Yes [xjNo
If yes, please identify below (1) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
Page 13 of 13
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent (an "Owner"). It is not to be completed by any legal entity which has only an indirect ownership, interest in the Applicant.
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
[ ]Yes [x]No
If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of the Applicant identified as a building code scofflaw or problem landlord pursuant to Section
— . 2-92-416 of the Municipal Code? • • • :: •' : — -
[ JYes j [ ]No [x] Not Applicable
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.
)
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I - GENERAL INFORMATION
Av Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Why Not Iron, Inc.
Check ONE of the following three boxes:
Indicate whether the Disclosing Party submitting this EDS is:
[5§ the Applicant
OR
[ ] a legal entity holding a direct or indirect interest in the Applicant State the legal name of the
Applicant in which the Disclosing Party holds an interest: : r ¦
> or : v r'feA '¦' ¦ ¦
3. [ ] a legal entity wjth iright of control (seb Section H.B.1.) State the legal name of the entity in
.which the Disclosme Party holds a right of control:
B. Business address of the Disclosing Party: 4425 W. Kinzie ¦
Chicago, IL 60624
„ ™ . . 773-379-0700 . . 773-379-0707 „ ... officemanager@
Telephone:; Fajc: . Email: whynotiron.com
Name of contact person: Sean R. Kelly
v ¦ ¦ r
E. Federal Employer Identification No. (if you have one): '¦—
Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
Application for Class 6B^i Status for propertyat 3410 W. Lake, Chicago
PIN 16-11-410-037
Which City agency or department is requesting this EDS? Dept. of Planning $ Development
If the Matter is a contract being handled by the City's Department of Procurement Services; please complete the following:
Specification # and Contract #
Ver. 01-01-12 Page 1 of 13
SECTION H - DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature of the Disclosing Party: . ¦ '.
[] Person j j Limited liability company
[] Publicly registered business corporation - [] Limited liability partnership
^4, Privately held business corporation [ J Joint venture •
[ ] Sole proprietorship [ ] Not-for-profit corporation .
[ ] General partnership ' . (Is the not-for-profit corporation also a 501 (c)(3))?
? .Limitedpartnership ' [JYes ' []No
[] Trust '"' ? Other (please specify)
2. For legal entities, the state (or foreign country) qf incorporation or organization, if applicable: Illinois • ¦
3. For legal entities not organized in the State of Illinois: Has the organization registered to do- ¦'-businessin the State of Illinois as a foreigri entity? ',
'. '' .• '¦¦/¦. .' " ' . •- •• '
[]Yes . ; .; t ].No \ • ' r {]N/A ' ' ' ¦ - ' '¦ ~ " I .
B. LF THE DISCLOSING PARTY IS A LEGAL ENTITY: • '
1. List below tile full names aqd 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 titleholderts).
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 Discldsing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name- Title'-
Sean R. Kellyj Manager'
2. Please provide the following information concerning, each person or entity having a direct or mdirect beneficial interest (mcluding 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 ofa trust, estate or other similar entity. If none, state "Nonfc." 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 •
Patricia Kelly, 4425 W. Kinzie, Chicago 60624 • 100%
SECTION TU - 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 fcjrJNo
'. * V ' •-
If yesrplease identifybelow the name(s) of such City ejected official^ re_tionship(s): '•
SECTION TV - 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 whp 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 adniinistrative 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.) ' Vhdurly rate" or "tb.d." is
hot an acceptable response.
(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.
. s • • • • • . _ ; • :• -
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 [xJNo - [ JNo person directly or —directly 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?
[JYes []No
FURTHER CERTIFICATIONS
1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article F')(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
2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section LT.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 arcivil 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;
c. 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) teiminated for cause, nr default; and
have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found-liable in a civil proceeding, or.in any.criminal or civil action, including actions concerning environmental violations, instituted by the City or by the. federal government, any state, or any other unit of local government.'
