CITY OF CHICAGO

APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE

1. ADDRESS of the property Applicant is seeking to rezone:

2. Ward Number that property is located in:. _______ __________ _

3. APPLICANT _ _ ______________________ _

ADDRESS ________________ CITY ________ _

STATE _ ___ ZIP CODE. _________ PHONE _______ _

EMAIL _________ CONTACT PERSON ____ ___ _ __ _

4. Is the applicant the owner of the property? YES _______ NO _ _____ _ If the 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. __________________________ _ _

ADDRESS. _ _____ _ _ _ ___ ___ CITY _ _ _ _____ _

STATE. ____ ZIP CODE _ ___ _ _ _ __ PHONE _ _ _ ____ _

EMAIL ____ _____ CONTACT PERSON _____ _ _ ___ _

5. If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following info1mation:

ATTORNEY _____ ______ ___ __________ _

ADDRESS _ _ _ ____ __________ _ _____ ___ _

CITY _____ ___ STATE _ ___ ZIP CODE _ _ _ _ ____ _

PHONE _____ _ _ FAX _ _ ______ EMAIL _____ _ _ _

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9.

If the applicant is a legal entity (Corporation, LLC, Pa1tnership, etc.) please provide the names of all owners as disclosed on the Economic Disclosure Statements.

On what date did the owner acquire legal title to the subject property? ________ _

Has the present owner previously rezoned this property? If yes, when?

Present Zoning District ________ Proposed Zoning District _ _______ _

LO. Lot size in square feet (or dimensions) ____________________ _

l l. Current Use of the property ----------------- --------

12. Reason for rezoning the property _________ _____________ _

13. Describe the proposed use of the property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building. (BE SPECIFIC)

14. The Affordable Requrements 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 -------- --------

Page 2

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ORDINANCE

Be it Ordained by the City Council of the City of Chicago: SECTION 1. That the Chicago Zoning Ordinance be amended by changing all of the Residential-Business Planned Development Number 306 symbols and indications as shown on Map Number 7-F in the area bounded by:

The public alley north of and parallel to West Diversey Parkway, the alley next east of North Broadway; West Diversey Parkway; North Broadway; a line 125 feet north of and parallel to West Diversey Parkway; and a line 186 feet west of the alley next east of North Broadway.

to those of a Residential-Business Planned Development Number 306, as amended. SECTION 2. This ordinance shall be in full force and effect from and after its passage and due publication. Common Address: 524-628 West Diversey Parkway/2801-2807 North Broadway Street

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Talar A. Berberian 312 580 5042 direct tberberian@thompsoncoburn.com

September 1, 2021 Dear Property Owner: In accordance with the requirements of the Chicago Zoning Ordinance, Section 17-13-0107, please be informed that on or about September 1, 2021, the undersigned filed an application for a planned development for the property located at 524-628 West Diversey Parkway/2801-2807 North Broadway Street. The property is zoned Residential Business Planned Development, as amended and approval is being sought for a Residential Planned Development, as amended. The applicant seeks to revise the existing Planned Development at the property by eliminating the proposed 8-story residential tower and replacing it with a 7,950 square foot (with 6,200 square feet of commercial space on the ground floor and 1750 square feet of storage space in the basement level), 1-story commercial building with a basement that is 15 feet and 6 inches in height. No changes are proposed to the existing residential building.

The applicant submitting an application for a planned development is Lincoln Park Plaza Lofts, LLC, located at 155 N. Michigan Avenue, Suite 9003, Chicago, Illinois 60607. The owners of the subject property are Lincoln Park Plaza Lofts, LLC, located at 155 N. Michigan Avenue, Suite 9003, Chicago, Illinois 60607 and Lincoln Park Plaza, LLC, located at 14 Main Street, Park Ridge, Illinois 60068. I am the attorney for the applicant and can be reached at Thompson Coburn, LLP, 55 East Monroe Street, 37th Floor, Chicago, Illinois 60603. My telephone number is (312) 580-5042. PLEASE NOTE THAT THE APPLICANT IS NOT SEEKING TO REZONE OR PURCHASE YOUR PROPERTY. THE APPLICANT IS REQUIRED BY LAW TO SEND THIS NOTICE BECAUSE YOU OWN PROPERTY WITHIN 250 FEET OF THE SUBJECT PROPERTY. Very truly yours,

Talar A. Berberian Attorney for Applicant

Applicant: Address: Introduced: Plan Commission:

Lincoln Park Plaza, LLC 524-628 West Diversey Parkway/2801-2807 North Broadway Street September 14, 2021 TBD

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RESIDENTIAL PLANNED DEVELOPMENT NO. 306 PLANNED DEVELOPMENT STATEMENTS

1. The area delineated herein as Planned Development Number 306, as amended (Planned Development) consists of approximately 59,024 square feet (1.35 acres) of property which is depicted on the attached Planned Development Boundary and Property Line Map (Property) and is owned or controlled by the Applicant, Lincoln Park Plaza, LLC.

2. The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors. All rights granted hereunder to the Applicant shall inure to the benefit of the Applicant’s successors and assigns and, if different than the Applicant, the legal title holder and any ground lessors. Furthermore, pursuant to the requirements of Section 17-8-0400 of the Chicago Zoning Ordinance, the Property, at the time of application for amendments, modifications or changes (administrative, legislative or otherwise) to this Planned Development are made, shall be under single ownership or designated control. Single designated control is defined in Section 17-8-0400.

3. All applicable official reviews, approvals or permits are required to be obtained by the Applicant or its successors, assignees or grantees. Any dedication or vacation of streets or alleys or grants of easements or any adjustment of the right-of-way shall require a separate submittal to the Department of Transportation on behalf of the Applicant or its successors, assigns or grantees.

Any requests for grants of privilege, or any items encroaching on the public way, shall be in compliance with the Planned Development.

Ingress or egress shall be pursuant to the Planned Development and may be subject to the review and approval of the Departments of Planning and Development and Transportation. Closure of all or any public street or alley during demolition or construction shall be subject to the review and approval of the Department of Transportation.

Pursuant to a negotiated and executed Perimeter Restoration Agreement (“Agreement”) by and between the Department of Transportation’s Division of Infrastructure Management and the Applicant, the Applicant shall provide improvements and restoration of all public way adjacent to the property, which may include, but not be limited to, the following as shall be reviewed and determined by the Department of Transportation’s Division of Infrastructure Management:

Full width of streets Full width of alleys

Applicant: Lincoln Park Plaza Lofts, LLC Address: 524-628 West Diversey Parkway/2801-2807 North Broadway Street Introduced: September 14, 2021 Plan Commission: TBD

2

Curb and gutter Pavement markings Sidewalks ADA crosswalk ramps Parkway & landscaping

The Perimeter Restoration Agreement must be executed prior to any Department of Transportation and Planned Development Part II review permitting. The Agreement shall reflect that all work must comply with current Rules and Regulations and must be designed and constructed in accordance with the Department of Transportation’s Construction Standards for work in the Public Way and in compliance with the Municipal Code of Chicago Chapter 10-20. Design of said improvements should follow the Department of Transportation’s Rules and Regulations for Construction in the Public Way as well as The Street and Site Plan Design Guidelines. Any variation in scope or design of public way improvements and restoration must be approved by the Department of Transportation.

4. This Plan of Development consists of 14 Statements: a Bulk Regulations Table; a Site Plan, a Roof Plan and Elevations prepared by Brininstool + Lynch, LTD.; and an existing Planned Development Boundary and Property Line Map and Zoning and Land Use Map dated March 23, 1983 as submitted October 12, 1983. Full-sized copies of the Site Plan, Roof Plan and Building Elevations are on file with the Department of Planning and Development. In any instance where a provision of this Planned Development conflicts with the Chicago Building Code, the Building Code shall control. This Planned Development conforms to the intent and purpose of the Chicago Zoning Ordinance, and all requirements thereto, and satisfies the established criteria for approval as a Planned Development. In case of a conflict between the terms of this Planned Development Ordinance and the Chicago Zoning Ordinance, this Planned Development shall control.

5. The following uses are permitted in the area delineated herein as a Planned

Development: multi-unit residential, business, and related uses as permitted in the B1-5, Neighborhood Shopping District and non-accessory parking.

6. The maximum permitted Floor Area Ratio (“FAR”) for the site shall be in accordance

with the attached Bulk Regulations Table. For the purposes of FAR calculations and measurements, the definitions in the Zoning Ordinance shall apply. The permitted FAR identified in the Bulk Regulations Table has been determined using a Net Site Area of 59,024 square feet

7. For purposes of height measurement, the definitions in the Chicago Zoning

Ordinance shall apply. The height of any building shall also be subject to height limitations, if any, established by the Federal Aviation Administration.

Applicant: Lincoln Park Plaza Lofts, LLC Address: 524-628 West Diversey Parkway/2801-2807 North Broadway Street Introduced: September 14, 2021 Plan Commission: TBD

3

8. Upon review and determination, Part II Review, pursuant to Section 17-13-0610, a Part II Review Fee shall be assessed by the Department of Planning and Development. The fee, as determined by staff at the time, is final and binding on the Applicant and must be paid to the Department of Revenue prior to the issuance of any Part II approval.

9. The Site Plans shall be in substantial conformance with the Landscape Ordinance

and any other corresponding regulations and guidelines, including Section 17-13-0800. Final landscape plan review and approval will be by the Department of Planning and Development. Any interim reviews associated with site plan review or Part II reviews, are conditional until final Part II approval.

10. The Applicant shall comply with Rules and Regulations for the Maintenance of

Stockpiles promulgated by the Commissioners of the Departments of Streets and Sanitation, Fleet and Facility Management and Buildings, under Section 13-32-085, or any other provision of the Municipal Code of Chicago.

11. The terms and conditions of development under this Planned Development

ordinance may be modified administratively, pursuant to Section 17-13-0611-A, by the Zoning Administrator upon the application for such a modification by the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors.

12. The Applicant acknowledges that it is in the public interest to design, construct,

renovate and maintain all buildings in a manner that provides healthier indoor environments, reduces operating costs and conserves energy and natural resources. The Applicant shall obtain the number of points necessary to meet the requirements of the Chicago Sustainable Development Policy, in effect at the time the Part II review process is initiated for each improvement that is subject to the aforementioned Policy and must provide documentation verifying compliance.

