Oct I, ,.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO
SECTION 1. Title 17 of die Municipal Code of the City of Chicago, the Chicago Zoning Ordinance, is hereby amended by changing all of the Ml-1, Limited Manufacturing/Business Park District symbols indications as shown on Map No. 22-G in the area bounded by
The Chicago, Rock Island And Pacific Railroad right-of-way; south Halsted Street; a line 176 feet north of an parallel to west 91st Street; and the alley next west of and parallel to south Halsted Street.
To those of M2-1, Light Industry District
SECTION 2. This ordinance shall be in force and effect from and after its passage and due publication.
Common Address of Property: 9040-9044 S. Halsted Street, Chicago, IL 60620
5Si: W inCK'ilNS AVENUT: , », r r . T _ r r -~ —, PHONE i773i282-*yU0
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OF
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REC ILL Land Surveyor No 35-3753
UC E*P NOVTMSER 30. 2020
CITY OF CHICAGO
APPLICATION FOR AN AMENDMENT TO T HE CHICAGO ZONING ORDINANCE
1- ADDRESS of the property Applicant is seeking to-rezone.'
. 9040-9044 S. Halsted Street, Chicago, Illinois 60620
2. Ward Number that property is located in: 21 • -
3 , APPLICANT William Spencer ADDRESS
Contact Person: Adam Kjngsle-y, attorney^ 773-218-7208 4. Is the applicant the owner of the property? YTiS
5- Ifthe Applicant/Owner ofthe property has obtained a-lawyer as their tepresentatiye for the ,*ef:»ringj;plea^ provide the follav^grbrfQilu^oti-:
ATTORNEY Adam Kingsley.
ADDRESS- 2227 W. Leland.Ave.
GJIY Chicago, IL 60625
' RHONE 773-218-7208
6,
Not Applicable.
Oh what date did the owner-acquire legal title to the .subjectproperty,? May 2^ 2008
Has the present owner previously rezoned this property?
Proposed Zoning District M2-1
10. LoLsize in square feet
|1010|
11. Gurrent Use of the property
Vacant/storage; existing bui ldihg used for vehicle inspection. 121. Reason for rezoning the property
¦ To' comply with the Use Standards oftheChicago Zoning;Ordinance, in order to e^abfrsh an outdoor rhotor vehicle sales lot.
13:. Describe the proposed use of the property after the rezoning.
j
T^estahlishjaii qutdoor-'motor vehicle sales jot; 16 paring;s|)aces; no residential-Jeristihg ?ttigle story •b.ujlding, approximately 4,4.00; sq. ft. area, 30 "height, to :remain' with no exterior changes
H ts property subject to ARO? No
|1010|
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I Ion. Thomas M. Tunney Chairman, Committee on Zoning 121 N. LaSalle Street Room 304, City Hall Chicago, Illinois 60602
The undersigned, Adam Kingsley, being first duly sworn on oath deposes and states as follows:
The undersigned certifies that he has complied with the requirement of Section 17-13-0107 of the Chicago Zoning Ordinance, by sending written notice to such property owners who appear to be the owner of the property within the subject area not solely owed by the applicant, and to the owners of all property within 250 feet in each direction of the lot line 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 diat the notice contained the address of the property sought to be rezoning; a statement of the intended use of the property; the name and address of the applicant; the name and address of the owner; and a statement that the applicant intends to file the application for a change in zoning on September 28, 2020.
Signature
Subscribed and Sworn to before me this
day of September 24, 2020
Notary Public
ERIC POULOS Official Seal Notary Public - State of Illinois My Commission Expires Aug 10, 2022 ,,maf w im W w w m>
The undersigned certifies diat the applicant has made a bona fide effort to determine the addresses of the parties to be notified under Section 17-13-0107 of the Chicago Zoning Ordinance, and that the accompanying list of names and address of surrounding properties witnin 250 fect of the subject site is a complete list containing the names and addresses of the people required to be served.