3. The certifications in subparts 3,4 and 5 concern:
the Disclosing Parry,
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 mdirectly: 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: -
a: bribed or- attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
agreed or colluded with other bidders.or prospective bidders, or been a party to any such agreement, or .been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to hid 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 (Livmg Wage Ordinance).
4. - Neither the Disclosing Parry, Affiliated.Entity or Contractor, or any of their employees, officials,,
agents or partners, is barred from conhactirig 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:
Not Applicable
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").
None
9. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a . complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, 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"). Asto any gift listed below, please also list the name of the City recipienti > .
"None ¦— - —'': '" '' • '• - —. ; ' '
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION.
1. - The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is |x] is not
a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.
. '- \ . , ¦ i
2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becorning 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. "
I. In accordance with Section 2-156-110 of the Municipal Code: Does anyofficial 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 fjrJNo
NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D.I., proceed to Part B. .
' 2. Unless sold pursuant to a process of competitiye\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 (hi) 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 §rJNo
3. If you checked "Yes" to Item D.I., 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.
X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all "records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (mcluding insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and me Disclosing Party has found no such records.
2. The Disclosing Party verifies that, as a result of conducting the search in step I 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, mcluding the names of any and all slaves or slaveholders described in those records:
SECTION VI - CERTDJICATJONS 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; pax 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):
None
(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 ah organization described in section 501(c)(4) of the Infernal 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". t
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- _i ... .;
Is the Disclosing Party the Applicant?
[JYes DflNo
If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action pro grams pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[JYes [x] 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?
[JYes .HNo
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[]Yes [JNo
If you checked "No" to question 1. or 2. above, pleaBe provide an explanation:
This application doea not involve performing work for the government.
Page 10 of 13
SECTION VH - 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 talcing 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 haining 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 contractor agreement (if not rescinded or void), at law, or in equity, mcluding 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 arc the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
F.2 If the Disclosing Party is the Applicant, 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 hiTed or to be hired in connection with the Matter certifications equal in form and substance to those in F. 1. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.
CERTIFICATION ----- -¦ - -— - —--
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf 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.
Why Not Iron, Inc.
(Sign here) Sean R. Kelly
name of Disclosing Party)
y^
(Print or type name of person signing)
Manager
(Print or type title of person signing)
Signed and sworn to before me on
(date) 1 \ W \ 1^
Notary Public.
at ^ County, CC-^ *jo,S (state).
r: /^M- ^ZAd+JL
Commission expires:_
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 wWch has oirdy an mdlrect ownership mterest m ;-;
' 's~ ' . ' .•' ' '
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 ddexman, the city clerk, the; city taasurer or any city department head as spouse or domestic
partner or as any of IhjS Rowing,' y^bjpf^y blood or adoption; parent ciuklbrom^ or uncle,
niece or nephew, godparent; grandchild, father-in-law, mother-in-law, sonrin-law, daughter-_4aw, stepfather, or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
"Apphcable^arry*' means £1) ajl exe^uave" officers of the^Disclosing Party hstedm Seictiqn EJB.La., if the
. Disclosing Party'is a cbtpoiaiigni au parhiqrs of the D^closing Parry, if the Disclosing Party is a general
partnership; all general partners and linntedparmers 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 hahility company; (2) all principal officers'of the Disclosing Party, and (3) any person haying more than
a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means-the president, chief
operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person
exercising similar authority. •' .
. Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have; a "familial relationship" with an elected city official or department head? >
[ ]Yes [x]No ' ••.
If yes, please identify below (1) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relatipnahip, 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 V ' ' .
Pursuant to Municipal Code Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to Section 2-92-416 of the Municipal Code?
[ JYes [ x]No
If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of
the Applicant identified as a building code scofflaw or problem landlord pursuant to Section
2r92-416 of _e Municipal Code? . vi- ¦'- ---- - - ^1 •
[ JYes ' ; : . : { ]No [xj Not Applicable
3. ' If yes to (1) or (2) above, please identify below the name of the person or legal entity
identified as a building code scofflaw or problem landlord and the address of the building or buildings to which the pertinent code violations apply.