13. The Applicant acknowledges that it is the policy of the City to maximize

opportunities for Minority and Women-owned Business Enterprises (“M/WBEs”) and city residents to compete for contracts and jobs on construction projects approved through the planned development process. To assist the city in promoting and tracking such M/WBE and city resident participation, an applicant for planned development approval shall provide information at three points in the city approval process. First, the applicant must submit to DPD, as part of its application for planned development approval, an M/WBE Participation Proposal. The M/WBE Participation Proposal must identify the applicant’s goals for participation of certified M/WBE firms in the design, engineering and construction of the project, and of city residents in the construction work. The city encourages goals of (i) 26% MBE and 6% WBE participation (measured against the total construction budget for the project or any phase thereof), and (ii) 50% city resident hiring (measured against the total construction work hours for the project or any phase thereof). The M/WBE

Applicant: Lincoln Park Plaza Lofts, LLC Address: 524-628 West Diversey Parkway/2801-2807 North Broadway Street Introduced: September 14, 2021 Plan Commission: TBD

4

Participation Proposal must include a description of the Applicant’s proposed outreach plan designed to inform M/WBEs and city residents of job and contracting opportunities. Second, at the time of the Applicant’s submission for Part II permit review for the project or any phase thereof, the Applicant must submit to DPD (a) updates (if any) to the Applicant’s preliminary outreach plan, (b) a description of the Applicant’s outreach efforts and evidence of such outreach, including, without limitation, copies of certified letters to M/WBE contractor associations and the ward office of the alderman in which the project is located and receipts thereof; (c) responses to the Applicant’s outreach efforts, and (d) updates (if any) to the applicant’s M/WBE and city resident participation goals. Third, prior to issuance of a Certificate of Occupancy for the project or any phase thereof, the Applicant must provide DPD with the actual level of M/WBE and city resident participation in the project or any phase thereof, and evidence of such participation. In addition to the forgoing, DPD may request such additional information as the department determines may be necessary or useful in evaluating the extent to which M/WBEs and city residents are informed of and utilized in planned development projects. All such information will be provided in a form acceptable to the Zoning Administrator. DPD will report the data it collects regarding projected and actual employment of M/WBEs and city residents in planned development projects twice yearly to the Chicago Plan Commission and annually to the Chicago City Council and the Mayor.

14. This Planned Development shall be governed by Section 17-13-0612. Should this

Planned Development ordinance lapse, the Zoning Administrator shall initiate a Zoning Map Amendment to rezone the property to RS-2 Residential Single-Unit (Detached House) District.

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Residential-Business Planned Development Number 306, As Amended

Bulk Regulations and Data Table

Net Site Area: 59,024 square feet Gross Site Area: 81,097 square feet Maximum Number of Dwelling Unit: 253 units Maximum Floor Area Ratio: 4.3 Maximum Number of Loading Spaces: 1 Minimum Number of Accessory Parking Spaces: 99 Maximum Number of Non-Accessory Parking Spaces: 101 Maximum Number of Parking Spaces Permitted: 200 Maximum Height of Buildings: Existing Tower: 153 feet Proposed commercial building: 15 feet, 6 inches

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ENTRY

LINE OF NEW CANOPY OVERHANG

EXISTING TREE

ENTRY

W. DIVERSEY PWKY

OUTDOOR PATIO

LEGEND - SITE PLAN

1. REFER TO G-008 FOR ALL GENERAL NOTES2. NO GRADING IN SCOPE3. GENERAL CONTRACTOR IS TO COORDINATE ALL

DIMENSIONS PRIOR TO INSTALLATION AND VERIFY AND DISCREPANCIES WITH THE ARCHITECT PRIOR TO INSTALLATION.

4. REFER TO MECHANICAL, ELECTRICAL, AND PLUMBING DRAWINGS FOR ITEMS BELOW GRADE

5. ALL EXISTING PARKWAY TREES TO BE PROTECTED, AND EXISTING SOD TO BE REPAIRED AS REQUIRED AFTER CONSTRUCTION

6. LANDSCAPE PLANTING SHOWN ON THE LANDSCAPE PLAN IS ALL EXISTING, AND WILL BE MAINTAINED AND REPLACED AS REQUIRED BY CURRENT AND SUBSEQUENT OWNERS IN ACCORDANCE WITH THE REQUIREMENTS OF CHAPTER 32 OF THE CHICAGO MUNICIPAL CODE, THE LANDSCAPING STANDARDS OF CHICAGO ZONING ORDINANCE, AND "THE GUIDE TO THE CHICAGO LANDSCAPE ORDINANCE"

GENERAL NOTES - SITE PLANS

EXISTING SIDEWALK, TO REMAIN

EXISTING GRASS, TO REMAIN

EXISTING TREE, TO REMAIN

© 2021 Brininstool + Lynch, Ltd.

Brininstool + Lynch, Ltd.312 640 05051144 West Washington Blvd.Chicago, Illinois 60607

2801 N. BROADWAYFOXTROT

2801 N. BROADWAY AVE.

CHICAGO, IL 60614

SITE PLAN

A-100

21003

0

1 Inch = 16 Feet

8 1616 32

21-0712 ISSUE FOR PERMIT

1/4" = 1'-0"1

SITE PLAN

DN

C

H

UP

A-601

1

2

3

4

A

20' -

0"

20' -

0"

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A-6011

A-301

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A-301 3

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A-401

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A-401

21' - 0" 3' - 10 1/2"

B C

27' - 5" 23' - 8"

A-6021

HOT PREP/WAREWASHING

102

RESTROOM

104

RESTROOM

105

MARKET

101

N.I.C.

105 104

A-601

3

3' -

6"

3' - 6"

6

1

1

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1

6

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1

3

SPIRITS

WINE

PANTRY

WINE

4' -

10

1/4"

4' -

6"

3' -

0"

3' -

6"

3' -

9 1

/4"

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SPIRITS

3' - 10 3/4"4' - 0"

PANTRY

IMPULSE

20' - 0"

5' -

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3' -

0"

4' -

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3' -

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18' - 0"

5' - 6" 3' - 0" 3' - 2" 3' - 0"

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A-301

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BUSSING

A-6018 10

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33

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1

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101

102

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11031

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11

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0 3

/4"

2' - 8"

2' - 0"

2' -

0"

21' - 4 1/2"

8' -

2 1

/2"

19' - 0 1/2"

26' - 0" 20' - 0"

14' -

8"

6' - 6"

PASS THRU

3' - 0" 2' - 4"

21' -

7 1

/2"

VIF

3' - 6 1/2"

VIF

3' - 10 1/2"

1' -

6"

MENU ABOVE

SUSPENDED WOOD SLAT CEILING ABOVE

DN

BANQUETTE

6

5

5

1. REFER TO G-008 FOR ALL GENERAL NOTES 2. REFER A-801 FOR PARTITION TYPES.3. REFER LIFE SAFETY PLANS FOR TRAVEL

DISTANCE AND WALL FIRE RATINGS.

EXISTING WALL TO REMAIN

NEW WALL, REFER TO PARTITION TYPES

WALL LEGEND

PLAN LEGEND - PARTITION

EXISTING TO REMAIN, N.I.C.

EXISTING DOOR TO REMAIN

NEW DOOR, REFER TO DOOR SCHEDULE

DOOR LEGEND

1

2

3

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A-401

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A-401

STORAGE

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20' -

3 1

/2"

20' -

0"

20' -

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19' -

4"

6' -

10"

6"5'

- 7

"7'

- 0

"

5' - 0"

B C

A-6026

23' - 8"

N.I.C.RESTROOM

B103

WALK-IN BOX

B105

WALK-INREFRIGERATION

B106

JC CLOSET

B102

B102

B103

5' - 0"

B104

4

4

1

2

1

11

3

3

3

3

WATER HEATER

SEWAGE EJECTOR

2

ELEC. PANELS

OPEN TO ABOVE

E101

COMPRESSORCLOSET

104

© 2021 Brininstool + Lynch, Ltd.

Brininstool + Lynch, Ltd.312 640 05051144 West Washington Blvd.Chicago, Illinois 60607

2801 N. BROADWAYFOXTROT

2801 N. BROADWAY AVE.

CHICAGO, IL 60614

FLOOR PLANS

A-101

21003

1/4" = 1'-0"2

LEVEL 01 FLOOR PLAN

21-0712 ISSUE FOR PERMIT

0

1 Inch = 4 Feet

2 44 8

1/4" = 1'-0"1

BASEMENT FLOOR PLAN

LEVEL 010' - 0"

B.O. DECK15' - 6"

B.O. CANOPY8' - 0"

7' -

6"

8' -

0"

15' -

6"

EXISTING MASONRY WALL

NEW ALUM. STOREFRONT SYSTEM

LEVEL 010' - 0"

B.O. DECK15' - 6"

3

A-401

B C

B.O. CANOPY8' - 0"

7' -

6"

8' -

0"

15' -

6"

1

A-402

A.1

EXISTING MASONRY WALL

NEW C-CHANNEL FASCIA & COLUMNS, SEE STRUCT DWGS

NEW ALUM. STOREFRONT SYSTEM

LEVEL 010' - 0"

B.O. DECK15' - 6"

B.O. CANOPY8' - 0"

7' -

6"

8' -

0"

15' -

6"

EXISTING MASONRY WALL

NEW ALUM. STOREFRONT SYSTEM

© 2021 Brininstool + Lynch, Ltd.

Brininstool + Lynch, Ltd.312 640 05051144 West Washington Blvd.Chicago, Illinois 60607

2801 N. BROADWAYFOXTROT

2801 N. BROADWAY AVE.

CHICAGO, IL 60614

ELEVATIONS

A-301

21003

1/4" = 1'-0"3

WEST ELEVATION

1/4" = 1'-0"1

SOUTH ELEVATION

21-0712 ISSUE FOR PERMIT

1/4" = 1'-0"2

SOUTHWEST ELEVATION

LEVEL 010' - 0"

B.O. DECK15' - 6"

BASEMENT-13' - 0"

3

A-401

B C

15' -

6"

13' -

0"

B.O. CANOPY8' - 0"

A.1

COMPRESSORCLOSET

STORAGE

HOT PREP/WAREWASHING

MARKET

LEVEL 010' - 0"

B.O. DECK15' - 6"

1 2 3 4 5

BASEMENT-13' - 0"

1

A-401

B.O. CANOPY8' - 0"

7' -

6"

8' -

0"

13' -

0"

PR

OP

ER

TY

LIN

E

WALK-INREFRIGERATION

WALK-IN BOX STORAGE RESTROOM JC CLOSET STORAGE

RESTROOMMARKET

10' - 0"

© 2021 Brininstool + Lynch, Ltd.