Kingsley Law Group
2227 W. Leland Ave., Chicago, Illinois 60625 773-218-7208 adam@kingsleylawgroup.com
September 23, 2020
Re: 9040-9044 S. Halsted Street, Chicago, IL - Intent to Apply for Zoning Change Dear Property Owner
In accordance with the requirements for an Amendment to the Chicago Zoning Ordinance, specifically Section 17-13-0107, please be advised that on or about September 28, 2020, the undersigned, will file an application for a change in the zoning from Ml-1 to M2-1 on behalf of William Spencer for the property located at 9040-9044 S. Halsted Street, Cliicago, IL.
The applicant intends to use the property to establish an outdoor used motor vehicle sales lot.
The applicant/owner, William Spencer, is located at 9040-9044 S. Halsted Street, Chicago, IL. The contact person for this application is Adam Kingsley, Kingsley Law Group, 2227 W. Leland Ave., Chicago, Illinois 60625. Phone number: 773-218-7208.
Please note that the applicant is not seeking to rezone or purchase your property. The applicant is required by law to send this notice because you own property within 250 feet of the property to be rezoned.
Very truly yours, Adam Kingsley
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: William Spencer
Check ONE of the following three boxes:
Indicate; whether the Disclosing Party submitting this EDS is:
{/j the Applicant
OR
[]a legal entity currently holding, or anticipated to hold within six months after City action on
the contract, transaction or other undertaking to which this EDS pertains (referred to below as the
"Matter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legal
name: ._
OR
Q a legal entity with adirect or indirect right of control ofthe Applicant (see;Section H(B)(1)> State the. legal name ofthe entity in which the Disclosing Party holds a right of control:
B. Business address ofthe Disclosing Party: 9040 S. Halsted Street
Chicago IL 60620
Telephone:' LV _" " ' . " , Fax: Email:
Name of .contact person: Adam Kingsley (attorney)
Federal Employer Identifjcation No. (if you have one): ,
Brief description of the Matter to which this EDS pertains. (Include project number and location of property, if applicable):
Application for Zoning Change - 9040 S. Halsted
G, Which City agency or department is requesting this EDS? DPD .
Ifthe Matter is a contract being handled by the City's Department of Procurement. Services, please complete the following:
Specification # _ and. Contract #
Ver.2018-1 Page 1 of 15
SECTION H - DISCLOSURE OF OWNERSHIP INTERESTS
A- NATURE OF THE DISCLOSING PARTY
[7] Person
Publicly registered business corporation Privately held business corporation Sole proprietorship General partnership Limited partnership Trust
~2 Limited liability company ~| Limited liability partnership
Joint venture ^] Not-for-profit corporation Is the not-for-profit corporation also a 501(c)(3))?
? Yes fjNo j~~j Other (please specify)
2. For.legal entities, the state (or foreign country) of incorporation or organization, if applicable:
3. For.legal entities not .organized in the State of Illinois: Has the organization registered todo businessinthe State of Illinois as a foreign entity?
[~~| Yes QNo [~J Organized in Illinois
IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
L List bejow the full names and titles., if applicable, of: (i) all executive officers'and all directors of the entity; (ii) for not-for-profit corporations, all members: if any, which are legal enrrties,(if there are no suchLmembers, write "no members which are legal entities"); (iii) for trusts, estates Or other sim^ar erjtitie?, the trustee, executor, administrator, or similarly situated party; (iv) for general or limited partnerships, limited liability companies, limited liability partnerships or joint ventures, each geaer^l.partner, managing member, manager or any other person ox legal.entity mat directly or iridirectly controls the day-to-day management of the Applicant
NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name; Title
2. Please; provide the following information concerning each person or legal entity having a direct or indirect, current or prospective (i.e. within 6 months after City action) beneficial interest (including ownership) in excess of 7.5% of the Applicant. Examples of such an interest include .shares in a . corporation,.partnership interest in a partnership or joint venture, interest of a member or manager in a
Page 2 of 15
limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None."
NOTE: Each, legal entity listed below may be required to submit an EDS on its own behalf.
Percentage Interest in the Applicant
SECTION III - INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTED OFFICIALS
Has the Disclosing Party provided any income or compensation to any City elected official during the
12-month period preceding the date of this EDS? QYes j/JNo
Does the Disclosing Party reasonably expect to provide any income or compensation to any City
elected official during the 12-month period following the date ofthis EDS? Yes [/] No
If "yes" to either ofthe above, please identify below the name(s) of such City elected official(s) and describe such income or compensation:
Does.any <3hy elected official or, to the best ofthe Disclosing Party's knowledge after reasonable inquiry 4 any City eiected^official's spouse or domestic partner, have a.financial interest (as defined in Chapter 2-156 of the Municipal Code of Chicago ("MCC")) in me Disclosing Party?
