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Record #: O2022-797   
Type: Ordinance Status: Passed
Intro date: 3/23/2022 Current Controlling Legislative Body: Committee on Zoning, Landmarks and Building Standards
Final action: 4/27/2022
Title: Zoning Reclassification Map No. 12-F at 5438 S Dearborn St - App No. 20984
Sponsors: Misc. Transmittal
Topic: ZONING RECLASSIFICATIONS - Map No. 12-F
Attachments: 1. O2022-797.pdf
ORDINANCE



BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:

SECTION 1. Title 17 of the Municipal Code of Chicago, the Chicago Zoning Ordinance be amended by changing all the RS3 Residential Single-Unit (Detached House) District symbols and indications as shown on Map No. 12-F in the area bounded by
A line 353.31 feet south ofthe intersection of West 54th Street as measured along the west right-of-way line of South Dearborn Street and perpendicular thereto; South Dearborn Street; a line 378.31 feet south of the intersection of West 54th Street as measured along the West right-of-way line of South Dearborn Street and perpendicular thereto; and the alley next west of and Parallel to South Dearborn Street,


to those of a RT4 Residential Two-Flat, Townhouse and Multi-Unit District.

SECTION 3. This ordinance shall be in force and effect from and after its passage and due publication.




Common Address of Property: 5438 South Dearborn Street

CITY OF CHICAGO APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE
ADDRESS of the property Applicant is seeking to rezone:
5438 S. Dearborn, Chicago, IL
Ward Number that property is located in: 3
APPLICANT: Center Court Development. LLC
ADDRESS: / "' d CITY:
STATE: ' ZIP CODE: 60643 PHONE: 312-782-1983
EMAIL: nick@sanibankslaw.com CONTACT PERSON: Nicholas J. Ftikas
Is the Applicant the owner of the property? YES X NO
Ifthe Applicant is not the owner of the property, please provide the following information regarding the owner and attach written authorization from the owner allowing the application to proceed.
OWNER: Same as Above
ADDRESS: CITY:
STATE: ZIP CODE: PHONE:
EMAIL: nick@sambankslaw.com CONTACT PERSON: Nicholas J. Ftikas
Ifthe Applicant/Owner ofthe property has obtained a lawyer as their representative for the rezoning, please provide the following information:

ATTORNEY: Law Offices of Samuel V.P. Banks. Nicholas Ftikas

ADDRESS: 221 N. LaSalle St 38th Floor

STATE: Illinois ZIP CODE: 60601

FAX: 312-782-2433 EMAIL: nick@sambankslaw.com

If the Applicant is a legal entity (Corporation, LLC, Partnership, etc.), please provide the names of all owners as disclosed on the Economic Disclosure Statements.
Kamau Murray. Manager
On what date did the owner acquire legal title to the subject property? December 2017
Has the present owner previously rezoned this property? If Yes, when? No
Present Zoning District: RS-3 Proposed Zoning District: RT-4
Lot size in square feet (or dimensions): 25 ft. by 97 ft. - 2.425 square feet
Current Use ofthe Property: The subiect property vacant and unimproved.
Reason for rezoning the property: The Applicant is proposing develop the subject property
with a new three-story, two (2) unit residential building.
Describe the proposed use of the property after the rezoning. Indicate the number of
dwelling unit number of parking spaces; approximate square footage of any commercial
space; and height of the proposed building. (BE SPECIFIC): The Applicant is proposing
develop the subiect property with a new three-story, two (2) unit residential building. The
proposed building will be masonry in construction and measure 38 ft. in height. Onsite
parking for two (2) cars will be provided at the rear of the subiect zoning lot.

14. . The Affordable Requirements Ordinance (ARO) requires on-site affordable housing units
and/or a financial contribution for residential housing projects with ten or more units that receive a zoning change which, among other triggers, increases the allowable floor area, or, for existing Planned Developments, increases the number of units (see attached fact sheet or visit www.cityofchicago.org/ARO for more information). Is this project subject to the ARO?

YES NO X
COUNTY OF COOK STATE OF ILLINOIS

Signature of Applicant


I, Kamau Murray', in my capacity as Manager of Center Court Development, LLC. being first duly sworn on oath, state that all of the above statements and the statements contained in the documents submitted herewith are. to the best of my knowledge, true and correct.