Brininstool + Lynch, Ltd.312 640 05051144 West Washington Blvd.Chicago, Illinois 60607

2801 N. BROADWAYFOXTROT

2801 N. BROADWAY AVE.

CHICAGO, IL 60614

SECTIONS

A-401

21003

1/4" = 1'-0"1

SECTION NORTH

1/4" = 1'-0"3

SECTION WEST

21-0712 ISSUE FOR PERMIT

PARCEL 1:

PARCEL 2:

600 & 620 WEST DIVERSEY PARKWAY, CHICAGO, ILLINOIS.

VICINITY MAP

ALTA/NSPS LAND TITLE SURVEY

L E G E N D

SURVEYSITE

450 SKOKIE BLVD. SUITE 105, NORTHBROOK, ILLINOIS, 60062TEL. (847) 864-6315 / FAX (847) 864-9341E-MAIL: SURVEYOR@BHSUHR.COM

NOTE: THIS PRELIMINARY PLAT IS CURRENTLY UNDER REVIEW FOR CORRECTIONS AND IS PROVIDED FORINFORMATIONAL PURPOSES ONLY. THE REQUIRED ALTA CERTIFICATION WILL BE INCLUDED AND SIGNED AFTER ALLREVISIONS ARE FINALIZED.PLEASE CONFIRM THE INFORMATION BELOW THAT WILL APPEAR IN THE CERTIFICATION.

Certified parties:

Table A Items:2, 3, 4, 7(a), 7(b)(1), 8, 9 (number of spaces only), 10, 13, 16, and 17

PRELIMINARY 7-14-21

352.88'

134.36'

186.24'

91.0

0'

216.

00'

129.

15'

PARKWAYW. DIVERSEY

AVEN

UE

18-STORYBRICK & CONCRETE

BUILDING #600N.

BR

OAD

WAY

N. CLARK STREET

BRICK BUILDING

#620

1-STORY 16-STORYBRICK & CONCRETE

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14-28-119-050-0000 LINCOLN PK HOTEL OPCO 1290 AVENUE OF THE AME NEW YORK, NY 10104

14-28-119-051-0000 LINCOLN PK HOTEL OPCO 1290 AVENUE OF THE AME NEW YORK, NY 10104

14-28-119-052-0000 LINCOLN PK HOTEL OPCO 1290 AVENUE OF THE AME NEW YORK, NY 10104

14-28-119-053-0000 LINCOLN PK HOTEL OPCO 1290 AVENUE OF THE AME NEW YORK, NY 10104

14-28-119-054-0000 LINCOLN PK HOTEL OPCO 1290 AVENUE OF THE AME NEW YORK, NY 10104

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14-28-122-017-1177 BONNIE L ALEXANDER 550 W SURF ST #201 CHICAGO, IL 60657