If "yes," please identify below the name(s) of such City elected official(s) and/or spouse(s)/domestic partners) and describe the financial interest(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 (as defined in MCC Chapter 2-156), accountant, consultant and any other person or entity whom.the Disclosing Party has retained or expects to retain in connection with the Matter, as. well as the nature ofthe relationship, and the total amount ofthe 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. Ifthe 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 15
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
nol an acceptable response.
Adam KIrigsley 2227 W. Leland Ave . Chicago, IL 60625 attorney S2;500 estimated
(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 MCC Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with-their child support obligations throughout the contract's term.
Has any person who directly or indirectly owns 10% or more ofthe Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
Yes jT/J No Q 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?
QYes QNo
B. FURTHER CERTIFICATIONS
1. [This paragraph 1 applies only ifthe Matter is a contract being handled by the City's Department of Procurement Services.] In the S-year period preceding the date of this EDS, neither the Disclosing Party npr any Affiliated Entity [see definition in (5) below] has engaged, m connection with the performance, ofany public contract, the services of an integrity monitor, independent private sector uispector general, or integrity compliance consultant (Le., an individual or entity with legale auditing, investigative, or qiher similar skills, designated by a public agency to help the agency monitor the activity of specified: agency vendors as well as help the vendors reform their business practices so they can be considered for agency contracts in the future, or continue with a contract in progress).
2r The Disclosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee, lax or other source, of indebtedness owed to the City of Chicago, including, but not limited to, water and sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the Disclosing Party delinquent in the payment of any tax administered by the Illinois Department of Revenue.
Page 4 of 15
3. The Disclosing Party and., if the Disclosing Party is a legal entity, all of those persons or entities identified tn Section Ll(B)( 1) of this EDS:
a-, arenot presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
h. have hot, during the 5 years before the date of this EDS, been convicted of a criminal offense, adjudged guilty, of 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 -pubhctr.arjsactioh; a violation of federal or state antitrust statutes; fraud; embezzlement;.theft:. forger>'; bribery; falsification or destruction of records: making false statements: or receiving stolen property;
are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) With committing any ofthe offenses set forth in subparagraph (b) above;
have not, during the 5 years before the dale ofthis EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
have not* during the 5 years before 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 Ippal government.
•4. The Disclosing Party understands and shall comply with the applicable requirements Of MCC Chapters 2t56 (Inspector General) and 2-156 (Governmental Ethics).
5. Certifications (5),. (6) and (7) 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 imderSection IVi "Disclosure of Subcontractors and Other Retained Parties");
aay "Affiliated Entity" (meaning a person or eritity that, directly or indirectly: controls die Disclosing Party, is controljed 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 diat directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
t 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 ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
Page 5 of 15
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 5 years before-the, date ofthis EDS, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a'Contractor during the 5 years before, the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee ofthe City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in .that officer's or employee's official capacity;
agreed or colluded with other bidders or prospective bidders, or been a .party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
made an admission of such conduct described in subparagraph (a) or (b) above that is a matter of record, but have; not been prosecuted for such conduct; or
violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Coritracts Requiring a Base Wage); (aX5)(Debarment Regulations); or (a)(6')(Minimum Wage Ordinance).
Npitijer trie pisclqsmg, Party, nor any 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 imfo&£Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by the United States Department of Commerce, State, or Treasury, orany successor federal agency.
[FOR APPLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [sje MCC Chapter 1-23, Article I for applicability and defined terms] of the Applicant is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision fox, any criminal offense.involving actual, attempted, or conspiracy to cornmitbribery, theft, fraud, forgery, perjury,-dishonesty or deceit against an officer or employee ofthe City or any "sister agency"; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, that. Article's permanent compliance timeframe supersedes 5-year compliance timeframes in this Section V.
.9. [FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit their subcontractprs to use, any facility listed as haying an active exclusion by the U.S. EPA on the federal System for Award Management ("SAM").
