Record #: O2010-7026   
Type: Ordinance Status: Passed
Intro date: 12/8/2010 Current Controlling Legislative Body: Committee on Transportation and Public Way
Final action: 4/13/2011
Title: Vacation of portion of W Beach Ave bounded by N Paulina St, N Ashland Ave and W Blackhawk St
Sponsors: Moreno, Proco Joe
Topic: STREETS - Vacations
Attachments: 1. O2010-7026.pdf
ORDINANCE
WHEREAS, the City of Chicago ("City") is a home rule unit of local government pursuant to Article VII, Section 6 (a) of the 1970 constitution of the State of Illinois and, as such, may exercise any power and perform any function pertaining to its government and affairs; and
WHEREAS, the properties at 1419 N. Paulina is owned by the applicant, Ryan
Cahalan; and
WHEREAS, Ryan Cahalan, proposes to use the portion of the street to be vacated herein for occupation by an existing building
WHEREAS, the City Council of the City of Chicago, after due investigation and consideration, has determined that the nature and extent of the public use and the public interest to be subserved is such as to warrant the vacation of part of public street, described in the following ordinance; now therefore,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
SECTION 1. All that part of the South 4 feet of West Beach Avenue, lying North of adjoining the North line of Lot 24 (except the East 4 inches thereof) in Block 9 in McReynold's and Other's Subdivision of part of the East Vi of the Northeast Vi of Section 6, Township 39 North, Range 14, East of the Third Principal Meridian, bounded to the West bythe West line of said Lot24, extended North and bounded to the East by the East line of said Lot 24 (except the East 4 inches thereof), extended North, all in Cook County, Illinois as shaded and indicated bythe words "TO BE VACATED" on the drawing hereto attached, which drawing for greater certainty is hereby vacated and closed, inasmuch as the same is no longer required for public use and the public interest will be subserved by such vacation.
SECTION 2. The vacation herein provided for is made upon the express condition that within 180 days after the passage of this ordinance, the applicant shall pay or cause to be paid to the City of Chicago as compensation for the benefits which will accrue to the owner of the property    abutting    said    part    of    public    street    hereby    vacated    the sum
      dollars ($ ),
which sum in the judgment of this body will be equal to such benefits.
SECTION 3. The vacation herein provided for is made upon the express condition that within one hundred eighty (180) days after the passage of this ordinance, the applicant shall file or cause to be filed for record in the Office of the Recorder of Deeds of Cook County, Illinois a certified copy of this ordinance, together with an attached drawing approved by authorized staff of the Maps and Plats Unit of the Chicago Department of Transportation.
 
 
 
 
 
 
 
 
 
 
 
Page 1
 
SECTION 4. This ordinance passage.
shall take effect and be in force from and after its
 
VacallorpApproved: /
Bobbv L vyare
Ading CorfrAissioner of Transportation
 
Page 2
 
Approved as to Form and Legality
 
Deputy Corporation C^j^^j^
Honorable Joe Moreno Alderman, 1sl Ward
 
PLAT OF VACATION
OF
THAT PART OF THE SOUTH 4 FEET OF WEST BEACH AVENUE LYING NORTH OF AND ADJOINING THE NORTH LINE OF LOT 24 (EXCEPT THE EAST 4 INCHES THEREOF) IN BLOCK 9 IN McREYNOLD'S AND OTHER'S SUBDIVISION OF PART OF THE EAST 1/2 OF THE NORTHEAST 1/4 OF SECTION 6, TOWNSHIP 39 NORTH, RANGE 14, EAST OF THE THIRD PRINCIPAL MERIDIAN, BOUNDED TO THE WEST BY THE WEST LINE OF SAID LOT 24, EXTENDED NORTH AND BOUNDED TO THE EAST BYTHE EAST LINE OF SAID LOT 24 (EXCEPT THE EAST 4 INCHES THEREOF), EXTENDED NORTH, ALL IN COOK COUNTY, ILLINOIS.
TOTAL LAND AREA = 400 sq.ft.
 