14-28-122-017-1178 ALISON GAYLE TUROFF 550 W SURF ST 301 CHICAGO, IL 60657

14-28-122-017-1179 AMANDA FEDER 550 W SURF ST 501 CHICAGO, IL 60657

14-28-122-017-1180 MOISES ALIPALA 612 W ALDINE 2N CHICAGO, IL 60657

14-28-122-017-1181 JONATHAN OCONNELL 36W718 OAK RIDGE LN ST CHARLES, IL 60174

14-28-122-017-1182 JERRY MODELO 550 W SURF 411 CHICAGO, IL 60657

14-28-122-017-1183 A MAGBANUA C 4322 N KEDVALE CHICAGO, IL 60641

14-28-122-017-1184 KEITH A HERBERT 550 W SURF #611 CHICAGO, IL 60657

14-28-122-017-1185 C SMITH 550 W SURF ST APT 110 CHICAGO, IL 60657

14-28-122-017-1186 JENNIFER KAISER 550 W SURF #210 CHICAGO, IL 60657

14-28-122-017-1187 ELISE AUERBACH 550 W SURF ST 310 CHICAGO, IL 60657

14-28-122-017-1188 AMY ROGALINER 550 W SURF ST 410 CHICAGO, IL 60657

14-28-122-017-1189 NEAL S GAINSBERG 334 WAGNER ROAD NORTHFIELD, IL 60093

14-28-122-017-1190 ASAF SAMI BLUBSHTEIN 550 W SURF ST APT 522 CHICAGO, IL 60657

14-28-122-017-1191 DOUG TOUSSAINT 5725 BARRINGTON RD MORRIS, IL 60450

14-28-122-017-1192 BENJAMIN W LARRISON 550 W SURF ST APT 524 CHICAGO, IL 60657

14-28-122-017-1193 PETER MOROH 550 W SURF 525 CHICAGO, IL 60657

14-28-122-017-1194 BENJAMIN W LARRISON 550 W SURF ST APT 524 CHICAGO, IL 60657

14-28-122-017-1195 JESSICA 550 W SURF ST #314 CHICAGO, IL 60657

14-28-122-017-1196 JUAN CARLOS VERASTEGUI 559 W SURF CHICAGO, IL 60657

14-28-122-017-1197 BRIAN RODY 550 W SURF #403 CHICAGO, IL 60657

14-28-122-017-1198 AMY M SMITH AS TRUSTEE 559 W SURF ST APT 200 CHICAGO, IL 60657

14-28-122-017-1199 EILEEN SCHATZ 550 W SURF ST 217 CHICAGO, IL 60657

14-28-122-017-1200 AXEL LEICHUM 550 W SURF #508 CHICAGO, IL 60657

14-28-122-017-1201 RICHARD A DAVIS 559 W SURF ST 307 CHICAGO, IL 60657

14-28-122-017-1202 KEITH GROEBE 203 N LASALLE ST #2500 CHICAGO, IL 60601

14-28-122-017-1203 ANGELA HANSON 550 W SURF 207 CHICAGO, IL 60657

14-28-122-017-1204 KEVIN MCCARTHY 559 W SURF ST #904 CHICAGO, IL 60657

14-28-122-017-1205 JONATHAN KADET 550 W SURF ST APT 215 CHICAGO, IL 60657

14-28-122-017-1206 HELEN BADESCH 559 W SURF ST APT 100 CHICAGO, IL 60657

14-28-122-017-1207 SEBASTIAN V ARDELEAN 559 W SURF ST APT 101 CHICAGO, IL 60657

14-28-122-017-1208 JERRY J CUNNINGHAM 559 W SURF 304 CHICAGO, IL 60657

14-28-122-017-1209 ANDREAS MELINAT 559 W SURF ST #407 CHICAGO, IL 60657

14-28-122-017-1210 STEPHEN DEWART 559 W SURF 300 CHICAGO, IL 60657

14-28-122-017-1211 SB HORWTZ MR HORWITZ 559 W SURF ST 504 CHICAGO, IL 60657

14-28-122-017-1212 DAVID J HURLEY 559 W SURF 900 CHICAGO, IL 60657

14-28-122-017-1213 STEVEN L ANDERSON 559 W SURF STSTE600 CHICAGO, IL 60657

14-28-122-017-1214 K R ELIA 550 W SURF 108 CHICAGO, IL 60657

14-28-122-017-1215 DOUG TOUSSAINT 5725 BARRINGTON RD MORRIS, IL 60450

14-28-122-017-1216 BRENT J ROSENBOWER 550 W SURF ST C 404 CHICAGO, IL 60657

14-28-122-017-1217 JAMES P SULLIVAN 559 W SURF ST 400 CHICAGO, IL 60657

14-28-122-017-1218 DEVIN CARTER 559 W SURF 401 CHICAGO, IL 60657

14-28-122-017-1219 ALI KELLY SOLAKSUBAS 559 W SURF #901 CHICAGO, IL 60657

14-28-122-017-1220 JEFFREY C SHARPE 559 W SURF 906 CHICAGO, IL 60657

14-28-122-017-1221 DRU FURBEE 559 W SURF ST APT 809 CHICAGO, IL 60657

14-28-122-017-1222 JOHN HAMBRICK 559 W SURF #604 CHICAGO, IL 60657

14-28-122-017-1223 MCKENNA ALISON 550 W SURF #412 CHICAGO, IL 60657

14-28-122-017-1224 CHEVONNE SWITZER 559 W SURF #701 CHICAGO, IL 60657

14-28-122-017-1225 KATHLEEN T LOGAN 559 W SURF ST APT 806 CHICAGO, IL 60657

14-28-122-017-1226 PATRICIA G KLING 550 W SURF #613 CHICAGO, IL 60657

14-28-122-017-1227 JC SCALABRE 440 N WABASH APT 507 CHICAGO, IL 60611

14-28-122-017-1228 KEVIN M SCHREIBER 550 W SURF 417 CHICAGO, IL 60657

14-28-122-017-1229 STEPHEN M STATKUS 2225 ILLINOIS ROAD NORTHBROOK, IL 60062

14-28-122-017-1230 ALPHA JALLOH 9421 S 54TH COURT OAK LAWN, IL 60453

14-28-122-017-1231 GAIL MEYER 550 W SURF UNIT 413 CHICAGO, IL 60657

14-28-122-017-1232 ANNE M BOUSE 2955 VAN NESS AVE #10 SAN FRANCISC, CA 94109

14-28-122-017-1233 KURT BOWEN 559 W SURF #505 CHICAGO, IL 60657

14-28-122-017-1234 KAREN EICH 559 W SURF ST APT 802 CHICAGO, IL 60657

14-28-122-017-1235 MONICA HASBUN 2728 N HAMPDEN CT 1502 CHICAGO, IL 60614

14-28-122-017-1236 CARMEN R KORDICK 559 W SURF ST APT 501 CHICAGO, IL 60657

14-28-122-017-1237 KATHERINE PETERSON 2195 140TH ST FORT DODGE, IA 50501

14-28-122-017-1238 REBECCA LALEZ 3911 N JANSSEN AVE CHICAGO, IL 60613

14-28-122-017-1239 KIMBERLY K SMITH 559 W SURF ST APT 803 CHICAGO, IL 60657

14-28-122-017-1240 MICHAEL A METZGER EL 677 WINGATE RD GLEN ELLYN, IL 60137

14-28-122-017-1241 EMILY SCHULZE 559 W SURF ST APT 609 CHICAGO, IL 60657

14-28-122-017-1242 EDWARD KEATING 550 W SURF 315C CHICAGO, IL 60657

14-28-122-017-1243 LUIS MONJE 550 W SURF ST #512 CHICAGO, IL 60657

14-28-122-017-1244 MICHAEL GALLAGHER PO BOX 13047 CHICAGO, IL 60613

14-28-122-017-1245 KRISTIN BONIFAS 550 W SURF ST#C109 CHICAGO, IL 60657

14-28-122-017-1246 HIEN HUYNH 550 W SURF ST 105 CHICAGO, IL 60657

14-28-122-017-1247 BERNADETTE ARNDT 559 W SURF #500 CHICAGO, IL 60657

14-28-122-017-1248 SHEILA MARIE WEIGERT 550 W SURF ST APT 507 CHICAGO, IL 60657

14-28-122-017-1249 MICHAEL LULAY 2323 NAPERVILLE RD NAPERVILLE, IL 60563

14-28-122-017-1250 ALAN GERARD LADUKE 559 W SURF ST APT 507 CHICAGO, IL 60657

14-28-122-017-1251 KEVIN R MORKIN 550 W SURF ST #313 CHICAGO, IL 60657

14-28-122-017-1252 CAROLINE ELIZABETH NOR 559 W SURF ST APT 704 CHICAGO, IL 60657

14-28-122-017-1253 RICHARD R WAGNER 550 W SURF #515 CHICAGO, IL 60657

14-28-122-017-1254 WINNEMAC HOLDINGS SURF 14044 NORWICH LANE ORLAND PARK, IL 60467

14-28-122-017-1255 HEIDI NORDBROCK 550 W SURF #C521 CHICAGO, IL 60657

14-28-122-017-1256 BRIAN RODY 550 W SURF 403 CHICAGO, IL 60657

14-28-122-017-1257 CAROL MAYER 559 W SURF 700 CHICAGO, IL 60657

14-28-122-017-1258 SHIRA JACOBSON 550 W SURF ST #212 CHICAGO, IL 60657

14-28-122-017-1259 ROBERT TODD HARGAN 559 W SURF ST #907 CHICAGO, IL 60657

14-28-122-017-1260 P TONER 559 W SURF 201 CHICAGO, IL 60657

14-28-122-017-1261 A N LOPINTO 70 LITTLE WEST ST #25E NEW YORK, NY 10004

14-28-122-017-1262 RANDALL S FLEER 550 W SURF 612 CHICAGO, IL 60657

14-28-122-017-1263 JASON MOORE 559 W SURF ST APT 801 CHICAGO, IL 60657

14-28-122-017-1264 MICHAEL B LULAY 2420 SUTTON LN AURORA, IL 60502

14-28-122-017-1265 HEMANSHU K J KANG 559 W SURF ST 807 CHICAGO, IL 60657

14-28-122-017-1266 WINNEMAC HOLDINGS SURF 14044 NORWICH LANE ORLAND PARK, IL 60467

14-28-122-017-1267 MAUREEN SULLIVAN 550 W SURF ST 306 CHICAGO, IL 60657

14-28-122-017-1268 AIMA MORI 550 W SURF ST APT 505 CHICAGO, IL 60657

14-28-122-017-1269 J ORIANS 550 W SURF 202 CHICAGO, IL 60657

14-28-122-017-1270 NOAH ZUENGLER 7222 THIRD AVE KENOSHA, WI 53143

14-28-122-017-1271 TAXPAYER OF 559 W SURF ST #C524 CHICAGO, IL 60657

14-28-122-018-1001 JUDITH MIRIAM SIEVERS 2836 N CAMBRIDGE 1 CHICAGO, IL 60657

14-28-122-018-1002 KELLY REINKE 2836 N CAMBRIDGE AVE#2 CHICAGO, IL 60657

14-28-122-018-1003 KRISTEN M KASHUL 2836 N CAMBRIDGE AVE#3 CHICAGO, IL 60657

14-28-122-018-1004 ATHIR JADDOU 2838 N CAMBRIDGE AVE 1 CHICAGO, IL 60657

14-28-122-018-1005 JOAN M RATHBONE 2838 N CAMBRIDGE AV CHICAGO, IL 60657

14-28-122-018-1006 CHRIS SUNGWOO LIM 2838 N CAMBRIDGE AVE#3 CHICAGO, IL 60657

14-28-122-018-1007 ASHLEY POWELL 2844 N CAMBRIDGE AVE#1 CHICAGO, IL 60657

14-28-122-018-1008 G GRIECO S A SMITH 2844 N CAMBRIDGE #2 CHICAGO, IL 60657

14-28-122-018-1009 DADA LAURA ANDREA 2844 N CAMBRIDGE 3 CHICAGO, IL 60657

14-28-122-018-1010 JARED FRANKLIN KING 547 W SURF ST #1 CHICAGO, IL 60657

14-28-122-018-1011 BRIGID E RAFFERTY 547 W SURF ST 2 CHICAGO, IL 60657

14-28-122-018-1012 JONATHAN M HARVEY 547 W SURF ST APT 3 CHICAGO, IL 60657

14-28-122-018-1013 VINCENT D BARONE 547 W SURF ST APT B CHICAGO, IL 60657

14-28-122-018-1014 MAXWELL J LOUNDS 549 W SURF ST 1B CHICAGO, IL 60657

14-28-122-018-1015 KRISTIN LOUISE KEMPIAK 549 W SURF #2 CHICAGO, IL 60657

14-28-122-018-1016 JULIE A UMNUS 549 W SURF 3 CHICAGO, IL 60657

14-28-122-018-1017 MICHELE A TARLETON 551 W SURF ST 1 CHICAGO, IL 60657

14-28-122-018-1018 TAXPAYER OF 551 W SURF ST UNIT 2 CHICAGO, IL 60657

14-28-122-018-1019 MATTHEW MCALLISTER 551 W SURF ST APT 3 CHICAGO, IL 60657

14-28-122-019-0000 SCOTT REDMAN 2441 W BRADLEY PL CHICAGO, IL 60618

14-28-123-002-0000 2833 N CAMBRIDGE LLC 2815 W ROSCOE CHICAGO, IL 60618

14-28-123-003-0000 WESTWARD360 1464 W WEBSTER AVE CHICAGO, IL 60614

14-28-123-004-0000 JAMES A SUPRENANT 2825 N CAMBRIDGE AVE CHICAGO, IL 60657

14-28-123-008-0000 BRM DIVERSEY LLC 520 W BELDEN CHICAGO, IL 60614

14-28-123-009-0000 JEROME H MEYER CO 640 N LASALLE ST #605 CHICAGO, IL 60654

14-28-123-018-1001 SCOTT NUNEZ 2817 N CAMBRIDGE AVE#1 CHICAGO, IL 60657

14-28-123-018-1002 ROSE PRIVA COONEY 2817 N CAMBRIDGE AVE#2 CHICAGO, IL 60657