10. [FOR APPLICANT ONLY] The Applicant 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 Certifications (2) and (9) above and will not, without the prior written consent,of the City, use any such
Page 6 of 15
contractor/subcontractor that docs not provide such certifications or that the Applicant has reason to believe has not provided or cannot provide truthful certifications.
IL Ifthe Disclosing Party is unable to certify to any ofthe above statements in this Part B (Further Certifications), the Disclosing Party must explain below:
Ifthe 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.
12. To'the best of the Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of.all current employees ofthe Disclosing Party who were, at any time during the 12-mohth period preceding the date of this EDS, an employee, or elected or appointed official, ofthe City of "Chicago (if none, indicate with "N/A" or "none").
13, To the best of the Disclos ing; Party's, knowledge after reasonable inquiry, the following is a completelist of.all gifts mat;the Disclosing Party has given of caused to be given, at anytime during the 12-mpnth period preceding the execution date of this EDS, to an employee, or elected or appointed official, ofthe City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail valueof less than $25 per recipient, .o*-:(iii) a political contribution otherwise duly reported as required by law (if none, indicate with "N/A" Or "none"). As to jany gift listed below, please also list the name of the Gity recipient.
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
.It The Disclosing Party certifies that the Disclosing Party (check one)
I~J is [/] is not
a "financial institution" as defined in MCC Section 2-32-455(b).
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 MCC Chapter 2-32. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defmed in MCC Chapter 2-32 . We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of die privilege Of doing business with the. City."
Page 7 of 15
Ifthe Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in. MCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explain here (attach additional pages if necessary):
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. CEiOTFICATION REGARDING FINANCIAL INTEREST IN CITY BUSINESS
Any words or terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D,
In accordance with MCC Section 2-15.6-110: To the best of the Disclosing Party's knowledge after reasonable.inquky, does any official or employee ofthe City have a financial interest in his or her own name Or in the name of any other person or entity in the Matter?
QYes LTjNo
NOTE': If you checked "Yes" to Item.D'(!), proceed to Items D(2) and D(3). If you checked "No" to Item D(l ), Skip Items D(2) and D(3) and proceed to Part R
Unless soldpursuant to a process of competitive bidding, or otherwise permitted, no City elected official. or employee shall have a financial interest in his or her ovyn 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? QYes [/JNo
If you checked "Yes" to Item D(l), provide the names and business addresses ofthe City officials or employees1 having such financial interest and identify the nature of the financial interest:
"Name Business Address Nature of Financial Interest
4. The Disclosing Party further certifies diat no prohibited financial interest in the Matter will be acquired by any City official or employee.
Page Soft 5
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please check either (J) 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 (2). Failure to comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
The Disclosing Party verifies that the Disclosing 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.
-LJ2. The Disclosing Party verifies that, as a result pf 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 ofthe 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 * as amended, who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
(If no explanation appears or begins on the lines above, or if the letters "NA" or ifthe 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, as amended have made lobbying contacts on behalf of me 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
Ver.2018-1 Page 9 of 15
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 cooperati ve agreement.
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 iirformation set forth topographs A(l) and A(2) above.
The Disclosing Party certifies mat either-: (i) it is hot an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986: or (ii) it is an organization described in section 501(c)(4) Ofthe Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities;" as that term is defined in the Lobbying Disclosure Act of 1995„as amended.
Ifthe Disclosing Party is the Applicant^ theDisclosing Party must obtain certifications equal in form and substance to paragraphs A(l) through A(4) above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration ofthe Matter and must make such certifications promptly available to the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
If the Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors fo submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant? QYes QNo
If "Yes," answer the three questions below:
Have ypu developed and do. you have on file affirmative action programs pursuant to applicable federal regulations? (See.41 CFR Part 60-2.)
QYes Q No
Have you filed with the Joint Reporting Committee, die Director ofthe Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
Q Yes QJ No QReports not required
Have you participated in any previous contracts or subcontracts subject to die equal opportunity clause?
