OFFICE OF THE MAYOR
CITY OF CHICAGO
LORI E. LIGHTFOOT
MAYOR
October 27, 2021
TO THE HONORABLE, THE CI TY COUNCIL OE THE CITY OF CHICAGO
Ladies and Gentlemen:
At the request ofthe Commissioner of Planning and Development, 1 transmit herewith ordinances authorizing the budget, scope of services and service provider agreements for various Special Service Areas.
Your favorable consideration of these ordinances will be appreciated.
Mayor
ORDINANCE REGARDING SPECIAL SERVICE AREA #44
WHEREAS, special service areas may be established pursuant to (i) Article VII, Sections 6(1) and 7(6) of the Constitution of the State of Illinois; (ii) the provisions of the Special Service Area Tax Law, 35 ILCS 200/27-5 et seq., as amended from time to time (the "Act"); and (iii) the Property Tax Code, 35 ILCS 200/1-1 et seq., as amended from time to time; and
WHEREAS, the City Council (the "City Council") of the City of Chicago (the "City") has previously enacted a certain ordinance on the date specified on Exhibit A attached hereto and hereby made a part hereof and published in the Journal ofthe Proceedings ofthe City Council of the City (the "Journal") for such date at the pages specified on Exhibit A hereto, and amended on the dates specified on Exhibit A hereto and published in the Journal for such dates as specified on Exhibit A hereto (as amended from time to time, the "Establishment Ordinance"), which established a certain special service area as indicated therein and as identified on Exhibit A hereto (the "Area") and authorized the levy of certain annual taxes, not to exceed the annual rate (the "Levy Cap") indicated therein and as described on Exhibit A hereto, of the equalized assessed value of the taxable property therein (the "Services Tax") to provide certain special services in and for the Area in addition to the services provided by and to the City generally as specified in the Establishment Ordinance (the "Special Services"); and
WHEREAS, the Establishment Ordinance provided for the appointment of a certain special service area commission for the Area (the "Commission") to advise the City Council regarding the amount of the Services Tax for the Area to be levied and for the purpose of recommending to the City Council for the Area: (i) a yearly budget based upon the costs of providing the Special Services; (ii) an entity to serve as service provider (the "Service Provider"); (iii) an agreement between the City and the Service Provider for the provision of Special Services to the Area (the "Service Provider Agreement"); and (iv) a budget to be included in the Service Provider Agreement (the "Budget") (the aforementioned items (i) through (iv) shall be known collectively herein as the "Recommendations"); and
WHEREAS, the Commission identified on Exhibit A hereto has heretofore prepared and transmitted to the Commissioner of Planning and Development (the "Commissioner") their Recommendations to the City Council, including the Budget attached hereto as Exhibit A; now, therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO AS FOLLOWS:
SECTION 1. Incorporation of Preambles. The preambles of this ordinance are hereby incorporated into this text as if set out herein in full
SECTION 2. Appropriations. There is hereby appropriated the sum in the amount and for the purposes necessary to provide the Special Services in and for the Area , the estimated amount of miscellaneous income and the amount required to be raised by the levy of the Services Tax indicated on Exhibit A hereto: Collectable Levy, Estimated Loss Collection, Carryover Funds, TIF Rebate Fund, and Estimated Late Collections and Interest
SECTION 3. Levy of Taxes There is hereby levied pursuant to the provisions of (i) Article VII, Sections 6(a) and 6(f)(2) of the Constitution of the State of Illinois: (ii) the Act: and (in) the Establishment Ordinance, the sum of the "Total Requested Levy" indicated on Exhibit A hereto
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as the amount of the Services Tax for the Area for the tax year 2021.
SECTION 4. Filing. The City Clerk of the City (the "City Clerk") is hereby ordered and directed to file in the Office of the County Clerk of Cook County, Illinois (the "County Clerk") a certified copy of this ordinance on or prior to December 28, 2021, and the County Clerk shall thereafter extend for collection together with all other taxes to be levied by the City , the Services Tax herein provided for, said Services Tax to be extended for collection by the County Clerk for the tax year 2021 against all the taxable property within the Area, the amount of the Services Tax herein levied to be in addition to and in excess of all other taxes to be levied and extended against all taxable property within the Area.