14-28-123-018-1003 TARA SALOMON 2817 N CAMBRIDGE AVE#3 CHICAGO, IL 60657

14-28-123-018-1004 ANDREW KOSTECKI 2817 N CAMBRIDGE#G CHICAGO, IL 60657

14-28-123-018-1005 PIOTR PIKUL 2819 N CAMBRIDGE 1S CHICAGO, IL 60657

14-28-123-018-1006 RYAN MARIETTA 2819 N CAMBRIDGE AV 2S CHICAGO, IL 60657

14-28-123-018-1007 S PEARSON 2819 N CAMBRIDGE CHICAGO, IL 60657

14-28-123-018-1008 AMY LATRIELLE 2819 N CAMBRIDGE 1N CHICAGO, IL 60657

14-28-123-018-1009 TAXPAYER OF 2819 N CAMBRIDGE 2N CHICAGO, IL 60657

14-28-123-018-1010 MICHAEL T DINNEGAN 2819 N CAMBRIDGE #3N CHICAGO, IL 60657

14-28-123-018-1011 ALEJANDRO JAVIER TRIMA 2821 N CAMBRIDGE AVE 1 CHICAGO, IL 60657

14-28-123-018-1012 ANDREW W FRANCIS 2821 N CAMBRIDGE#2 CHICAGO, IL 60657

14-28-123-018-1013 ELIZABETH E CIBULA 2821 N CAMBRIDGE 3 CHICAGO, IL 60657

14-28-123-018-1014 ELIZABETH E CIBULA 2821 N CAMBRIDGE #3 CHICAGO, IL 60657

14-28-123-018-1015 TAXPAYER OF G2 2819 N CAMBRIDGE #2N CHICAGO, IL 60657

14-28-123-018-1016 ABDULLAH K SALLAJ 2821 N CAMBRIDGE #1 CHICAGO, IL 60657

14-28-123-018-1017 TARA SALOMON 2817 N CAMBRIDGE AVE CHICAGO, IL 60657

14-28-123-018-1018 S PEARSON 2819 N CAMBRIDGE CHICAGO, IL 60657

14-28-123-018-1019 MICHAEL T DINNEGAN 2819 N CAMBRIDGE #3N CHICAGO, IL 60657

14-28-123-018-1020 ROSE PRIVA COONEY 2817 N CAMBRIDGE AVE#2 CHICAGO, IL 60657

14-28-123-018-1021 PIOTR PIKUL 2819 N CAMBRIDGE 1S CHICAGO, IL 60657

14-28-123-018-1022 AMY LATRIELLE 2819 N CAMBRIDGE 1N CHICAGO, IL 60657

14-28-123-018-1023 RYAN MARIETTA 2819 N CAMBRIDGE AV 2S CHICAGO, IL 60657

14-28-123-019-1001 ROBERT KATE FORSHIER 519 W SURF ST 1 CHICAGO, IL 60657

14-28-123-019-1002 CARRIE JAMESON 519 W SURF 2 CHICAGO, IL 60657

14-28-123-019-1003 ZEKE NIERENBERG 519 W SURF ST #3 CHICAGO, IL 60657

14-28-123-019-1004 PHILLIP RIZZO 521 W SURF ST APT 1 CHICAGO, IL 60657

14-28-123-019-1005 CHRISTOPHER J LANE 521 W SURF 2 CHICAGO, IL 60657

14-28-123-019-1006 KATHERINE KEY 521 W SURF #3 CHICAGO, IL 60657

14-28-123-019-1007 CATHERINE W ANDREW 523 W SURF #1 CHICAGO, IL 60657

14-28-123-019-1008 ANNIE E ZUPAN 523 W SURF ST APT 2 CHICAGO, IL 60657

14-28-123-019-1009 MARK HUDDLE 523 W SURF 3 CHICAGO, IL 60657

14-28-123-019-1010 MARILYN GEARY 525 W SURF APT 1 CHICAGO, IL 60657

14-28-123-019-1011 KRISTIN DERANETT 525 W SURF #2 CHICAGO, IL 60657

14-28-123-019-1012 J CHRISTIAN MANALLI TR 525 W SURF ST UNIT 3 CHICAGO, IL 60657

14-28-123-019-1013 BREANNA DISO 527 W SURF ST UNIT 1 CHICAGO, IL 60657

14-28-123-019-1014 DANIEL P COSGROVE 527 W SURF ST #2 CHICAGO, IL 60657

14-28-123-019-1015 MICHAEL WOZNIAK 527 W SURF ST 3 CHICAGO, IL 60657

14-28-123-019-1016 529 SURF LLC 1117 CROFTON AVE N HIGHLAND PK, IL 60035

14-28-123-019-1017 MONICA URDA 529 W SURF ST APT 2 CHICAGO, IL 60657

14-28-123-019-1018 PAGE HARTZELL 529 W SURF ST APT 3 CHICAGO, IL 60657

14-28-123-019-1019 SHELBY HILL 2835 N CAMBRIDGE AVE#1 CHICAGO, IL 60657

14-28-123-019-1020 MARTIN M BABCOCK 2835 N CAMRIDGE AVE#2 CHICAGO, IL 60657

14-28-123-019-1021 ANNE COOPER 2835 N CAMBRIDGE AVE 3 CHICAGO, IL 60657

14-28-123-019-1022 JAMES JENKINS 2837 N CAMBRIDGE AVE#1 CHICAGO, IL 60657

14-28-123-019-1023 J HUFFMAN U2 2837 N CAMBRIDGE AVE CHICAGO, IL 60657

14-28-123-019-1024 YANKI LARA TUMER 2837 N CAMBRIDGE #3 CHICAGO, IL 60657

14-28-123-019-1025 DARCI AITA 529 W SURF ST UNIT B CHICAGO, IL 60657

14-28-123-019-1026 J HUFFMAN U2 2837 N CAMBRIDGE AVE CHICAGO, IL 60657

14-28-123-019-1027 MONICA URDA 529 W SURF ST APT 2 CHICAGO, IL 60657

14-28-123-019-1028 ZEKE NIERENBERG 519 W SURF ST #3 CHICAGO, IL 60657

14-28-123-019-1029 MARK HUDDLE 523 W SURF 3 CHICAGO, IL 60657

14-28-123-019-1030 SHELBY HILL 2835 N CAMBRIDGE AVE#1 CHICAGO, IL 60657

14-28-123-019-1031 ANNE COOPER 2835 N CAMBRIDGE AVE 3 CHICAGO, IL 60657

14-28-123-019-1032 CHRISTOPHER J LANE 521 W SURF 2 CHICAGO, IL 60657

14-28-123-019-1033 KATHERINE KEY 521 W SURF #3 CHICAGO, IL 60657

14-28-123-019-1034 PHILLIP RIZZO 521 W SURF ST APT 1 CHICAGO, IL 60657

14-28-123-019-1035 CARRIE JAMESON 519 W SURF 2 CHICAGO, IL 60657

14-28-123-019-1036 J C MANALLI 525 W SURF#3 CHICAGO, IL 60657

14-28-123-019-1037 JOHN C HOEFFERLE 4040 GRAND AVE WESTERN SPGS, IL 60558

14-28-123-020-0000 DANA NIELSEN/BRODER D 38 NEWBURY ST. 3RD FL BOSTON, MA 21163

14-28-301-004-0000 TRADER JOES INC 703 PO BOX 5049 RE DEPT MONROVIA, CA 91017

14-28-301-017-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-301-018-0000 PARKWAY VENTURE LLC P O BOX 232 HIGHLAND PK, IL 60035

14-28-301-019-0000 BITCO CLARK STREET LLC 56 SKOKIE VALLEY RD HIGHLAND PK, IL 60035

14-28-301-021-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-301-022-0000 JEFFREY T YAMANE 634 W SCHUBERT AV CHICAGO, IL 60614

14-28-301-025-0000 NRG CS HOLDINGS LIMITE 225 W HUBBARD ST CHICAGO, IL 60654

14-28-301-026-0000 NRG CS HOLDINGS LIMITE 225 W HUBBARD ST CHICAGO, IL 60654

14-28-301-027-1001 B FERGUSON 628 W SCHUBART AVE #1F CHICAGO, IL 60614

14-28-301-027-1002 HILLARY C MOORE 628 W SCHUBERT AVE #2F CHICAGO, IL 60614

14-28-301-027-1003 CTLTC 000000132862 10 S LASALLE ST #2750 CHICAGO, IL 60603

14-28-301-027-1005 SCHULTZ REAL ESTATE HO 730 N VICTORIA DR PALATINE, IL 60074

14-28-301-027-1006 ALEX HONG JU LIN 21910 PAINT BRUSH LN DIAMOND BAR, CA 91765

14-28-301-028-1001 LIPING SONG 636 W SCHUBERT AVE#A CHICAGO, IL 60614

14-28-301-028-1002 ANUJA DADWAL 636 W SCHUBERT AVE #B CHICAGO, IL 60614

14-28-301-028-1003 JENNA L GLASS 636 W SCHUBERT AVE #C CHICAGO, IL 60614

14-28-301-028-1004 LIPING SONG 636 W SCHUBERT AVE#A CHICAGO, IL 60614

14-28-301-028-1005 ANUJA DADWAL 636 W SCHUBERT AVE #B CHICAGO, IL 60614

14-28-301-028-1006 JENNA L GLASS 636 W SCHUBERT AVE #C CHICAGO, IL 60614

14-28-301-029-1001 APARNA SHARMA 616 W SCHUBERT AV #1E CHICAGO, IL 60614

14-28-301-029-1002 KYLE E KOROL 616 W SCHUBERT AVE#2E CHICAGO, IL 60614

14-28-301-029-1003 TAXPAYER OF 616 W SCHUBERT #3E CHICAGO, IL 60614

14-28-301-029-1004 ANDREW J MOAG 616 W SCHUBERT 4E CHICAGO, IL 60614

14-28-301-029-1005 MARCELLO BERZERI 618 W SCHUBERT #1W CHICAGO, IL 60614

14-28-301-029-1006 TAYLOR MCGREGOR 618 W SCHUBERT AVE#2W CHICAGO, IL 60614

14-28-301-029-1007 PATRICK SHARP 3804 N JANSEN AVE CHICAGO, IL 60613

14-28-301-029-1008 JEFFEREY JOHNSUN HEL 618 W SCHUBERT AVE#4W CHICAGO, IL 60614

14-28-301-029-1009 MARIA HAWILO 622 W SCHUBERT AVE#1E CHICAGO, IL 60614

14-28-301-029-1010 JIARUI LI 622 W SCHUBERT AVE#2E CHICAGO, IL 60614

14-28-301-029-1011 SONIA SHAH 622 WEST SCHUBERT #3E CHICAGO, IL 60614

14-28-301-029-1012 SIMON DAVIES 622 W SCHUBERT AVE#4E CHICAGO, IL 60614

14-28-301-029-1013 MITCHELL AARON ADAM CO 624 W SCHUBERT AVE#1W CHICAGO, IL 60614

14-28-301-029-1014 PAUL BARHAM 624 W SCHUBERT AVE 2W CHICAGO, IL 60614

14-28-301-029-1015 JEREMY A DAVIDOFF CH 624 W SCHUBERT AVE#3W CHICAGO, IL 60614

14-28-301-029-1016 J DORN 624 W SCHUBERT AVE CHICAGO, IL 60614

14-28-301-030-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-301-031-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-301-032-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-301-035-1001 PEDRO ALBUQUERQUE 632 W SCHUBERT AVE #1 CHICAGO, IL 60614

14-28-301-035-1002 RAKESH SHETTY 632 W SCHUBERT AVE #2 CHICAGO, IL 60614

14-28-301-035-1003 TIMOTHY L RYAN TRUSTEE 632 W SCHUBERT AVE #3 CHICAGO, IL 60614

14-28-306-001-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-306-002-0000 2735 N CLARK ST LLC 2735 N CLARK ST CHICAGO, IL 60614

14-28-306-003-0000 CO RYAN PTS DEPT 800 PO BOX 460169 HOUSTON, TX 77056

14-28-306-004-0000 PLANNED PARTNERSHIPS 1333 N KINGSBURY 301 CHICAGO, IL 60642

14-28-306-005-0000 SAKURA PROPERTY MGMT 730 W DIVERSEY PKWY CHICAGO, IL 60614

14-28-306-006-0000 ROBERT CEISEL DDS 671 NORTH STATE STREET CHICAGO, IL 60654

14-28-306-007-0000 2717 N CLARK BONNIE MG 8430 W BRYN MAWR AVE85 CHICAGO, IL 60631

14-28-306-008-0000 DAVID COHEN CF CLARK 7 MOUNTAIN ROAD LEXINGTON, MA 24201

14-28-306-009-0000 DAVID COHEN CF CLARK 7 MOUNTAIN ROAD LEXINGTON, MA 24201

14-28-306-011-0000 VICTOR PATEL 601 W DIVERSEY PKWY CHICAGO, IL 60614

14-28-306-012-0000 VICTOR PATEL 601 W DIVERSEY PKWY CHICAGO, IL 60614

14-28-306-013-0000 VICTOR PATEL 601 W DIVERSEY PKWY CHICAGO, IL 60614

14-28-306-020-1001 MATHIEU THEUREAU 942 W MONROE ST UNIT 3 CHICAGO, IL 60607

14-28-306-020-1002 EDWARD C WOOD 2712 N LEHMAN 2S CHICAGO, IL 60614

14-28-306-020-1003 QUINN K MANFREDINI 2712 N LEHMANN CT#3S CHICAGO, IL 60614

14-28-306-020-1004 JOSHUA TOHEN 2712 N LEHMANN CT#4S CHICAGO, IL 60614

14-28-306-020-1005 GERTNER JOSEPH FAMILY 2712 N LEHMANN CT#1N CHICAGO, IL 60614

14-28-306-020-1006 THOMAS CAITO 2712 N LEHMANN CT#2N CHICAGO, IL 60614

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14-28-308-030-1174 BRADLEY A ANASTASIA 2754 N HAMPDEN CT#2105 CHICAGO, IL 60614