FILLING OUT THIS APPENDIX B CONSTITUTES ACKNOWLEDGMENT AND AGREEMENT THAT THIS APPENDIX B IS INCORPORATED BY REFERENCE INTO, AND MADE A PART OF, THE ASSOCIATED EDS, AND THAT THE REPRESENTATIONS MADE IN THIS APPENDIX B ARE SUBJECT TO THE CERTIFICATION MADE UNDER PENALTY OF PERJURY ON PAGE 12 OF THE ASSOCIATED EDS.
)
CITY OF CHICAGO AFFIDAVIT FOR COOK COUNTY CLASS 6b TAX INCENTIVE
On behalf of 3410 W Lake LLC (the "Applicant"), I hereby certify, represent and warrant the following to the City of Chicago:
Attached as Exhibit 1 hereto and hereby incorporated herein is a true and correct list of all real estate owned in Cook. County, Illinois by the Applicant, including all permanent index numbers associated with such real estate.
Attached as Exhibit 2 hereto and hereby incorporated herein is a true and correct Disclosure of the Ownership Interests of the Applicant as set forth in Cook County's Code of Ethical Conduct (Cook County, 111., Code, Ch. 2, Art. VII, Div. 2, Subdiv. VI. Section 2-610).
Tne Applicant is not delinquent in the payment of any property taxes administered by Cook County or by a local municipality.
A. Attached as Exhibit 3 hereto and hereby incorporated herein is a true and correct Cook County Incentives Class Living Wage Ordinance Affidavit ("Living Wage Affidavit") for the Applicant. The Applicant hereby represents and warrants that it shall provide a Living Wage Affidavit to the City for any lessees of the Subject Property (as hereinafter defined) who enter into a lease for the Subject Property on or after July 1,2020.
S. The Applicant is in compliance with all applicable laws, as required by the Cook County Tax Incentive '" Ordinance, Classification System for Assessment, as amended from time to time (the "Tax Incentive Ordinance").
Under penalty of perjury, I hereby certify, represent and warrant that I have the knowledge and Ihe authority to provide this Affidavit to the City of Chicago on behalf of the Applicant. This Affidavit shall be deemed to be the Applicant's Economic Disclosure Statement, as defined in the Tax Incentive Ordinance. The Applicant hereby submits this Affidavit to the City of Chicago for purposes of complying with the provisions of the Tax Incentive Ordinance.
I hereby acknowledge that the City of Chicago has not, and will not independently verify the certifications, representations and warranties contained herein. I further acknowledge that the City of Chicago is entitled to and is in fact relying upon the certifications, representations and warranties contained herein in connection with its support and consent for the Class 6b application of the Applicant to the Office of the Assessor of Cook County, Illinois pursuant to the Tax Incentive Ordinance in connection with property located at 3410 West Lake Street, in Chicago, Illinois (the "Subject Property").
I understand and acknowledge that if the certifications, representations or warranties contained herein are untrue in any respect, the support and consent of the City of Chicago for the Class 6b classification of the Subject Property may be revoked, and other penalties ot low or in equity may apply.
APPLICANT:
Name of Company:^10 W Lake L^LG^n Illinois limited liability company By:.
Print Name of Signatories ean R- Kelly
Print Title of Signatory: Manager
at^ yC^oOK a My Commission expires on
Signed and swom before me on |__|
(County) ~£^Ll*i(Notary Public)
. (Date) '_ (State)
EXHIBIT 1
Sec attached list of all real estate owned in Cook County, Illinois by the Applicant, including all permanent
index numbers associated with such real estate.