OFFICIAL SEAL %
iq-jo i Nicholas Ftikas
- * NOTARY PUBLIC, SWE OF I^O'S
My Commission ExpirB^er^^^fJ








Date of Introduction:

File Number:

Ward:
RH GRAN A Til SURVEYING SERViCE. PC PH- (/OH) 371-4-478
fax (yoa) .m-39?:,'
R.I: GRAN A III SURVEYING SERVICE. P C 6005 W !5S(n STREET BLDG OAK TORES!', ILL >J04b2
LOT 14 111 BLOCK 2 IN COBURN'S ADDITION TO CHICAGO. BEING A SWIWWSWW OF ML SWm 593 25 FEET OF THAT PART OF IHE SOUTHEAST i OF THE SOUTHEAS! i OF SECTION 9. TOV.NSIIIP 38 NORTH. RANGE 14, l-ASI OF THE THIRD PRINCIPAL MERIDIAN, LYING EAST OF THE CHICAGO, ROCK ISLAND AND PACIFIC RAILROAD. IN COOK COUNTY, ILLINOIS

PIN LOT 14 20-09-422- 074 - 0000 COMMON ADDRESS: 5438 SOUTH DEARBORN
LOT 7.2 S SBVS'U" W 97 00

LOT 14
NO BUILDINGS








7—
Uj Uj
Ct 7—
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- EAST EDGE OF ALLEY PAVEMENT
'/
N 8SV5'W E 97.00 LOT 15
ct o in ct Uj Q

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CO
LOT 76



LOT 77


56' PUBLIC ALLEY


STA1E OF ILLIHOIS )
)SS
COUNTY OF COOK )
THIS IS TO CERTIFY THAT R.H GRANATH SUR^YING SERVICE. F.C HAS ISSUED THIS PLAT FROM FIELD SURVEY DATA OBTMNED AT THE PROPERTY INDICATED IN THE CAPTION LEGAL DESCRIPTION AND PUBLIC RECORDS. AND THAT THE FOREGOING IS A TRUE AND CORRECT REPRESENTATION OF THE SAME. THIS PLAT OF SURVEY CONFORMS TO THE CURRENT ILLINOIS MINIMUM STANDARDS OF PRACVCE PER TITLE 63 CHAPTER VII. SUBCHAPTER b SECTION 1270 56 IN THE RULES FOR THE ILLINOIS PROFESSIONAL LAND SURVEYOR ACT NO BOUNDARY CORNERS HERE SET DURING THIS FIELD SURVEY OF THE SUBJECT PROPERTY 3Y CLIENT AGREEMENT (ITEM 3D OF SAID RULES). ALL DIMENSIONS ARE IN FEET AND DECIMAL PARTS THEREOF.
Difji telly signed by Slcvcn Grand DN cn-Slcvcn Granain, o-R H C Surveying Service. Ou. rmnll--ilp*3l6rj#1iol com c^US Date: 2022 02J3D 15 21 AG -0GW
COMPARE ALL DIMENSIONS BEFORE BUILDING AND REPORT ANY DISCREPANCIES Al ONC.
STEVEN R. GRANATH I.P L.S No 31G9 VALID ONLY IF EMBOSSED SEAL IS AFFIXED
Written Notice, Form of Affidavit: Section 17-13-0107
March 23, 2022

Honorable Thomas Tunney
Acting Chairman, Committee on Zoning
121 North LaSalle Street
Room 304 - City Hall
Chicago, Illinois 60602


To Whom It May Concern:

The undersigned, Nicholas Ftikas, being first duly sworn on oath, deposes and says the following:

That the undersigned certifies that he has complied with the requirements of Section 17-13-0107 ofthe Zoning Code of the City of Chicago, by sending written notice to such property owrners who appear to be the owners of the property within the subject area not solely owned by the Applicant, and on the owners of all property within 250 feet in each direction of the lot line of the subject property, exclusive of the public roads, streets, alleys and other public ways, or a total distance limited to 400 feet. That said written notice was sent by USPS First Class Mail no more than 30 days before filing the application.

That the undersigned certifies that the notice contained the address of the property sought to be rezoned as 5438 S. Dearborn, Chicago, Illinois; a statement of intended use of said property; the name and address ofthe Applicant and Owner; and a statement that the Applicant intends to file an application for a change in zoning on approximately March 23, 2022.