 
 
 
 
 
 
 
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DWG: 06-01-10-3202
 
 
FILE NO. 6-1-10-3202
 
TOTAL AREA of STREET TO r3E VACATED = 400.2 Sq. Ft.
 
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
 
 
SECTION 1 ■■ GENERAL INFORMATION
^ Lecal'n&mc of Disclciinc FaiiysucrniiDnc ihi; EDS. inciudc d/b:a/ if applicable:
 
 
 
Check ONE of the following ihrre bo>tt;
Indicoie whnhei Disc;c;;r.c Pany jut-mntinc >hi: EDS j: l.      ihe Appitcani OR
  1. [] s lerei tr.ir.v hclc'ing a cure: f: md.-ifci :nit iesi :r, .he Arr ;ic2ir   S taie the legal name of the
Applicani in which Disclosing Patty holds an tnieresi:      
OR
  1. ' ] a 5ptc:fiec iccei i'r,ii;y -.Mih i ::ch: ci conucl iset Sec-.ic-i. Vh.\ b.i State the legal name of
ihe entiiv in which Disclosing P;:ty holds a light of conuol:      
 
E. Business iddiess of Disclosing Pai:y
C. Telephone
D. Name cf cc-ntac. person:   ^/^^x      C^y/<>/4xr
E Fedttal l.T.piovei jricr.nficaiion Nr. ni you have one'::
 
F Eiief dcscr.pnon of ccnnaci. i:;r.Mc:icn oi cihcr undtiuking 'it it tied to below as the "Manet") to which this EDS penams. ilnciude prc.itci numbci and iccaiicn 01 piopeny. if applicable):
_L^^      Jnr    300      «J   /V/f ^ ^
G. Which Cny agency cr riepai>mt pus tequesiing this EDS?      <^f ~^^^P^r^r^^
If :hc Mauej :s a ccr.:iact being nir.-dled by ;he City'; Dcpar::v,! nt of Frocuiement Services, please rompieie the following:
 
Sptcificaucn *      sno Coniraci =      
 
f. lmt-o:
 
 
 
Paee i of
 
 
SECTION 11 -- DISCLOSURE OF OWNERSHIP INTERESTS A. NATURE OF DISCLOSING PARTY
 
i.   indic£ic ihe nature of the Disclosing Fcny:
Eon
[ ]      Publicly ic2i5icrcd business ccipc-:i;cr.
( ]      Privately held business ccrpcrstior,
[ ]      Sole proprietorship
| ]      General partnership*
[ ]      Limited partnership"
[ ]      Trust
[ ] Limited liabiliiy company*
[ 1 Limited liability panneiship*
[ ] Joint venture*
[ ] Not-for-profit corporation
ds ihe noi-foi-prom coiporation also a i01(c)(2))?
[]Yes' []No [ "j Other (please specify'i
 
* Noie B.l -b below.
For lecal eniiiics. the state icr fcie:-.'n ccunuy: cf ir.corpoiaucn ci cirinization. if applicable:
 
 
 
For iecal endues sot oirtTiiseo: :r. ±i S :ie of *;':l:r.ois: Has :he cigav.iaiion registered to do business in the State of Illinois as a foreign entity?
( ] Yes      -II N< XN/A
E. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
I a      l ist below ihe full r.ur.c; ir.c ;i;ies of til cm'cuiivc officer; mc all diiectors of the cntuy.
F or not-for-pi of it corpoisncns. aiso      ccic« ail rr.e:r.be:s. :; tny. w hie'r.      ieeai entities. If there sit no such members- write "uc merr.btis." Fii nusts. enaics or other smiir.:; tnutics. list below the lerai litleholderls).
Name      / Ti,)e
A/O JM&UV^>      
 
 
 
 
 
 
 
 
;      ]f vou checked "Ger,ei;j par.iiership." "Limited partnership." "Limiied liability
company." "Limited liabiiiiy partnership" or "Joint venture" in response to item A.l. above (Naiure of Disdosinc FarivO, list below the r;£rmt and litle of each eenerai partner, managing member, manager or
 
 
Page 2 of \:
 
 
anv oihei person or entity that ccntic:; ihe day-io-csy manicemeni of ihe Disclosing Parly. NOTE. Each iegai eninv lisied beiow mus: sucmn sn EDS on iis own bchaif.
 