Property owned by the Applicant, 3410 W Lake LLC:
3410 W. Lake, Chicago, 60624 PIN 16-11-410-037-0000
EXHIBIT 1
See attached list of all real estate owned in Cook County, Illinois by the Applicant, including all permanent
index numbers associated with such real estate.
Property owned by the Applicant, 3410 W Lake LLC:
3410 W. Lake, Chicago, 60624 PIN 16-11-410-037-0000
EXHIBIT 2
See attached Cook County Disclosure of Ownership Interests of the Applicant.
COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATEMENT
The Cook County Code of Ordinances (§2-610 et seq.) requires that any Applicant for any County Action must disclose information concerning ownership interests in the Applicant. This Disclosure of Ownership Interest Statement must be completed with all information current as of the date this Statement is signed. Furthermore, this Statement must be kept current, by filing an amended Statement, until such time as the County Board or County Agency shall take action on the application. The information contained in this Statement will be maintained in a database and made available for public viewing. County reserves the right to request additional information to verify veracity of information containted In this statement
If you are asked to list names, but there are no applicable names to list, you must state NONE. An incomplete Statement will be returned and any action regarding this contract will be delayed. A failure to fully comply with the ordinance may result in the action taken by the County Board or County Agency being voided.
"Applicant' means any Entity or person making an application to the County for any County Action.
"County Action" means any action by a County Agency, a County Department, or the County Board regarding an ordinance or ordinance amendment, a County Board approval, or other County agency approval, with respect to contracts, leases, or sale or purchase of real estate.
"Person" "Entity" or "Legal Entity" means a sole proprietorship, corporation, partnership, association, business trust, estate, two or more persons having a joint or common interest, trustee of a land trust, other commercial or legal entity or any beneficiary or beneficiaries thereof.
This Disclosure of Ownership Interest Statement must be submitted by :
An Applicant for County Action and
A Person that holds stock or a beneficial interest in the Applicant and is listed on the Applicant's Statement (a "Holder") must file a Statement and complete #1 only under Ownership Interest Declaration.
Please print or type responses clearly and legibly. Add additional pages if needed, being careful to identify.each.portion of the form to which each additional page refers.
This Statement Is being made by the [|x |] Applicant or
[J f) Original Statement or [| j] Amended Statement
FEIN # Only:
Street Address: 4425 W. Kinzie
City: Chicago
Email: of f icemanager@whynotiron. com
Cook County Business Registration Number:
(Sole Proprietor, Joint Venture Partnership)
Corporate File Number (if applicable): 05770424
Form of Legal Entity:
| | Sole Proprietor f~J Partnership Q Corporation
| [ Association Q Joint Venture ,
fxl Other (describe) Limited Liability Company
DISCLOSURE OF OWNERSHIP INTEREST - 1
Ownership Interest Declaration:
1. List the name(s), address, and percent ownership of each Person having a legal or beneficial interest (including ownership) of
more than five percent (5%) in the Applicant/Holder.
Name Address Percentage Interest in
Applicant/Holder
Sean R. Kelly 4425 W. Kinzie, Chicago 60624 100%
2. If the interest of any Person listed in (1) above is held as an agent or agents, or a nominee or nominees, list the name and address of the principal on whose behalf the interest is held.
Name of Agent/Nominee Name of Principal Principal's Address
I No
Is the Applicant constructively controlled by another person or Legal Entity? [ | [ ] Yes [
If yes, state the name, address and percentage of beneficial interest of such person, and the relationship under which such control is being or may be exercised.
Percentage of Beneficial Interest
Corporate Officers, Members and Partners Information:
For all corporations, list the names, addresses, and terms for all corporate officers. For all limited liability companies, list the names, addresses for all members. For all partnerships and joint ventures, list the names, addresses, for each partner or joint venture.
Name Address Title (specify title of Term of Office
Office, or whether manager or partner/joint venture) Sean R. Kelly 4425 W. Kinzie, Chicago Manager
Declaration (check the applicable box):
I state under oath that the Applicant has withheld no disclosure as to ownership interest in the Applicant nor reserved
any information, data or plan as to the intended use or purpose for which the Applicant seeks County Board or other County
Agency action.