SECTION 5. Service Provider Agreement. The Commissioner, or a designee of the Commissioner (each, an "Authorized Officer"), are each hereby authorized, subject to approval by the Corporation Counsel as to form and legality, to enter into, execute and deliver a Service Provider Agreement as authorized herein with the entity indicated on Exhibit A hereto as the Service Provider, for a one-year term in form acceptable to such Authorized Officer, along with such other supporting documents, if any, as may be necessary to carry out and comply with the provisions of the Service Provider Agreement. The Budget shall be attached to the Service Provider Agreement as an exhibit. Upon the execution of the Service Provider Agreement and the receipt of proper documentation, the Authorized Officer and the City Comptroller are each hereby authorized to disburse the sum appropriated pursuant to Section 2 above to the Service Provider in consideration for the provision of the Special Services described in the Budget. The Department of Planning and Development shall promptly make a copy of the executed Service Provider Agreement (and any amendments thereto) readily available for public inspection. The Authorized Officer is also authorized to sign amendments to the Service Provider Agreement entered into pursuant to this Section 5 so long as such amendments do not alter the identity of the Service Provider and/or the amounts appropriated and/or levied pursuant to Sections 2 and 3 hereof.
SECTION 6. Enforceability. If any section, paragraph or provision of this ordinance shall be held to be invalid or unenforceable for any reason, the invalidity or unenforceability of such section, paragraph or provision shall not affect any ofthe remaining provisions of this ordinance.
SECTION 7. Conflict. This ordinance shall control over any provision of any other ordinance, resolution, motion or order in conflict with this ordinance, to the extent of such conflict.
SECTION 8. Publication. This ordinance shall be published by the City Clerk, in special pamphlet form, and made available in her office for public inspection and distribution to members of the public who may wish to avail themselves of a copy of this ordinance.
SECTION 9. Effective Date. This ordinance shall take effect 10 days after its passage and publication.
S \SHARED\Finance\SSA\SSA-2021\Ranti - 16. 33. 44 48. 72 73\SSA 44\0(dinance\SSA #44 Levy Ordinance 2021 docx|1010|EXHIBIT A SPECIAL SERVICE AREA #44
Total Requested Levy
Morgan Park Beverly Hills Business Association
Establishment Ordinance Date: November 7, 2007 Journal pages: pages 13653 through 13724
Amendment(s) to Establishment Ordinance
Date: December 12, 2007
Journal pages: pages 17060 through 17063
Date: December 9, 2015
Journal pages: pages 14757 through 14768
See attached Budget.
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Exhibit A Budget
Special Service Area # 44
SSA Name: 103rd Street/Beverly
2022 BUDGET SUMMARY
Budget and Services Period. January 1, 2022 through December 31. 2022
2021 Levy
CATEGORY (Funded Categories Comprise Scope of Services) Collectable Levy Estimated Loss Collection Carryover Funds TIF Rebate Fund #0A52 Estimated Late Collections and Interest Total All Sources
1.00 Customer Attraction $4,500 $0 $0 $0 $0 $4,500
2.00 Public Way Aesthetics $14,945 $0 $0 $0 $0 $14,945
3.00 Sustainability and Public Places $0 $0 $0 $0 $0 $0
4.00 Economic/ Business Development $0 $0 $0 $0 $0 $0
5.00 Public Health and Safety Programs $0 $0 $0 $0 $0 $0
6.00 SSA Management $2,950 $0 $0 $0 $0 $2,950
7.00 Personnel $5,383 so CO $0 tmemimmmm $0 $5,383
Sub-total $27,778
GRAND TOTALS Levy Total $27,778 $0 $0 $0 $27,778
LEVY ANALYSIS
Estimated 2021 EAV. $3,008,102
Authorized Tax Rate Cap 2.500%
Maximum Potential Levy limited by Rate Cap $75,203
Requested 2021 Levy Amount $27,778
Estimated Tax Rate to Generate 2020 Levy 0.9234%
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I GENERAL INFORMATION
A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Check ONE of the following three boxes:
Indicate whether the Disclosing. Party submitting this EDS is:
fx] the Applicant
OR
[ J 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 Applieant. State the Applicant's legal
name: _ _ _ __ u
' OR"~~
[ ] a legal entity with a direct or indirect right of control ofthe Applieant (see Section 11(B)(1)) Stale the legal name of the entity in which the Disclosing Party holds a right of control:
Business address ofthe Disclosing Party: Wl'} ^ WfrftYW AW.