Name        • Ti'lt
e /
 
 
 
 
 
 
 
Z.   Please provide the following inicin-iaiion concerning each person oi entity having a direct or indirect beneficial inieresi (inducing ownership) in excess of        of ihe Disclosing Party. Examples of such an inieresi include shiir: in t ccrpoiaiion. panr.crship inieresi m a pannership or .ioini venture, inieresi of a member c<i rr.ansrei in a i;n,ncd liibiiny cciv.r any. or inieresi of a beneficiary of a uust. esiaie or oihei iimiiar entity, if none. siaic -None." N'OTE: Pursuant to Secuon r.)5<s-030 of the Municipal Code of Chicago i"Munic;pal Code"), ihe Cily may requite any such additional infoimauon fiom anv applieani which    leasc-nacly mended 10 achieve full disclosure.
^an-.c      Business .-.c'dres;      Peiceniage iniciest in ihe
Disclosing Panv
/V^tf-       .      
 
 
 
 
 
SECTION 1)1 - BtSlNCSS REL.A 1 IONS HI PS WITH CITY ELECTED OFFICIALS
Has ihe Disclosing Party had a "business relationship," as defined in Chapier 1-156 of the Municipal Code, wilh anv City elecied official in ihe )l months before the dare this EDS is signed?
I ) Ve« XN°
If ves. please identify below ihe nimeisi of such Cny tiecicd offrcial(s) and describe such re)aiionship(s):
 
 
 
 
SECTION JV .- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
 
The Discicsinc Party must disciose ihe name and business aodiess of each subcontractor, aiiornev. lobbvisi. accoumani. censuiun: and any other person or entity *r,cm the Disclosing Party his retained or expect; 10 reiain in connec:ion with the Maiter. a; well as the nature of the relationship, and the total
Pace 3 of j ?
 
 
mount ofjihc fees paid oi estirr.aiec :o oe raid. The Discicjj.E P;Hy is noi jequired to disclose ir,riovtes: uho ate paid scieiy :'r.toi;ch the Discicsine Parly's iegular payroll.
 
"Lcbbvisi" means any person or in:::yAno unoc::ekcs ic ir.fiuutcc £ny legislative oi administtaiive idion on bchaif of any peison or e::::iy o:hu :han: (i / a rio;-:"ci-p:cfu entity, on an unpaid basis, oi (2) himself. "Lcbbvist" also means a.-y rtiscn or entity an\ par: cf whose duties as an employee of ^ncihcr include; undcnakine 10 infiutr.ee any ieg:;i:-tive or ic'mini;trattve action.
 
!f the Disdosine Party i; uncer.iir, w hether a di;do;ure :; itcuued under this Section, the Di;cic;ine Partv must either ask the C:'.'. ^nether disclosure :s lecuited cr make the disclosure.
 
Nerne      Eusine;;          Relationship to Disclosing Party      Fees
(indicate whether      Address           ';ubconuacioi. r-.ncniey.      (indicate wheiher
retained cr anticipated                          lobbyist, etc.:      paid or esiimatcd)
to be retained')                                                       .      .
 
 
 
 
 
 
(Add sheet; if necessary)
[ ] Check here if the Disclosing piny ;.ss r.c: tr.smed. r.ci r-.pec:; 10 retain, any such persons or entities.
 