I state under oath that the Holder has withheld no disclosure as to ownership interest nor reserved any information required to be disclosed.
DISCLOSURE OF OWNERSHIP, INTEREST - 2
1. REAL ESTATE OWNERSHIP DISCLOSURES.
The Applicani must indicate by checking the appropriate provision below and providing all required information that either:
a) The following is a complete list of all real estate owned by the Applicant in Cook County:
16-11-410-037-0000
PERMANENT INDEX NUMBER(S):
(ATTACH SHEET IF NECESSARY TO LIST ADDITIONAL INDEX NUMBERS)
OR:
_The Applicant owns no real estate in Cook County.
2. EXCEPTIONS TO CERTIFICATIONS OR DISCLOSURES.
If the Applicant is unable to certify to any of the Certifications or any other statements contained in this EDS and not explained elsewhere in
this EDS, the Applicant must explain below: .
If the letters, "NA", the word "None" or "No Response" appears above, or if the space is left blank, it will be conclusively presumed that the Applicant certified to all Certifications and other statements contained in this EDS.
DISCLOSURE OF OWNERSHIP INTEREST - 3
COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATEMENT SIGNATURE PAGE
Name<
etherized
der Representative (please print or type)
TX
Sean R. Kelly
Signature
officemanager@whynotiron.com
E-mail addross
My confession exfGS&iClAL SEAL LINDA MNORWICK NOTARY PUBLIC - STATE OF ILLINOIS MY COMMISSION EXPIRES:04/19/18
Notary Seal
DISCLOSURE OF OWNERSHIP INTEREST - 4
EXHIBIT 3
See attached Living Wage Affidavit for the Applicant.
Cook County Assessor's Office
118 North Clark Street, Ciiicaco. IL 60C02
PHONli: J12.443.7550 WUDS1TF.: WWWXOOKCOUNTYASSESSOR COM
Incentives Class Living Wage Ordinance Affidavit
Sean R. Kelly gg agerrt for tne app|jcant set forth below, who is seeking a
classification incentive as referenced below, I do hereby state under oath as follows:
As the agent for the applicant set forth below, I have personal knowledge as to the facts stated herein.
The property identified by PIN(s) with commonly known address(es), listed in Exhibit A attached and herein incorporated, are/is the subject of a pending application/renewal (circle as appropriate) for one of the following development Incentives provided by the Code of Ordinances of Cook County, Chapter 74, Article II, Division 2, The Cook County Real Property Assessment Classification Ordinance. Sec.74-60 et seq., as amended:
Class 8 (industrial property) Class 9
JTJie--eook^County Assessor's Office has Issued the following control number regarding this
application/renewal (circle as appropriate), 62976 , _
4. I haverreviewed the Code of Ordinances of Cook County, Chapter 34, Article IV, Division 1 and The Cook County Living Wage Ordinance, Sec. 34-127 et seq., as amended (the "Ordinance"), and certify that the applicant is in compliance with the above referenced Cook County Living Wage Ordinance, due to one of the following options (check as appropriate):
x Applicant i3 currently paying a living wage to its employees, as defined in the Ordinance.
OR
Applicant Is not required to pay a living wage, pursuant to the Ordinance.
Agent's Mailing Address 3410 W. Lake LLC
Sean R. Kelly - Manager
Agent's Name & Title 773-379-0700
Agent's Telephone Number 4425 W. Kinzie, Chicago
Applicant's Name
officetnanager@whynotiron.com
Applicant's e-mail address
Subscribed and sworn before me this ' *
Signatufarof fJoteryJ^ublic '
Exhibit A
(Please type or Print)
PIN(s) Common Address
16-11-410-037-0000 3410 W. Lake, Chicago 60624