? Xes QNo
If you checked "No" to question (1) or (2) above, please provide an explanation:
Page 10 of 15
FURTHER ACKNOWLEDGMENTS AND CERTIFICATION
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 Ordinance, MCC Chapter 2-156, imposes certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of this ordinance and a training program is available on line at www.cityofChicago.org/Efhics , 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 this ordinance.
Cr 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), afclaw, or in. equity, including terminating the Disclosing Party's participation in the Matter and/pi declining to allow the Disclosing Party to participate in other City transactions. Remedies at law fora false statement of material fact may include incarceration and an award to the City of treble damages.
Itis'-the. City's policy tp make this document available to the public on its Internet site and/or upon request. Some or all ofthe information provided in, andappended to, this EDS maybe made publicly available on the Internet, in response to a Freedom of Information Act request, or otherwise. By cpmpletingand 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 iriformation contained in this EDS and also authorizes the City to verify the accuracy of any iriformation submitted inthis.EDS,
The iriformation 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 MCC Chapter 1-23, Article I (imposing PERMANENT INELIGIBILITY for certain specified offenses), the irrformation provided herein regarding eligibility must be kept current for a longer period, as required by MCC Chapter 1-23 and Section 2-154-020.
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CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS, and all applicable Appendices, are true, accurate -and complete as of the date furnished to the City.
William Spencer
(Print or type exact legal name of Disclosing Party) Bv
(Sign here)
William Spencer
(Print or type name of person signing)
(Print or type title of person signing)
•Signed and swom to before me on (date)
Notary Public
at toPtC- Qjunty, ^L (state).
Commission expires:
"OFFICIAL SEAL" KIRA SCOTT
Poge 12 of 15
CITY OF'CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
FAMILIAL RELATIONSHD7S 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%. It is not tp be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Under MCC Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party of any "Applicable Parly" 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 deparhnent head as spouse or domestic partner or as any pf 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 ofthe Disclosing Party listed in Section ILBT.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, ifthe Disclosing Party is; a general partnership; all general partners and limited partners ofthe Disclosing Party, ifthe Disclosing Party is a limited partnership; all managers, managing members and members ofthe pisjclpsjyrxg Party^ ifthe Disclosing Party js a limited liability company; (2) all principal officers ofthe Disclosing garty; and (3) any person.having more than a 7.5% ownership interest in the Disclosing Party . 'Trineipal 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? .
QYes nNo
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 arid 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.
Ver.2018-1 Page 13 of 15
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAWYPROBLEM 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% (an "Owner") It is hot to be completed by any-legal entity which has only an indirect ownership interest in the Applicant.
1. Pursuant to MCC Section 2-154-010, is the Applieant or any Owner identified as a building code scofflaw or problem landlord pursuant to MCC Section 2-92-416?
? Yes.
2. If the Applicant is a legal entity publicly traded on any exchange, is any officer or director of, the Applieant identified as a building code scofflaw or problem landlord pursuant to MCC. Section 2-92-416?
[/[ The Applicant is not publicly traded on any exchange.
3 If .yes to (1) or (2) above, please identify below the name of each person or legal entity identified as a building code scofflaw or problem landlord and the address of each building or buildings to which the pertinent code violations apply.
Page 14 of 15
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX C
PROHIBITION ON WAGE & SALARY HISTORY SCREENING - CERTIFICATION
This Appendix is to be eompieted only by an Applicant that is completing this EDS as a "contractor" as defined inMCC Section 2-92-385. That section, which should be consulted (www.amlegal.com ), generally covers a party to any agreement pursuant to which they; (i) receive City of Chicago funds in consideration for services, work or goods provided (including for legal or other professional services), or (ii); pay the City money for a license, grant or concession allowing them to conduct a business on City premises.
On behalf of an Applicant that is a contractor pursuant to MCC Section 2-92-385,1 hereby certify that the Applicant is in compliance with MCC Section 2-92-385(b)(l) and (2), which prohibit: (i) screening job applicants based on their wage or salary history, or (ii) seeking job applicants' wage or salary history from current or former employers. I also certify that the Applicant has adopted a policy that includes those proliib.itions.
? No
[/] N/A -1 am not an Applicant that is a "contractor" as defined in MCC Section '2-92-3 85. This certification shall serve as the affidavit required by MCC Section 2-92-385(c)'(l). If you checked "ho" to the above, please explain,
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