SECTION V - CERTIFICATIONS
 
A. COURT-ORDERED.CHILD SUPPORT COMPLIANCE
 
Under Municipal Code Section      If. substantial c-.< '-.ci; cf business entities that contract wjib
the Ciivmusi remain in ccmpiianci -v;ih :heir child suppoti etiicanens throughout the term of the contract.
Has any person who directly or inc'in ctiy owns J 0% or more cf the Disclosing Party been declared in anearaee on any child support cb'utaiicns by any Illinois court of competent juiisdiciion?
 
| ] Yes      '   ^C r*:lcn owns        or rr.ore of the Disclosing Party.
 
if "Yes," has ihe person entered m;o a court-approved asrt t rr.ent for payment of all support owed and is the peison in compliance wjih thai agreement?
 
( ] Ye;      | ] Nc
 
 
Page 1 of j':
 
 
5. FURTHER CERTIFICATIONS
•    The DtscicsinG Paiiy and. :;" :he Disclosing Party :s   ierai entity, ail of those peisons oi entities dentified in Seciion JJ.B.l. of this EDS:
o    aie noi presently debaried. s-.sper.ced. rrcpesed foi c'e'ccimeni. c'tciaied ineligible or voluntarily excluded from any nansaciiens by tny federal, stale or local unit of government:
 
t.   have not. within a fjveytar-f;iod preceding the caie of ;hi; EDS. been convicted of a criminal offense, adiudged guilty, or r.;-d a civil judgment undeied acamsi them in connection wjih: obtainine, aitempting 10 obtain, or performing a public (federal, stale or local) itansaciion or contract under a public ::r:nsac'.icn: a violation of fecnai or state antitrust statutes; fraud; embezzlement: lheft: forgery, t.-iotry: falsification or obstruction of records: making false siaiemenis: or receiving stolen ptcperty:
c    are not presently indictee f<ri ot oiheiu i;e cnminaiiy »>i c -vmK charged by a governmental entity (federal, staie cr locafi « nh cvmrr.issicn of any o; ;he offenses enumerated in clause B.l.b. of this Section V:
 
c.
have not. wiihin a fiveyt ai r-t rioc pieceding ihe caie ct' :his EDS. had one ot mote public transactions (federal. sia:e or ioc^ii -.eiminated for csuse or default: and
have noi. within a i"ive.\ t o: pi hoc pita cine ihe c'sie   f lhis E DS. been convicted, adjudged ruiltv. oi found liable in a cv-jj pioceedina, or :n any ci;mina) or c;vii action, including acnons ccncftning environmental \ loianons. :nsiiiuied by the City ot by ihe federal government, any staie. or anv oihei unit of local government.
 
The ceriificattons in subparts 2. j and <J concern:
  • ihe Disclosing Party;
  • snv "Applicable Party" l mtaning any party participating in ihe performance of the Matter, including but noi limiied 10 any peisons or iecai entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
  • anv "Affiliated Entity" (meaning a peison or entity thai, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is. with ihe Disclosing Party, under common connol of another person or <niu>. Indicia of control include, wjihoui limitation: :nierlocking management or ownership: identity cf inicicsis among family members, shared facilities ;nd equipment: common use of employers: oi organization of a business entity foliowjng the :nc)igibiliiv of a business entity -.o do business wjih federal ot state or local govemmem. includine :he Citv. using subsianiially the    Tit T.anagement. ownership, or ptinctpais as the ineligible entity); with respect to Applicable Parties, the term Affiliated Entity means a person or entity that directlv or :ridirecilv controls the Applicable Party, is controlled by n. or. with the Applicable Paity, j; under ccmmoil COIIltol of another person oi enniy;
 
 
Paec f of ::•
 
 
• anv if sponsible efficial of the Disclosing Pany. any Applicable Fauy or any Affiliaieci Entiiy 01 anv eiher official, agent 01 employee of ihe D:scicsmc Pany. any Applicable Pariy or any Affilisied Eninv. acting pursuant 10 the duccnon oi auihon:a:ion of l lesponsible official of ihe Disclosing Fanv. any Applicable Pany oi any Affiliated Enmy icolleciiveiy "Agems").
 