14-28-308-030-1175 CHARLES JACOBSON 2754 N HAMPDEN CT#2008 CHICAGO, IL 60614

14-28-308-030-1176 THOMAS C KYROS 2754 N HAMPDEN CT#1505 CHICAGO, IL 60614

14-28-308-030-1177 DEBORAH BENSON 1005 WADE STREET HIGHLAND PK, IL 60035

14-28-308-030-1178 ROBERT M UNETICH 1811 WOODLANDS CR PITTSBURGH, PA 15241

14-28-308-030-1179 MARK E SKROCH 2754 N HAMPDEN CT 1705 CHICAGO, IL 60614

14-28-308-030-1180 ALEKSANDRA SUFLETA 2754 N HAMPDEN CT 1603 CHICAGO, IL 60614

14-28-308-030-1181 DAVID FLANIGAN 2754 N HAMPDEN #1608 CHICAGO, IL 60614

14-28-308-030-1182 RICHARD J SANFRATELLO 2438 N HAMLIN AVE#2C CHICAGO, IL 60647

14-28-308-030-1183 MICHAEL RUN 2754 N HAMPDEN CT 1208 CHICAGO, IL 60614

14-28-308-030-1184 ADRIENNE L SABORA 2754 N HAMPDEN CT#1805 CHICAGO, IL 60614

14-28-308-030-1185 MANABENDRA DAS 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1186 CLAIRE MAURELLO 2754 N HAMPDEN #404 CHICAGO, IL 60614

14-28-308-030-1189 SUZETTE M LORENZ 2754 N HAMPDEN CT 403 CHICAGO, IL 60614

14-28-308-030-1191 T D KHAYKIN 2754 N HAMPDEN CT 1806 CHICAGO, IL 60614

14-28-308-030-1193 JOY NDACKSON 2754 N HAMPOEN CT 1008 CHICAGO, IL 60614

14-28-308-030-1194 KATHRYN E KEEHN 2754 N HAMPDEN CT 1408 CHICAGO, IL 60614

14-28-308-030-1195 MARK R MANDELL 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1196 AHMAD RAMI ASFAHANI 2754 N HAMPDEN CT#2002 CHICAGO, IL 60614

14-28-308-030-1197 MATTHEW VAN ANTWERP 2754 N HAMPDEN CT#1405 CHICAGO, IL 60614

14-28-308-030-1198 FORTITUDE LLC 1703 W SCHOOL ST CHICAGO, IL 60657

14-28-308-030-1199 SKYLER R HESTNES 2754 N HAMPDEN CT#407 CHICAGO, IL 60614

14-28-308-030-1200 DOMINIC DUNLAP 1409 N ASHLAND AV 2N CHICAGO, IL 60622

14-28-308-030-1201 ARRIKA L SCMNEIDER 2754 N HAMPDEN CT 1601 CHICAGO, IL 60614

14-28-308-030-1202 JOEL MEADOW 2754N HAMPDEN CT 704 CHICAGO, IL 60614

14-28-308-030-1203 KELSEY C MADOCK 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1204 CTLTC 3397909 10 S LASALLE ST #2750 CHICAGO, IL 60603

14-28-308-030-1206 BRADLEY A ANASTASIA 2754 N HAMPDEN CT#2105 CHICAGO, IL 60614

14-28-308-030-1207 JEFFRY KATZ 2754 N HAMPDEN CT 1308 CHICAGO, IL 60614

14-28-308-030-1208 JUDITH RITHOLZ 1906 2754 N HAMPDEN CHICAGO, IL 60614

14-28-308-030-1209 RAJAT CHAND 2754 N HAMPDEN CT#1305 CHICAGO, IL 60614

14-28-308-030-1210 JUDY DEACETIS 2741 S SALIDA DEL SOL MESA, AZ 85202

14-28-308-030-1211 WILL BARQUIN 2754 N HAMPDEN CT U180 CHICAGO, IL 60614

14-28-308-030-1212 SHU WEI MIAO 2754 N HAMPDEN CT 503 CHICAGO, IL 60614

14-28-308-030-1213 CHERYL GAITLEY 2754 N HAMPDEN CT#806 CHICAGO, IL 60614

14-28-308-030-1217 DENNIS HERSTOWSKI 2754 N HAMPDEN CT 402 CHICAGO, IL 60614

14-28-308-030-1218 ARLENE BALANGUE CO JM 742 N 530 E OREM, UT 84097

14-28-308-030-1219 MANUEL GONZALEZ 2754 N HAMPDEN CT 508 CHICAGO, IL 60614

14-28-308-030-1220 BIRGER BUESCHING 1 2ND STREET APT 802 JERSEY CITY, NJ 73024

14-28-308-030-1221 ALELI MARIE ADAO 8068 S CARROLTON CT HANOVER PARK, IL 60133

14-28-308-030-1222 THERESA M OSUNERO 2754 N HAMPDEN CT 701 CHICAGO, IL 60614

14-28-308-030-1223 ELIZABETH VENECEK 2754 N HAMPDEN COURT CHICAGO, IL 60614

14-28-308-030-1224 BARRY SHEEHAN 2754 N HAMPDEN CT 1704 CHICAGO, IL 60614

14-28-308-030-1225 BARAD REAL ESTATE LLC 3180 HIGH PASS LN LISLE, IL 60532

14-28-308-030-1227 KRISTINA M HRVOJEVIC 2754 N HAMPDEN CT#601 CHICAGO, IL 60614

14-28-308-030-1228 ZACHARY JASON ARANOFF 2754 N HAMPDEN CT#1203 CHICAGO, IL 60614

14-28-308-030-1229 KATHLEEN M ABELL 2754 N HAMPDEN CT#1802 CHICAGO, IL 60614

14-28-308-030-1230 MARK TYLE 2754 N HAMPDEN #1701 CHICAGO, IL 60614

14-28-308-030-1231 PETER M BERG 2754 N HAMPDEN CT 1904 CHICAGO, IL 60614

14-28-308-030-1232 NICHOLAS TSOTSOS 2754 N HAMPDEN CT#1206 CHICAGO, IL 60614

14-28-308-030-1233 RANDY BACHAND 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1234 COURTNEY HIKAWA 2754 N HAMPDEN CT 1403 CHICAGO, IL 60614

14-28-308-030-1235 JASON MICHAEL ABATE 2754 N HAMPDEN CT #803 CHICAGO, IL 60614

14-28-308-030-1236 A SINGHAL 2754 N HAMPDEN CT 1903 CHICAGO, IL 60614

14-28-308-030-1237 LINDA BENTLEY 2170 E SRYDER RD PIQUA, OH 0

14-28-308-030-1238 T MROWCZYNSKI 2754 N HAMPDEN CT 1501 CHICAGO, IL 60614

14-28-308-030-1239 V S LINTAG 2754 N HAMPDEN RD CHICAGO, IL 60614

14-28-308-030-1240 PETER W KROL 2754 N HAMPDEN COURT CHICAGO, IL 60614

14-28-308-030-1241 TRACI ANNA HOLLETT 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1242 JUSTEEN N STREICH 2754 N HAMPDEN CT#505 CHICAGO, IL 60614

14-28-308-030-1243 CHRISTOPHER A WICHURA 2754 N HAMPDEN 902/903 CHICAGO, IL 60614

14-28-308-030-1244 JOSEPH BARRY 2754 N HAMPDEN CT 1706 CHICAGO, IL 60614

14-28-308-030-1245 JAMES KU 2754 N HAMPDEN COURT CHICAGO, IL 60614

14-28-308-030-1246 ADARSH MANJUNATH 2754 N HAMPDEN CT 406 CHICAGO, IL 60614

14-28-308-030-1247 MICHAEL SPEECHLEY 2754 N HAMPDEN CT 801 CHICAGO, IL 60614

14-28-308-030-1248 THOMAS BERNARD 29 COREY CAY AVE ST AUGUSTINE, FL 32092

14-28-308-030-1249 JAMES R BONHAM 2754 N HAMPDEN #1404 CHICAGO, IL 60614

14-28-308-030-1250 MORGAN GAGNON 2754 N HAMPDEN CT#506 CHICAGO, IL 60614

14-28-308-030-1251 ROGER BARTOS 2071 SHERIDAN RD BUFFALO GRV, IL 60089

14-28-308-030-1252 TIMOTHY BUCK 848 N RAINBOW 4545 LAS VEGAS, NV 89107

14-28-308-030-1253 WILLIAM P MOFFITT 49 WATROO POINT CHARLESTON, SC 29492

14-28-308-030-1254 LUKE MCCONNELL 2754 N HAMPDEN CT 1003 CHICAGO, IL 60614

14-28-308-030-1255 KYLE C HAGEY 2754 N HAMPDEN CT#1803 CHICAGO, IL 60614

14-28-308-030-1256 KATIE KRONE 2754 N HAMPDEN CT#1101 CHICAGO, IL 60614

14-28-308-030-1257 NICHOLAS J MINELLA 1001 W MADISON ST#204 CHICAGO, IL 60607

14-28-308-030-1258 HYUN TAE KIM 2754 N HAMPDEN CT#901 CHICAGO, IL 60614

14-28-308-030-1259 NINA M GROSSMAN 2754 N HAMPDEN CT 504 CHICAGO, IL 60614

14-28-308-030-1260 RANDY BACHAND 2754 N HAMPDEN CT CHICAGO, IL 60614

14-28-308-030-1261 CHARLES JACOBSON 2754 N HAMPDEN CT#2008 CHICAGO, IL 60614

14-28-308-030-1262 KELSEY C MADOCK 2754 N HAMPDEN CT 1703 CHICAGO, IL 60614

14-28-308-030-1263 JW REAL ESTATE INC 1411 MCHENRY RD BUFFALO GRV, IL 60089

14-28-308-030-1264 JANET STEWART 2754 N HAMPDEN CT 1503 CHICAGO, IL 60614

14-28-308-031-0000 LLC 512 WRIGHTWOOD 512 W WRIGHTWOOD AVE CHICAGO, IL 60614

14-28-309-037-0000 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1001 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1002 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1003 SCOTT SCHAFF 2773 N HAMPDEN CT 203 CHICAGO, IL 60614

14-28-309-038-1004 BRIAN J ZIMMER TRUST 2773 N HAMPDEN CT 204 CHICAGO, IL 60614

14-28-309-038-1005 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1006 HAOTIAN FENG 2773 N HAMPDEN CT 206 CHICAGO, IL 60614