&M0 } J^JpObA^
Telephone: D3- T?^ lW Fax: ._. Email: qPnH^il^^.
Name of contact person: LtMf o\AM£ U>V\ft 0V>
Federal I^mployer Identification No. (if you have one):
V. Uriel'description ofthe Mailer to which this EDS pertains. (Include project number and location of property, if applicable): To allOtA/ T)X Hl,^ CViM»\ \\ i|It" f}4d ^:-o u ixn\bMS ru'ali] o\ tw^o w po\/'k ^c-aM s(A\v^
G. Which City agency or department is requesting this EDS? V* JM^ p£y/elu |7md-l'-t
Ifthe Matter is a contract being bundled by the City's Department of Procurement Services, please complete the following:
Specification //
SUCTION II - DISCLOSURE OE OWNERSHIP INTERESTS
A. NATURE or Tin; DISCLOSING PARTY
I. Indicate the nature of the Disclosing Parly:
) ) Person ( | Limited liability company
| | Publicly registered business corporation 1 ] Limited liability partnership
[ ) Privately held business corporation | J Joint venture
j I Sole proprietorship |X] Not- for-profit corporation
j ] General partnership (Is the not-for-profit corporation also a 501(c)(3))?
| 1 Limited partnership jX) Yes [ j No
1 1 Trust \ ] Other (please specify)
2. Lor legal entities, the state (or foreign country) of incorporation or organization, if applicable:
3. For legal entities not organized in the Stale oflllinois: Has the organization registered to do business in the State oflllinois as a foreign entity?
| JYes [ [No j)<| Organized in Illinois
B. IF THE DISCLOSING PARTY IS A LEGAL ENTIT Y:
I. List below 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 entities (if there are no such members, write "no members which are legal entities"); (iii) for trusts, estates or other similar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general or limited partnerships, limited liability companies, limited liability partnerships or joint ventures, each general partner, managing member, manager or any other person or legal entity that directly or indirectly controls the day-lo-day management ofthe Applicant.
NOTE: Each legal entity listed below must submit an EDS on its own behalf.
Name . ~ Title
Z. Please provide the loilowing information concerning each person or legal entii.v having a direct or indirect, current ot prospective (i.e. within 6 months after City action) beneficial interest (including ownership) in excess ol'7.s% of ihe Applicant Examples of .such lid interest include shares in a corporation, partnership interest in a partneisbip oi joint venture, interest of a member or manager in a
^MoR^an cpapik ^BevteRly cHills
BUSINESS ASSOCiATlO N
Morgan Park Beverly Hills Business Association Board of Directors 2021
Debra Gawrys, President
Mark Mielnicki, Vice President
Laurie Duncan Cleary, Secretary
Marti Jatis, Treasurer
Shirley Blazjeczyk, Director
Mark Fechner, Director
Keith Lewis, Director
Jamenda McCoy, Director
Mary Moss, Director
Joan Each Rowan, Director
Caroline Connors, Executive Director
10827 S. Western Ave. ? Chicago, IL. 60643 • (773) 779-2rj30 • infoQ>mpbhba.oro
w vv w. m p b h b a .org
limned liability company, or interest of a beneficiary of a trust, estate or other similar enfn y 1 f none, state "None."
NOTE: Each legal entity listed below may be required to submit an F.DS on its own behalf.
Name Business Address Percentage interest in the Applicant
/ y (.' )_U. _
SECT?ON III -- INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTED OFFICIALS
Mas the Disclosing Party provided any income or compensation to any City elected official during the
12-month period preceding the date of this F.DS? [ J Yes )< ] No
Does the Disclosing Parly reasonably expect to provide any income or compensation to any City
elected official during the 12-month period following the date of this EDS? 1 | Yes ] )'], No
If "yes" lo either of the above, please identify below the name(s) ofsuch Cily elected official(s) and describe such income or compensation:
Does any City elected official or, lo the best ofthe Disclosing Party's knowledge after reasonable
inquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined in
Chapter 2-1 56 ofthe Municipal Code of Chicago ("MCC")) in the Disclosing Parly?