Neither ihe Disc losinc Potty, noi any Appiiczbit Faity. not any Affiliated Entity of cither ihe Disclcsinc Panv or any Applicable Party not sny Agems have, duitng the f:\e years before the daie this EDS is signed, or, w;ih respect to an Applicable Party, an Affiliated Entity, or an Affiliated Entity of an Applicable Partvduiing tbe five >ear; before ihe caie of such Applicable Party'; or Affiliated Entity's contract or encagemt nt m connection with ihe Matter:
a.   bribed or anerr>pied to bribe, or been convicted or adjudged guilty of bribery or attempting 10 tribe, a public officet or employee of the Cily. the S'.aie of Illinois, or any agency of ihe federal :ove:nmeni ct of any s-ate rr h-cai government in ihe Ur.:tec Siaics of America, in thai officer's or emplovee'j official capacny:
 
t.   icjeed or coliuded with other r.idders ot piospecnve bidders, or been a party to any such
igter ment. oi been c onvicied or icjvcvca guilty cf arit ercent ot collusion among bidders or r-iespective traders, ir, ic;::iin; of frece'em cf ccmpcrr.icn by agrecmeni to bid a fixed price or otherwise; or
c.   —ace an admission of such icr.duct described m a. cr c. stove :'r.at is a mailer of record, but have noi ret:, prosecuied for such conduct: or
 
c.   viciaied the pr.vjsicns cf Municipal Cede Section I-cI-6i 0 (Living Wage Ordinance).
  1. Neither the H iscicsinc Party. -.;'filiated Enmy oi Applicatle Patty, ot any of their employees, officials, agems or ; ;.tiners. is taned from ccnuacung with any unit cf siaic or local government as a tesuii of encaging in ot tt mg convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-roiatinc in violriicn of "0 ILCS f.33.E-4: or (3) any simiiar ci'ferse cf any state or of the United Stales of America :bai contain; not same i it minis as ihe cf/rnsc of bid-rigging or bid-roiaiing.
  2. Neither the T iscicsing Pany nor any Affilialed Entity is iisied on any of the following lists maintained by the Office cf Foreign Assets Control of the U.S. Department of the Treasury oi the Burtau cf Industry tnd Stcurny of the U.S. Depanmcni cf Commcice or their successors: the Speciallv Dcsitnaied Nationals List, ihe Denied Persons Li;t, the Unverified List, the Entity List and the Debarred List.
  3. The Disclosing Pany under;tands and shall comply wjth (1) ihe applicable requirements of the Govt:nmental Ethics Oidinance of the City. Title 2. Chapiei Z-! f 6 of ihe Municipal Code; and (2) all :he apriicable provision; cf Chapiei 2-it of the Municipal Code tOffice of the inspector General).
 
 
 
 
Pace 6 of 13
 
 
fc If ihe Disc los ing Pany 1; ur.acie to certify 10 any cf '.he ;':ove s laiernenis in this Pan B (Further Ccnificauori; i. the Disclosing Party must explain beiow;
 
Jfthe letter; "NA." the word "None' or no icspcnsc arotar; on the line; above, it will be conclusively pre;umed that the Disclosing Pany certified to the above statements.
 