That the Applicant has made a bonafide effort to determine the addresses of the parties to be notified under Section 17-13-0107 of the Zoning Code of the City of Chicago and that the Applicant certifies that the accompanying list of names and addresses of surrounding property owners within 250 feet is a complete list containing the names and last known addresses of the owners of the property required to be served.

Law Offices of Samuel V.P. Banks

Nicholas J. Ftikas Attorney for Applicant

, \ OFFICIAL SEAL I
< ' VINCENZO SERGIO f
J miu\t ll mmm IE If I ¦ ¦ I tl ri iriri IHr-fTi mnaiiluli in ¦ ll I im fl

Via USPS First Class Mail
March 23,2022


Dear Sir or Madam:

In accordance with the Amendment to the Chicago Zoning Code enacted by the City Council, Section 17-13-0107-A, please be informed that on or about March 23, 2022, I, the undersigned, intend to file an application for a change in zoning from a RS-3 Residential Single-Unit (Detached House) District to a RT-4 Residential Two-Flat, Townhouse and Multi-Unit District, on behalf of the Applicant/Property Owner, Center Court Development, LLC, for the property located at 5438 S. Dearborn, Chicago, IL.

The Applicant is proposing develop the subject property with a new three-story, two (2) unit residential building. The proposed building will be masonry in construction and measure 38 ft. in height. Onsite parking for two (2) cars will be provided at the rear of the subject zoning lot.

The Applicant/Property Owner, Center Court Development, LLC, maintains principal
offices at. - - ^
I am the attorney for the Applicant/Property Owner. I will serve as the contact person for this zoning application. My address is 221 N. LaSalle St., 38th Floor, Chicago, IL 60601. My telephone number is (312) 782-1983.
Sincerely,

Law Offices of Samuel V.P. Banks



Nicholas J. Ftikas Attorney for the Applicant




*Please note the Applicant is NOT seeking to purchase or rezone your property.

*The Applicant is required by Ordinance to send this notice to you because you are shown to own property located within 250 feet of the property subject to the proposed Zoning Amendment.

To whom it may concern:

Kamau Murray
Center Court Development, LLC
I, Kamau jVlurray, as Manager of Center Court Development, LLC. the Owner of the subject property located at 5438 S. Dearborn. Chicago, IL, authorize the Law Offices of Samuel V.P. Banks to file a Zoning Amendment Application with the City of Chicago for that property.
FORM OF AFFIDAVIT


Chairman, Committee on Zoning Room 304 - City Hall Chicago, IL 60602

To Whom It May Concern:

I, Kamau Murray, as Manager of Center Court Development, LLC, understand that the Law Offices of Samuel V.P. Banks has Filed a sworn affidavit identifying Center Court Development, LLC, as the Owner holding interest in land subject to the proposed zoning amendment for the property identified as 5438 S. Dearborn. Chicago, IL. 1, Kamau Murray, as Manager of Center Court Development, LLC. being first duly sworn under oath, depose and say that Center Court Development. LLC. holds that interest for itself and no other person, association, or shareholder.

Kamau Murray, Manager Center Court Development, LLC




Subscribed and Sworn to before me


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: Center Court Development, LLC

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:
[X| 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. thc Applicant. State the Applicant's legal
name:
OR
[ ¦¦] a legal entity with a direct or indirect right of control ofthe Applicant (see Section 11(B)(1)) State thc legal name ofthe entity in which thc Disclosing Party holds a right of control:


B. Business address ofthe Disclosing Party:
Telephone: 312-782-1983 pax: 312-782-2433 Email: nick@sambankslaw.com
Name of contact person: Nicholas Ftikas - Attorney
Federal Employer Identification No. (if you have one):
Brief description ofthe Matter to which this EDS pertains. (Include project number and location of property, if applicable):

Zoning Amendment Application concerning 5438 S. Dearborn, Chicago, IL.