[ | Yes \/\ No
If "yes," please identify below Ihe namc(s) ofsuch City elected official(s) and/or spouse(s)/domestic partners) and describe the financial inlerest(s).
SECTION IV - DISCLOSURE OE SUBCONTRACTORS AND OTHER RETAINED PARTIES
The Disclosing Partv must disclose the name and business address of each subcontractor, attorney, lobbyist {as defined in MCC Chapter 2-1 56), accountant, consultant and any other person or entity whom the Disclosing Parly has retained or expects to retain in connection with the Mailer, as well as the nature of Ihe relationship, and ihe total amount ofthe fees paid or estimated to be paid. The Disclosing Party is not required lo disclose employees who are paid solely through ihe Disclosing Parly's regular payroll ll'lhe Disclosing Party is uneeitain whether a disclosure is required under this Section, ihe Disclosini;. Parly must either ask ihe City whether disclosuic is required or make the i.lisciosuie
Pai;e 3 oi 15
Name (indicate whether Business retained or anticipated Address to be retained)
Relationship to Disclosing Parly (subcontractor, attorney, lobbyist, etc.)
Fees (indicate whether Iwid^^.^UiLVIk^tl-) NOT E: "hourly rale" or "i.b.d." is
not an acceptable response.
(Add sheets it'necessary)
(' ] Check here it'the Disclosing Party has noi retained, nor expects to retain,-any such persons or entities. SECTION V CERTIFICATIONS
COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under MCC Section 2-92-415, substantial owners of business entities that contract with the City musl 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 Parly been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
| ] Yes | | No |yj No person directly or indirectly owns 10% or more of the Disclosing Parly.
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is (he person in compliance with thai agreement?
f | Yes ( | No
FURTHER CERTIFICATIONS
| This paragraph 1 applies only ifthe Matter is a contract being handled by the City's Department of Procurement Services.] ln the 5-year period preceding the date of this EDS, neither Ihe Disclosing Parly nor any Affiliated Entity |see definition in (5) below] has engaged, in connection with the performance ofany public contract, the services of an integrity monitor, independent private sector inspector general, or integrity compliance consultant (i c... an individual or entity with legal, auditing.
investigative, or other similar skills, designated by a public agency to help die agency monitor the activity of specified agency vendors as well as help the vendors reform then business practices so they can be considered for agency contracts in the future, or continue with a contract in progress).
The Disclosing Parly and its Affiliated Entities arc noi delinquent in the payment ofany line, fee, lax or other source of indebtedness owed lo ihe Cily of Chicago, including, but not limited to, water and sewer charges, license fees, parking tickets, properly taxes and sales la.xes, nor is the Disclosing huly delinquent in ihe payment ofany tax administered by (he Illinois Department, of Revenue.
Page a of 15
SSA 44 103rd Street Retained Parties/Cost Estimates 2022
Liberty Flag & Banner, 2747 York Street, Blue Island, IL 60406 (anticipated) Contractor
$3,500 Holiday decorations
Semmer Landscape, 1000 W. 94th Street, Chicago, IL 60620 (anticipated) Contractor
$10,000 Snow removal/sidewalk maintenance
The ACT Group, 6228 N. Broadway, Chicago, IL 60660 (anticipated)
Auditor
$2500
City Grange, 1818 W. 99th Street, Chicago, IL 60643 (anticipated) Garden Center
$4,000 Summer and autumn planters
The Disclosing Parly and, ii" Ihe Disclosing Party is a legal entity, all of those persons or entities identified in Section 11(B)(1) of this EDS:
are noi 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, during the 5 years before Ihe 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 slate 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, slate or local) with committing any ofthe offenses sel forth in subparagraph (b) above:
have not, during Ihe 5 years before the date of Ibis EDS, had one or more public transactions (federal, stale 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 oflocal government.