14-28-309-038-1007 ALAN WOLPER 2773 N HAMPDEN CT 301 CHICAGO, IL 60614

14-28-309-038-1008 RONALD AND LORI OWENS 2773 N HAMPDEN CT 302 CHICAGO, IL 60614

14-28-309-038-1009 DAVID SMITH 2773 N HAMPDEN CT 303 CHICAGO, IL 60614

14-28-309-038-1010 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1011 RYAN POWERS 2773 N HAMPDEN CT APT CHICAGO, IL 60614

14-28-309-038-1012 SHEN LI 2773 N HAMPDEN CT APT CHICAGO, IL 60614

14-28-309-038-1013 DOUGLAS KORTFELT 2773 N HAMPDEN COURT CHICAGO, IL 60614

14-28-309-038-1014 ZACHARY LEVIN 2773 N HAMPDEN CT 402 CHICAGO, IL 60614

14-28-309-038-1015 MICHAEL CEDILLOS 2773 N HAMPDEN APT 403 CHICAGO, IL 60614

14-28-309-038-1016 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1017 XIAOWEN ZHONG 2773 N HAMPDEN CT 405 CHICAGO, IL 60614

14-28-309-038-1018 HOWARD E PATTIS 2773 NORTH HAMPDEN 406 CHICAGO, IL 60614

14-28-309-038-1019 CLARE MUNANA 2773 N HAMPDEN CT 501 CHICAGO, IL 60614

14-28-309-038-1020 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1021 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1022 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1023 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1024 ROBERT W STONE 2773 N HAMPDEN CT 506 CHICAGO, IL 60614

14-28-309-038-1025 ARLAN MCMILLAN 2773 N HAMPDEN CT PH01 CHICAGO, IL 60614

14-28-309-038-1026 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1027 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1028 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1029 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-309-038-1030 521 DIVERSEY LLC 3151 N. HALSTED ST. CHICAGO, IL 60657

14-28-120-017-0000 CURRENT RESIDENT 2875 N CLARK ST CHICAGO, IL 60657

14-28-123-015-0000 CURRENT RESIDENT 2800 N PINE GROVE #8E CHICAGO, IL 60657

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT

AND AFFIDAVIT

SECTION I -- GENERAL INFORMATION

A. Legal nae of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:

LINCOLN PARK PLAZA LOFTS LLC

Check ONE of the following three boxes:

Indicate whither the Disclosing Party submitting this EDS is:1. {XJ tle Applicant

OR2. { ] a legal entity currently holding, or anticipated to hold within six months after City action on

the contract, transaction or other undertaking to which this EDS pertains (referred to below as the"Matter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legalname:

3. [1 a legal entity with a direct or indirect right of control of the Applicant (see Section II(B)( 1))State the legl name of the entity in which the Disclosing Party holds a right of control:

B. Business address of the Disclosing Party: 14 Main St., Park Ridge, Il 60068

C. Telephone: (847) 720-7906 Fax:

D. Name

E. Federal

person: Gerard P. Walsh, Jr.

Email: gpw@gpwalshlaw.com

Identification No. (if you have one): 83-1059210

F. Brief desription of the Matter to which this EDS pertains. (Include project number and location ofproperty, if applicable):

Amend Plarned Development for retail buildout

G. Which Cty agency or department is requesting this EDS?Dept. of Planned Development

If the Matte is a contract being handled by the City's Department of Procurement Services, pleasecomplete the following:

ification # and Contract #

Ver.2018-1 Page 1 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT

AND AFFIDAVIT

SECTION I -- GENERAL INFORMATION

A. Legal nae of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:

LINCOLN PARK PLAZA LOFTS LLC

Check ONE of the following three boxes:

Indicate whither the Disclosing Party submitting this EDS is:1. {XJ tle Applicant

OR2. { ] a legal entity currently holding, or anticipated to hold within six months after City action on

the contract, transaction or other undertaking to which this EDS pertains (referred to below as the"Matter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legalname:

3. [1 a legal entity with a direct or indirect right of control of the Applicant (see Section II(B)( 1))State the legl name of the entity in which the Disclosing Party holds a right of control:

B. Business address of the Disclosing Party: 14 Main St., Park Ridge, Il 60068

C. Telephone: (847) 720-7906 Fax:

D. Name

E. Federal

person: Gerard P. Walsh, Jr.

Email: gpw@gpwalshlaw.com

Identification No. (if you have one): 83-1059210

F. Brief desription of the Matter to which this EDS pertains. (Include project number and location ofproperty, if applicable):

Amend Plarned Development for retail buildout

G. Which Cty agency or department is requesting this EDS?Dept. of Planned Development

If the Matte is a contract being handled by the City's Department of Procurement Services, pleasecomplete the following:

ification # and Contract #

Ver.2018-1 Page 1 of 15

SECTION 1 -- DISCLOSURE OF OWNERSHIP INTERESTS

A. NATUPJE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:[]Person

[xl Limited liability company[I Publicly registered business corporation [I Limited liability partnership[ J Privately held business corporation

{ ] Joint venture[1 Sole prorietorship [ ] Not -for-profit corporation{ I General partnership (Is the not -for-profit corporation also a 50 1(c)(3))?[ J Limited parthership [ J Yes [ j No[1 Trust

{ J Other (please specif')

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to dobusiness in he State of Illinois as a foreign entity?

[1 Yes [ ] No [x] Organized in Illinois

B. IF THE blsCLOSING PARTY IS A LEGAL ENTITY:

1. List blow the fill names and titles, if applicable, of: (1) all executive officers and all directors ofthe entity; (i) for not -for-profit corporations, all members, if any, which are legal entities (if thereare no such Fembers, write "no members which are legal entities"); (iii) for trusts, estates or othersimilar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general orlimited 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 orindirectly cntrols the day-to-day management of the Applicant.

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

Name TitleDonal P. BairySr. President

2. Please p9ovide the following information concerning each person or legal entity having a direct orindirect, current or prospective (i.e. within 6 months after City action) beneficial interest (includingownership) in excess of 7.5% of the Applicant. Examples of such an interest include shares in acorporation, partnership interest in a partnership or joint venture, interest of a member or manager in a

Ver.2018-1 Page2ofl5

SECTION 1 -- DISCLOSURE OF OWNERSHIP INTERESTS

A. NATUPJE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:[]Person

[xl Limited liability company[I Publicly registered business corporation [I Limited liability partnership[ J Privately held business corporation

{ ] Joint venture[1 Sole prorietorship [ ] Not -for-profit corporation{ I General partnership (Is the not -for-profit corporation also a 50 1(c)(3))?[ J Limited parthership [ J Yes [ j No[1 Trust

{ J Other (please specif')

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to dobusiness in he State of Illinois as a foreign entity?

[1 Yes [ ] No [x] Organized in Illinois

B. IF THE blsCLOSING PARTY IS A LEGAL ENTITY:

1. List blow the fill names and titles, if applicable, of: (1) all executive officers and all directors ofthe entity; (i) for not -for-profit corporations, all members, if any, which are legal entities (if thereare no such Fembers, write "no members which are legal entities"); (iii) for trusts, estates or othersimilar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general orlimited 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 orindirectly cntrols the day-to-day management of the Applicant.

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

Name TitleDonal P. Bairy Sr. President

2. Please p9ovide the following information concerning each person or legal entity having a direct orindirect, current or prospective (i.e. within 6 months after City action) beneficial interest (includingownership) in excess of 7.5% of the Applicant. Examples of such an interest include shares in acorporation, partnership interest in a partnership or joint venture, interest of a member or manager in a

Ver.2018-1 Page2ofl5

limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none,state "None"

NOTE: Eah legal entity listed below may be required to submit an EDS on its own behalf.1. James Purcell 14 Main St., Park Ridge, Ii 60068 - owns 20%

Name Business Address Percentage Interest in the Applicant2. Donal P. Barry, Sr- 14 Main St., Park Ridge, 1160068 - owns 20%

3. Donal P. Barry, Jr- 14 Main St., Park Ridge, 1160068 - owns 20%

4. Sean T. Barry -14 Main St., Park Ridge, 1160068 - owns 20%5. Margaret 14 Main St., Park Ridge, 1160068 - owns 20% Total: 100%

SECTION ifi -- INCOME OR COMPENSATION TO, OR OWNERSIIIP BY, CITY ELECTEDOFFICIAIIS

Has the Dislosing Party provided any income or compensation to any City elected official during the12 -month period preceding the date of this EDS? [1 Yes [Xi No

Does the Disclosing Party reasonably expect to provide any income or compensation to any City

elected offijial during the 12 -month period following the date of this EDS? [ IIYes [Xj No

If "yes" to either of the above, please identifr below the name(s) of such City elected official(s) anddescribe such income or compensation:

Does any Cty elected official or, to the best of the Disclosing Party's knowledge after reasonableinquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined inChapter 2-1 56 of the Municipal Code of Chicago ("MCC")) in the Disclosing Party?

[]Yes [X]No

If "yes," pleise identifr below the name(s) of such City elected official(s) and/or spouse(s)/domesticpartner(s) and describe the fmancial interest(s).

SECTION W -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

The Disclosing Party must disclose the name and business address of each subcontractor, attorney,lobbyist (as Iefmed in MCC Chapter 2-156), accountant, consultant and any other person or entitywhom the Disclosing Party has retained or expects to retain in connection with the Matter, as well asthe nature othe relationship, and the total amount of the fees paid or estimated to be paid. TheDisclosing arty is not required to disclose employees who are paid solely through the DisclosingParty's regulr payroll. If the Disclosing Party is uncertain whether a disclosure is required under thisSection, the Disclosing Party must either ask the City whether disclosure is required or make thedisclosure.

Ver.2018-1 Page3ofl5

limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none,state "None"

NOTE: Eah legal entity listed below may be required to submit an EDS on its own behalf.1. James Purcell 14 Main St., Park Ridge, Ii 60068 - owns 20%

Name Business Address Percentage Interest in the Applicant2. Donal P. Barry, Sr- 14 Main St., Park Ridge, 1160068 - owns 20%

3. Donal P. Barry, Jr- 14 Main St., Park Ridge, 1160068 - owns 20%

4. Sean T. Barry -14 Main St., Park Ridge, 1160068 - owns 20%5. Margaret 14 Main St., Park Ridge, 1160068 - owns 20% Total: 100%

SECTION ifi -- INCOME OR COMPENSATION TO, OR OWNERSIIIP BY, CITY ELECTEDOFFICIAIIS

Has the Dislosing Party provided any income or compensation to any City elected official during the12 -month period preceding the date of this EDS? [1 Yes [Xi No

Does the Disclosing Party reasonably expect to provide any income or compensation to any City

elected offijial during the 12 -month period following the date of this EDS? [ IIYes [Xj No

If "yes" to either of the above, please identifr below the name(s) of such City elected official(s) anddescribe such income or compensation:

Does any Cty elected official or, to the best of the Disclosing Party's knowledge after reasonableinquiry, any City elected official's spouse or domestic partner, have a financial interest (as defined inChapter 2-1 56 of the Municipal Code of Chicago ("MCC")) in the Disclosing Party?