C. CERT1F.1CAT10N OF STATL'S AS FINANCIAL INSTITUTION
 
For purpose; of this Pan C. under Municipal Code Senior. 2-:Z—iii ib). the term "financial institution" mean; a bank, savings and loan as social ion. thrift, ctedii union, montage banker, mortgage broker, trust ccmpanv. savings bonk, ;.-.ve;:r.fni Hank, recunnes broker, municrpai securities broker, securities dctiei. municipal securities c'eaiei sccunnes vinderwuie:: iriur.icipal securities underwiitet, investment tiust. \enture capital company, tar.'r. :,c Iding oc—ipany. fjr.ar.clDl services holding company, or any "licensee undei the Ccr.sumet ;r.;ia:]r.-,eni Lean Act. the Sales F :nance Agency Act. or ihe Residential Monraee Licensing Ac:. Howevei. "financial ■.r.smuticn" specifically shall not include any entiiy whose ciedcrr.ir.ant business is the ricic'mg of ;ax oefcred. defined contribution, pension plan; to public cmpiowrs in accoidar.ee wish Secnons -03(bi and Ai'i of the Internal Revenue Code. i.Addiiior.ai definitions rr.ay be t'our.d in Municipal Code Section 2-32-Sf 5(b).)
I. CERTIFICATION The Disclosing Pany tt r:\uts :hs\ t he disclosing Party (check one)
: j ^      j^is noi
a "financial insmuiion" as defined ir. Section 3-33--.'f (b) of the Municipal Code.
I.   If ihe Disclosing Pany IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predaioiy lender a; defined in Chapter 2-32 of the Municipal Code. We funhei pledge ihai none of out affiliates is. and none of them will become, a predatorv lender as defined in Chapter 2-32 of :he Municipal Code. Wc understand thai becoming a predatory iender or becoming an affiiiaie of a pit calory \i ndcr may result in the io;; of the privilege of doing business wiib the City "
 
If ihe Disdosir.r Pany is unable 10 rr.ake this pieo'fe because    or c-ny of its affiliates ias defined in Sccnon 3-33 -.'.'(b) of :he Municipal Code) is a piec'aiery lender -.vnhin ihe meaning of Chapter
 
 
Page 7 of i.'
 
 
" of lhc Municipal C ode. explain heie lauach addnicnai oapcs if necessarv;:
~* A/M      —-            
 
 
 
 
f ihe letters "NA." the word "None." oi no tespcnse apreaTS on ihe lines above, ii will be onclusivelv presumed lhal ihe Discicsine Pany certified 10 ihe above statements.
 
D. CERTIFICATION REGARDING INTEREST IN CiTY BUSINESS
 
Any words or terms that air defined in Chapter Z-!6 of :he Municipal Code have the same meanings when used in lhis Pari D.
1.   in accoidance with Section 2-1 i6-": 10 o:' :he Municipal Code: Does any official or employee ofnhe Ciiv have a financial inieiest in his cr her own name or :n ihe name of any other peison or entuv in the Malter?
f]Yes y(yo
NOTE:  If you checked "Yes" io ncm D.l... pioceed to ntms D.I. and D.3. If you checked "No" io liem D.l., proceed io Part E.
 
Unless sold putsuam ic a pioces; cf competitive bidding, or otherwise permitted, no Ciiv elected official ot employee shall htvr a t"ir.2ncial inieiest in his oi hei own name or in ihe name of any oihei peison or entity m the putchase ci any piopeny thai Ii) belongs to the Cily, or (ii) is sold for laxc; or assessments, ct (iii) is sold by \ ntue of ierai piocess at ihe suil of the City icollectivelv. "City Picperty Sale""). Ccmpens&non foi picrcity taken r-uisuani to ihe City's eminent domain powci does not constitute a financial inteiesi   ithin the meaning of this Part D.
 
Docs the Matter involve i Ciiv Piopeny Sale?
 
[ ] Yes (]No
 
3.   If you checked "Yes" to Item D.! piovide the names and business addresses of ihe Ciiv officials or employees having such inicicsi and identify ihe nature of such inteiesi:
 
Name      Business Address      Nature of Inieresi
 
 
 
 
 
v. The Disclosing Pany funhei certifies thai no prohibited financial interest in ihe Mailer wj]] be acquited by any City official or employee.
 