The Disclosing Parly understands and shall comply with the applicable requirements of MCC Chapters 2-56 (Inspector General) and 2-156 (Governmental Ethics).
5. Certifications (5), (6) and (7) concern:
» the Disclosing Parly;
<* 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 Parly, is controlled by the Disclosing Parly, or is, with the Disclosing Parly, 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 ent ity following the ineligibility of a business entity to do business w ith federal or slate or local government, including the City, using substantially the same management, ownership, or principals as ihe ineligible entity. Willi respect io Contractors, ihe term Affiliated Emily means a person or entity lhat directly or indirectly controls the Contractor, is controlled by ii, or, with the Contractor, is under common control of another person or entity;
* anv responsible official oflhe Disclosing Party, any Contractor or any Affiliated Enlity or any oilier official, agent, or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant lo Ihe direction or authorization of a responsible official ofthe Disclosing Parly, anv Contractor or any Affiliated Emily (collectively " Agents").
l-W 5 of 15
Neither Ihe Disclosing Party, nor any Contractor, nor any Affiliated Entily of either the Disclosing Party or any Contractor, nor any Agents have, during the 5 years before the date of ibis EDS, or. with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 years before the date ofsuch 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 ofthe federal government or ofany 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 ofsuch 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)(Contracts Requiring a Base Wage); (a)(5)(Dcbarment Regulations); or (a)(6)(Minimum Wage Ordinance).
Neither the Disclosing Party, nor any Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of slate or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 JECS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense ofany state or ofthe United Stales of America thai contains the same elements as the offense of bid-rigging or bid-rotating.
Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions Lis! maintained by the United States Department' of Commerce, Stale, or Treasury, or any successor federal agency.
| FOR APPLICANT ONLY] fi) Neither the Applicant nor any "controlling person" [see MCC Chapter 1-23, Article I for applicability and defined terms j ofthe Applicant 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 MCC Chapter I -23, Article I applies to tlie Applicant, thai Article's permanent compliance timeframe supersedes-5-year compliance timeframes in this Section V.
(FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use. nor permit their subeoniractofs to use, any facility listed as having an active exclusion by the U.S. EPA on the federal System for Award Management ("SAM").
10 |FOR APPI .ICANT ONLY| I he Applicant will obtain Iroin any contractors/subcontractors hired or lo be hired in connection with ihe Mailer certifications equal in form and substance to ihose in CU'lilkalioJi.s (2) and (9) above and will not. without the prior written consent of the City, use airy such
contractor/subcontractor (hat does not provide such certifications or lhat the Applieant has reason to believe has not provided or cannot provide truthful certifications.
I i. Ifthe Disclosing Party is unable lo certify lo any ofthe above statements in this Part B (further Certifications), the Disclosing Parly musl explain below:
Ifthe letters "NA," the word "None," or no response appears on the lines above, il will be conclusively presumed (hat the Disclosing Parly certified lo the above statements.
12. To the best ofthe Disclosing Parly'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-monlh period preceding the date of this EDS, an employee, or elecled or appointed official, ofthe Cily of Chicago (if none, indicate with "N/A" or "none").
Kllytic _
13. To the best ofthe Disclosing Parly's knowledge after reasonable inquiry, the following is a complete list of all gilts lhat the Disclosing Party has given or caused lo be given, at any time during the 12-monlh period preceding the execution date of this EDS, to an employee, or elected or appointed official, ofthe Cily 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 $25 per recipient, or (iii) a political contribution otherwise duly reported as required by law (if none, indicate with "N/A" or "none"). As lo anv gift, listed below, please also list the name ofthe Citv recipient.
... Llil _ _ _ L
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (cheek one)
[ | is [<\1 is not
a "financial inslilulion" as delined in MCC Section 2-32-455(b).
Ifthe Disclosing Parly 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 ol them will become, a prcd.ilwrv lender as defined in MCC Chapter 2-32 We undersland that becoming a predator* lender ot becoming an affiliate ol'a predatory lendei may result in (he loss of Ihe privilege of doing business with the Cil\."