G. Which City agency or department is requesting this EDS? ~ Zoning
Specillcation # Ver.2018-1

If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:

and Contract #
Pasie 1 of 15
SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY
1. Indicate the nature ofthe Disclosing
f ] Person
[ ] Publicly registered business corporation
[ ] Privately held business corporation
[ ] Sole proprietorship
[ ] General partnership
[ ] Limited partnership
[ ] Trust
Party:
[X] Limited liability company
] Limited liability partnership
[ ] Joint venture
[ ] Not-for-profit corporation
(Is the not-for-profit corporation also a 501(c)(3))?
[ | Yes |" ] No j 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: Flas the organization registered to do business in the State of Illinois as a foreign entity?

[X] Organized in Illinois

B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

1. 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-to-day management ofthe Applicant.

NOTE: Each legal entity listed below must submit an EDS on its own behalf.

Name Title

Kamau Murray Manager



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% ofthe 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 ofa beneficiary ofa trust, estate or oilier similar entity, ff none, state "None."
NOTE: Each legal entity listed below may be required to submit an EDS on its own behalf.
Name Business Address Percentage Interest in thc Applicant

Kamau Murray - 11740 S. Longwood, Chicago, IL 60643 100%



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? [ JYes [Xj No

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 of this EDS? [ ] Yes [X] 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:

N/A.
Does any City elected official or. to 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 2-156 ofthe Municipal Code of Chicago ('''MCC")) in the Disclosing Party?
[ ] Yes IX] No

If "yes." please identify below the name(s) of such City elected official(s) and/or spouse(s)/domestic partner(s) and describe the financial interest(s).

N/A
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 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. 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 thc disclosure.

Paae 3 of 15

Name (indicate whether Business retained or anticipated Address to be retained)
Law Offices of Sam Banks
Relationship to Disclosing Party Fees (indicate whether
(subcontractor, attorney. paid or estimated.) NOTE:,
lobbyist, etc.) "hourly rate" or "t.b.d." is
not an acceptable response.
221 N. LaSalle St., 38th Floor Attorney Est. $5,000.00
Chicago. lL 60601
(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 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 .1.0% or more ofthe Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [Xj No [ ] No person directly or indirectly owns 10% or more ofthe Disclosing Party. .-

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?

[ ] Yes [ ] No
FURTHER CERTIFICATIONS

[This paragraph 1 applies only ifthe Matter is a contract being handled by the City's Department of Procurement Services.] In the 5-year period preceding the date of this EDS, neither the Disclosing Party nor any Affiliated Entity [see definition in (5) below] has engaged, in connection with the performance of any public contract, the services of an integrity monitor, independent private sector inspector general, or integrity compliance consultant (i.e., an individual or entity with legal, auditing, investigative, or other 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).
The Disclosing Party and its Affiliated Entities are not delinquent in the payment ofany fine. fee. tax 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 .1.5

The Disclosing Parly and. iflhe Disclosing Parly is a legal enlity. all of those persons or entities identified in Section 11 (B)(1) oflhis LDS:

are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, slate or local unit of government;
have not. during the 5 years before the date oflhis EDS, been convicted ofa 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 ofthe offenses set forth in subparagraph (b) above;
have not, during the 5 years before the date of this 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 oflhis EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental, violations, instituted by the City or by the federal government, any stale, or any other unit of local government.
The Disclosing Party understands and shall comply with the applicable requirements of MCC Chapters 2-56 (Inspector General) and 2-1.56 (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 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 ofa business entity following the ineligibility ofa 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;
o any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee ofthe Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization ofa responsible official ofthe Disclosing Party, any Conlractor or any Affiliated Entity (collectively "Agents").

Page 5 of 15

Neither the Disclosing Party, nor an) Conlractor. new any Aflilialed Enlity of either the Disclosing Party or any Contractor, nor any Agents have, during the 5 years before the date oflhis EDS. or. with respect to a Contractor, an Affiliated Entity, or an Aflilialed Entity ofa 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 ofthe federal government or ofany state or local government in the United Slates 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)(Contracts Requiring a Base Wage); (a)(5)(Debarment Regulations): or (a)(6)(Minimum Wage Ordinance).

6. 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 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 ofany stale or ofthe United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.

1 .¦ Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by the United States Department of Commerce, Stale, or Treasury, or any successor federal agency.
[FOR APPLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [see 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 for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, 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.
[FOR APPLICANT ONLY] Thc Applicant and its Affiliated Entities will not use. nor permit their ¦ subcontractors to use, any facility listed as having an active exclusion by the U.S. EPA on the federal System for Award Management ("SAM").
[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 ofthe City, use any such
Ver.2018-1 Page 6 of 15

contractor/subcontractor that does not provide such certifications or that the Applicant has reason to believe has not provided or cannot provide truthful certifications.