 
Face S of )';
 
 
£ CERTIFICATION REGARDING SLAVERY ERA BUSINESS
The Disclosing Pariv has searched any and all records of ihe Disclosing Party and any and all niedcccssor entities for record; of invesimenis or prefns from slavery, the slave industry, or slaveholder insurance policies fiom "he slavery era 'including insurance policies issued 10 slaveholder; thai provided coverage foi damage 10 cr injury or deaih of their slaves) and has disclosed in lhis EDS any and all such lecoids 10 ihe City. !r, addition, the Disclosing Party must disclose ihe name; ol any and all slaves or slaveholders c'escii'oed in those records. Failure io comply wiih these disc losuie lequncmeni; may make the Mailer to which this EDS pertains voidable by the City.
Please check either J. or !. beiow. Jf the Disclosing Pany checks 7... the Disclosing Party must disclose below or in an attachment to this EDS all r:qui;tie infoimanon as se; forth in that paragraph I
 
X 1. The Disclosing Party verifies that tat the Disclosing Party has searched any and ail leco/ds of ihe Disdosine Pariv and any and all piedece;;oi tr.utie; foi records of investment; or profits from «lavcrv. the slave industry, or slaveholder insurance pdlicie;. and lb) ihe Disc losing Party ha; found no records of investments or profits from slavery, tf.e ;;avc industry, or siavt holder insurance policies and no records of names of any slaves or slaveholders.
2. The Disclosing Party verifies ihai. as a result of conducting the search in step Ha) above, the Disclosine Pariv has found lecoids lelaung to invesimenis or profits fiom slavery, the ;lave industry, or Slaveholder insurance policies and/oi the name; of any slaves or slaveholder. The Disclosing pariv veiifies that ihe following consiiiutes full disclosure of all such records.
 
 
 
 
 
 
 
 
SECTION V] - CERTIFICATIONS FOR FEDERALLY-FUNDED MATTERS
NOTE: Jf the Matter is federally funded, complete lhis Section V). If the Mauer i; not federally funded, proceed to Section V)L
 
A. CERTIFICATION REGARDING LOBBYING
 
].   List below the r.ames of all person; or entities registered under the federal Lobbying Disclosure Act of l??-1 who have made lobbying contacts on behalf of the Disclosing party wuh ie«peci to ihe Manet: 'Beein list heie. add sheet; as necessarv'i:
-L2fyi      —      :      
 
 
 
Pace 9 of )?
 
 
H "•    if lhc Disclosing Pany :s lhc Applicant, ihe Diicics:ng p«ny will c'ciiin from any conirac:prs'Subccni:acioit hued oi tc cc hitcd in cor.ntction with lY.t Metier certifications ecual in i'oitt, and substance ic these :n H.l. and H.I. above i;,c will no:, without ;ht riict written consent of the C:;v. use anvjuch ccniracicrsubconnac :cr that cot; r.ot preside such cfi-.tficaiicn; ot that the Dt;c':c;;ng Pany ha; tca;cn to beiieve r.a; r.o! ptcvidtc ct cst.r.ot picvice truthful eetiificattcn;.
NOTE". If the Di;cio;ing Pany car.not cenrfy a; 10 ar;y cf :ht :ierr.s tr; H.'... H.I. st H.*. above, an explanatory statement must be attached to chi; EDS.
 
 
CERTIFICATION
Under :>en»iiv of penury, the ptrror, ?icr.ir.-j below: i: •.vsuar.:* tha'. he-srte :s iuihotiied to cnecuie this £DS cn behalf of rhe Di;ric::nc Psjiy. ;:.d <:".■ « ii:sn:« ir s: :ii e::::f!cai:cr,j ana statements ccntiintd sn this EDS itf :;ue. tccuime irvc coT.rirre is cf the catt f-jsr.rfhcc :c the City
 
 
!Fr.r.i cj type name ol person sjgningi
 
ipitni or type tnle of person ;ipnmg i
 
Sicnec and «wom to befcie me on fda.ic; j^ffl!)^ f) r      by j rgVc"*. Q
21   <£- uo k-    County,   JT M t^ua     (state j.
'^Cfh'n^.      .     Notery Public
Cerr.miJSior. empties:        •'0 3 ^ 5-<~i i X—
 
•OFFICIAL SEAL* StewnD-VanOnron NoaryPuSc,S!a).8olBiois Uy Corrsiassfcn Expires Oct S^2Q12