P.'H'.e 7 of IS
If Ihe Disclosing Parly is unable lo make this pledge because ii or any of ils affiliates (as delined in MCC Section 2-32-455(1))) is a predatory lender within the meaning of MCC Chapter 2-32, explain here (attach additional pages if necessary):
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.
D. CERTIFICATION 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.
I n accordance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledge after reasonable inquiry, does any official or employee of die City have a financial interest in his oilier own name or in the name ofany other person or entity in the Matter?
| J Yes L/| No
NOTE: Ifyou cheeked "Yes" to Item D(l), proceed to Items D(2) and D(3). Ifyou cheeked "No" to Item D( I), skip Items D(2) and D(3) and proceed to Part E.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name ofany other person or entity in the purchase of any properly that (i) belongs to the City, or (ii) is sold for laxes or assessments, or (iii) is sold by virtue of legal process at the suit ofthe City (collectively, "Cily Properly Sale"). Compensation for property taken pursuant lo the City's eminent domain power does not constitute a financial interest within the meaning of this Pari D.
Does the Mailer involve a City Property Sale?
{ ] Yes [ 1 No
Ifyou checked "Yes" to Item D(l), provide Ihe names and business addresses ofthe Cily officials or employees having such financial interest and identity ihe nature ofthe financial interest:
Name Business Address Nature of f inancial (merest
¦l. fhe Disclosing Parly lurlher certifies thai uo prohibited financial interesi in the Mailer will be acquired by anv Citv olllcial oi employee.
\'-AVy. x m 15
F CERTIFICATION REGARDING SLAVERY ERA BUSINESS
Please cheek cither (1) or (2) below, li the Disclosing Early cheeks (2). the Disclosing Parly 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 Mailer voidable by the Cily.
X. 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records ol Ihe Disclosing Party and any and ail 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 in jury or death of their slaves), and the Disclosing Parly has found no such records
2. The Disclosing Party verifies that, as a result of conducting the search in step (1) above, the
Disclosing Parly 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 ofany 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 Vll. For purposes of ibis Section VI, tax credits allocated by the Cily and proceeds of debt obligations ofthe City are not federal funding.
A. CERTIFICATION REGARDING LOBBYING
I. 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 Parly with respect to the Matter: ( Add sheets if necessary):
(If no explanation appears or begins on ihe lines above, or ifthe letters "NA" or ifthe woid "None" appear, it will be conclusively presumed that the Disclosing Parly means that NO persons or entities registered under (he Lobbying Disclosure Act of 1995, as amended, have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
2. fhe Disclosing Pari} has noi spoil and will noi expend nn\ federally appropriated ihnds to pay any person or entity listed in paragraph A( 1 ) above loi his or her lobbying acl.tvii.ies or to pay any person Ol enlil} lo influence or ailcmpl io influence an officer or cmp!o\ee of anv agency, fis 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 ofany federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or io extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
The Disclosing Party will submit an updaied eertilicalion at the end of each, calendar quarter in which there occurs any event that materially affects the accuracy ofthe statements and information set forth in paragraphs A( l ) and A(2) above.
The Disclosing Parly certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii ) iL is an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986 but has not engaged and will noi engage in "Lobbying Activities," as thai term is defined in the Lobbying Disclosure Act of 1995, as amended.
Ifthe 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 subeonlraet and Ihe Disclosing Party musl maintain all such subcontractors' certifications for the duration ofthe Mailer and must make such certifications promptly available lo the City upon request.
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
Ifthe Matter is federally funded, federal regulations require the Applicant and ail proposed subcontractors to submit the following information with their bids or in writing al the outset of negotiations.
Is the Disclosing Parly the Applicant?
| ] Yes [ J No
If "Yes," answer the three questions below:
Flave you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
| ] Yes [ .] No
Have you filed with the Joint Reporting Committee, the Director of ihe Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
j J Yes [ | No I j Reports no! required
1 lave you participated in any previous contracts or subeonuacls subject lo the equal opportunity clause?
I I Yes | | No
II you checked "No" to question ( I ) or (2) above, please provide an explanation:
I'nge 10 oi l?
SECTION VII - FURTHER ACKNOWLEDGMENTS AND CERTIFICATION
The Disclosing Party understands and agrees thai.