1 1. Ifthe Disclosing Party is unable to certify to any ofthe above statements in this Part B (Further Certifications), the Disclosing Party must explain below:

N/A


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 ofthe 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 1.2-month 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").
nTa


13. To the best ofthe 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 oflhis 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 $25 per recipient, or (iii) a. political contribution otherwise duly reported as required by law (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name ofthe City recipient.

N/A


C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is fX] is not
a "financial institution" as defined in MCC Section 2-32-455(b).
Ifthe 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 defined 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 ofthe privilege of doing business with the City."

Page 7 of 15

Iflhe Disclosing Party is unable lo 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):

N/A

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 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 2-156-1 10: To the best ofthe Disclosing Party's knowledge after reasonable inquiry, 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?

[ ] Yes [X] No

NOTE: If you checked "Yes" to Item D( 1). 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 E.
Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elecled 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 property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit ofthe City (collectively. "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.

Does the Matter involve a City Property Sale?

[ ] Yes [X] No
If you checked "Yes" to Item D(l). provide the names and business addresses ofthe City officials or employees having such financial interest and identify the nature of the financial interest:'

Name Business Address Nature of Financial Interest

N/A



4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.

Page 8 of 15

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Please check either (1) or (2) below. Ifthe Disclosing Paity checks (2). tlie Disclosing Parly-must disclose below or in an attachment lo 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.

X 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the 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 injury or death of their slaves), and the Disclosing Party has found no such records.

2. The Disclosing Party verifies that, as a result of conducting the search in step (1) above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names ofany and all slaves or slaveholders described in those records:

N/A



SECTION VI - CERTIFICATIONS FOR. FEDERALLY FUNDED MATTERS

NOTE: Ifthe Matter is federally funded, complete this Section VI. Ifthe 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):

N/A


(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 thc Lobbying Disclosure Act of 1995. as amended, 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 ofany agency, as defined
by. applicable federal law. a member of Congress, an officer or employee of Congress, or an employee
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or a member ol" Congress, in connection with the award ofany federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or lo extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event thai materially affects the accuracy ofthe statements and information set forth in paragraphs A(l.) and A(2) above.
The Disclosing Party certifies thai either: (i) it is not an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1.986: 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, 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 Parly 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

Ifthe 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. Not Federally Funded ;

Is the Disclosing Party the Applicant? [ ] Yes " ' ['] No

If "Yes," answer the three questions below:
Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes [ ] 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 [ ] No [ ] Reports not required
Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes ' [ ] No

If you checked "No" to question (1) or (2) above, please provide an explanation:

N/A

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SECTION VII- FURTHER ACKNOWLEDGMENTS AND CERTIFICATION

The Disclosing Parly understands and agrees thai:
The certifications, disclosures, and acknowledgments contained in litis EDS will become part ofany 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. c i ty o fc h i cago. or g/E thics. 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 Part}' must 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 it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law. or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other City transactions. 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 ofthe information provided in. and appended to. this EDS may be made publicly available 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.
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 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-\54-1)20.








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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 ofthe 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.



(Print or type exact legal name of Disclosing Party)

(Sign here)


(Print or type name of person signing)


(Print or type title7 of person signing)

Signed and sworn to before me on (date) at [_J&&L. County, tSTZ.


Notary Public


Commission expires: /' 2 V ' ~L£ j


















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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5%. 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 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, ihe Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any 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.l.a ifthe Disclosing Party is a corporation: all partners ofthe 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 ofa 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 relationship, and (4) the precise nature of such familial relationship.

N/A







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CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX B

BUILDING CODE SCOFFLAW/.PROBLEM LANDLORD CERTIFICATION

This Appendix is to be completed only by (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 thc 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?

[ ] Yes [X] No
Ifthe 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?

f ] Yes [ ] No [Xj The 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.

N/A























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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 thai"is completing this EDS as a "contractor" as defined in MCC Section 2-92-385. That section, which should be consulted (www.amiegal.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 prohibitions.
[ ] Yes [ ]No
[Xj N/A -1 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(c)(l). If you checked "no" to the above, please explain.



N/A

















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