The certifications, disclosures, and acknowledgments contained in this f.DS will become part ofany contract or other agreement between the Applicant and the City in connection with the Mailer, whether procurement, Cily assistance, or other Cily action, and are material inducements to the City's execution ofany contract or taking other action with respect to the Matter. The Disclosing Party understands thai 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.citvofehicaeo.org/Ethics , and may also be obtained from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, 11,60610, (312) 744-9660. The Disclosing Party musl comply fully with this ordinance.
Ifthe City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which il is submitted may be rescinded or be void or voidable, and Ihe Cily may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating ihe Disclosing Parly's participation in the Matter and/or declining to allow the Disclosing Party lo participate in other City transactions. Remedies at law for a false statement of material fact may include incarceration and an award lo the City of treble damages.
ll is the City's policy lo make this document available to the public on its Internet site and/or upon request. Some or all ofthe information provided in, and appended lo, this EDS may be made publicly available on the Internet, in response to a Freedom of Infonnation Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which ii may have against the City in connection with the public release of information contained in this EDS and also authorizes the City lo verify the accuracy ofany information submitted in (his EDS.
The information provided in this EDS must be kepi current. In the event of changes, the Disclosing Party musl supplement this EDS up to the time the Cily lakes action on the Matter. Ifthe Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must updaie tins 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 information provided herein regarding eligibility must be kept current for a longer period, as required by MCC Chapter 1 -23 and Section 2-1 54-020.
i'agc 11 of 15
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 ofthe date furnished to the City.
Print or type exact legal name of Disclosing Pai
(Print ortype exact legal name of Disclosing Party)
(Sign here)
(Print or type name of person signing)
(Print or type title of person signing)
Signed and sworn to before me on (date) Oc\o^)€cf^ o^OrO / »
at _iLoo.K . County, (state).
y
Notary Public
Official seal ADAM REYES NOTARY PUBLIC. STATE OF lUlNOlS CnmmiMion Otc. 2.2024
Commission expires: /.-^)/c\0£~>)0,->) Lj
Page 12 of 15
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 75%. It is not to 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 or any "Applicable Parly" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected cily official or department head. A "familial relationship" exists if, as of Ihe dale this EDS is signed, (he Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related lo the mayor, any alderman, the city clerk, the city treasurer or any city department bead as spouse or domestic partner or as any ofthe 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 II.B.I .a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe Disclosing Party, ifthe Disclosing Party is a limited partnership; all managers, managing members and members ofthe Disclosing Party, ifthe Disclosing Party is a limited liability company: (2) all principal officers ofthe Disclosing Party; and (3) any person having more than a 7.5% 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 Parly or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected cily official or department head?
!. I Yes |X] No
If yes, please identify below (1) the name and title ofsuch person, (2) the name ofthe legal entity to which Slicll person is connected; (3) the name and title ofthe elected city official or department bead io whom such person has a familial relationship, and (4) the precise nalurc ofsuch familial relationship.
l';igc 13 (if 15
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B
BUILDING CODE SCOFFLAW/PROJJLEM 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 not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building code scofflaw or problem landlord pursuant to MCC Section 2-92-416?
I I Yes lyjNo
I f 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 MCC Section 2-92-416?
[ J Yes [ | No D<5 ^ne Applicant is not publicly traded on any exchange.
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 completed only by an Applicant that is completing this EDS as a ''contractor" as defined in MCC Section 2-92-385. That section, which should be consulted (ww w,amlcgai.com ), generally covers a party to any agreement pursuant to which they: (i) receive Cily 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 lo 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 thai the Applieant is in compliance with MCC Section 2-92-385(b)(l) and (2), which prohibit: (i) screening job applicants based on Iheir wage or salary history, or (ii) seeking job applicants' wage or salary hislory from current or former employers. I also certify that the Applicant has adopted a policy lhal includes those prohibitions.
[XjYes
i: INo
| J N/A - I am not an Applicant.that is a "contractor" as defined in. MCC Section 2-92-385. This certification shall serve as the affidavit required by MCC Section 2-92-385(e)(1). Ifyou cheeked "no" lo the above, please explain.
Pa tic 15 of] 5