[]Yes [X]No

If "yes," pleise identifr below the name(s) of such City elected official(s) and/or spouse(s)/domesticpartner(s) and describe the fmancial interest(s).

SECTION W -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

The Disclosing Party must disclose the name and business address of each subcontractor, attorney,lobbyist (as Iefmed in MCC Chapter 2-156), accountant, consultant and any other person or entitywhom the Disclosing Party has retained or expects to retain in connection with the Matter, as well asthe nature othe relationship, and the total amount of the fees paid or estimated to be paid. TheDisclosing arty is not required to disclose employees who are paid solely through the DisclosingParty's regulr payroll. If the Disclosing Party is uncertain whether a disclosure is required under thisSection, the Disclosing Party must either ask the City whether disclosure is required or make thedisclosure.

Ver.2018-1 Page3ofl5

Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whetherretained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:to be retaind) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.Jack Parrino Thompson Coburn LLC, 55 E. Monroe St., Chicago, Ii - Attorney - Est. $10,000

(Add sheets if necessary)

{ J Check hre if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.

SECTION -- CERTIFICATIONS

A. COURT1-ORDERED CHILD SUPPORT COMPLIANCE

Under MC Section 2-92-4 15, substantial owners of business entities that contract with the City mustremain in c mpliance with their child support obligations throughout the contract's term.

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared inarrearage or any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [x} No [1 No person directly or indirectly owns 10% or more of the Disclosing Party.

If "Yes," ha the person entered into a court -approved agreement for payment of all support owed andis the persor. in compliance with that agreement?

{]Yes []No

B. FURTHER CERTIFICATIONS

1. [This paiagraph 1 applies only if the Matter is a contract being handled by the City's Department ofProcuremen± Services.] In the 5-year period preceding the date of this EDS, neither the DisclosingParty nor any Affiliated Entity [see defmition in (5) below] has engaged, in connection with theperformanc of any public contract, the services of an integrity monitor, independent private sectorinspector geieral, 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 theactivity of specified agency vendors as well as help the vendors reform their business practices so theycan be consi1ered for agency contracts in the future, or continue with a contract in progress).

2. The Discosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee,tax or other ource of indebtedness owed to the City of Chicago, including, but not limited to, waterand sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the DisclosingParty delinquent in the payment of any tax administered by the Illinois Department of Revenue.

Ver.2018-1 Page4ofl5

Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whetherretained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:to be retaind) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.Jack Parrino Thompson Coburn LLC, 55 E. Monroe St., Chicago, Ii - Attorney - Est. $10,000

(Add sheets if necessary)

{ J Check hre if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.

SECTION -- CERTIFICATIONS

A. COURT1-ORDERED CHILD SUPPORT COMPLIANCE

Under MC Section 2-92-4 15, substantial owners of business entities that contract with the City mustremain in c mpliance with their child support obligations throughout the contract's term.

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared inarrearage or any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [x} No [1 No person directly or indirectly owns 10% or more of the Disclosing Party.

If "Yes," ha the person entered into a court -approved agreement for payment of all support owed andis the persor. in compliance with that agreement?

{]Yes []No

B. FURTHER CERTIFICATIONS

1. [This paiagraph 1 applies only if the Matter is a contract being handled by the City's Department ofProcuremen± Services.] In the 5 -year period preceding the date of this EDS, neither the DisclosingParty nor any Affiliated Entity [see defmition in (5) below] has engaged, in connection with theperformanc of any public contract, the services of an integrity monitor, independent private sectorinspector geieral, 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 theactivity of specified agency vendors as well as help the vendors reform their business practices so theycan be consi1ered for agency contracts in the future, or continue with a contract in progress).

2. The Discosing Party and its Affiliated Entities are not delinquent in the payment of any fine, fee,tax or other ource of indebtedness owed to the City of Chicago, including, but not limited to, waterand sewer charges, license fees, parking tickets, property taxes and sales taxes, nor is the DisclosingParty delinquent in the payment of any tax administered by the Illinois Department of Revenue.

Ver.2018-1 Page4ofl5

3. The Dislosing Party and, if the Disclosing Party is a legal entity, all of those persons or entitiesidentified in Section ll(B)(1) of this EDS:

a. are not 4resentiy debarred, suspended, proposed for debarment, declared ineligible or voluntarilyexcluded from any transactions by any federal, state or local unit of government;

b. have no, during the 5 years before the date of this EDS, been convicted of a criminal offense,adjudged gtilty, or had a civil judgment rendered against them in connection with: obtaining,attempting o obtain, or performing a public (federal, state or local) transaction or contract under apublic transction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery;bribery; falsification or destruction of records; making false statements; or receiving stolen property;

c. are not resently indicted for, or criminally or civilly charged by, a governmental entity (federal,state or locail) with committing any of the offenses set forth in subparagraph (b) above;

d. have no 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

e. have not during the 5 years before the date of this EDS, been convicted, adjudgedguilty, or foundliable in a cvil proceeding, or in any criminal or civil action, including actions concerningenvironmental violations, instituted by the City or by the federal government, any state, or any otherunit of local government.

4. The Disjlosing Party understands and shall comply with the applicable requirements of MCCChapters 2-56 (Inspector General) and 2-156 (Governmental Ethics).

5. Certificaions (5), (6) and (7) concern: the Disclosing Party;

any "Ciontractor" (meaning any contractor or subcontractor used by the Disclosing Party inconnection with the Matter, including but not limited to all persons or legal entities disclosedunder Setion IV, "Disclosure of Subcontractors and Other Retained Parties");o any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls theDisclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, undercommon control of another person or entity). Indicia of control include, without limitation:interlocking management or ownership; identity of interests among family members, sharedfacilitiesand equipment; common use of employees; or organization of a business entity followingthe ineligibility of a business entity to do business with federal or state or local government,including the City, using substantially the same management, ownership, or principals as theineligibl entity. With respect to Contractors, the term Affiliated Entity means a person or entitythat directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, isunder comnon control of another person or entity;o any reponsible official of the Disclosing Party, any Contractor or any Affiliated Entity or anyother official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity,acting prsuant to the direction or authorization of a responsible official of the Disclosing Party,any Contractor or any Affiliated Entity (collectively "Agents").

Ver.2018-1 Page5ofl5

3. The Dislosing Party and, if the Disclosing Party is a legal entity, all of those persons or entitiesidentified in Section ll(B)(1) of this EDS:

a. are not 4resentiy debarred, suspended, proposed for debarment, declared ineligible or voluntarilyexcluded from any transactions by any federal, state or local unit of government;

b. have no, during the 5 years before the date of this EDS, been convicted of a criminal offense,adjudged gtilty, or had a civil judgment rendered against them in connection with: obtaining,attempting o obtain, or performing a public (federal, state or local) transaction or contract under apublic transction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery;bribery; falsification or destruction of records; making false statements; or receiving stolen property;

c. are not resently indicted for, or criminally or civilly charged by, a governmental entity (federal,state or locail) with committing any of the offenses set forth in subparagraph (b) above;

d. have no 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

e. have not during the 5 years before the date of this EDS, been convicted, adjudgedguilty, or foundliable in a cvil proceeding, or in any criminal or civil action, including actions concerningenvironmental violations, instituted by the City or by the federal government, any state, or any otherunit of local government.

4. The Disjlosing Party understands and shall comply with the applicable requirements of MCCChapters 2-56 (Inspector General) and 2-156 (Governmental Ethics).

5. Certificaions (5), (6) and (7) concern: the Disclosing Party;

any "Ciontractor" (meaning any contractor or subcontractor used by the Disclosing Party inconnection with the Matter, including but not limited to all persons or legal entities disclosedunder Setion IV, "Disclosure of Subcontractors and Other Retained Parties");o any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls theDisclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, undercommon control of another person or entity). Indicia of control include, without limitation:interlocking management or ownership; identity of interests among family members, sharedfacilitiesand equipment; common use of employees; or organization of a business entity followingthe ineligibility of a business entity to do business with federal or state or local government,including the City, using substantially the same management, ownership, or principals as theineligibl entity. With respect to Contractors, the term Affiliated Entity means a person or entitythat directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, isunder comnon control of another person or entity;o any reponsible official of the Disclosing Party, any Contractor or any Affiliated Entity or anyother official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity,acting prsuant to the direction or authorization of a responsible official of the Disclosing Party,any Contractor or any Affiliated Entity (collectively "Agents").

Ver.2018-1 Page5ofl5

Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the DisclosingParty or an Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, withrespect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 yearsbefore the ate of such Contractor's or Affiliated Entity's contract or engagement in connection with theMatter:

a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe,a public officer or employee of the City, the State of Illinois, or any agency of the federal governmentor of any state or local government in the United States of America, in that officer's or employee'sofficial capcity;

b. agreed o 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 9f freedom of competition by agreement to bid a fixed price or otherwise; or

c. made an admission of such conduct described in subparagraph (a) or (b) above that is a matter ofrecord, but 11iave not been prosecuted for such conduct; or

d. violated he provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a BaseWage); (a)()(Debarment Regulations); or (a)(6)(Minimum Wage Ordinance).

6. Neither he Disclosing Party, nor any Affiliated Entity or Contractor, or any of their employees,officials, agnts or partners, is barred from contracting with any unit of state or local government as aresult of engaging in or being convicted of(1) bid -rigging in violation of 720 ILCS 5133E-3; (2)bid-rotatingin violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the UnitedStates of Axierica that contains the same elements as the offense of bid -rigging or bid -rotating.

7. Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by theUnited Stats Department of Commerce, State, or Treasury, or any successor federal agency.

8. [FOR A1PLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [ MCCChapter 1-2, Article I for applicability and defined terms] of the Applicant is currently indicted orcharged witl1i, 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 requirementfor doing buiness with the City. NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, thatArticle's pernanent compliance timeframe supersedes 5 -year compliance timeframes in this Section V.

9. [FOR A1PLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit theirsubcontractors to use, any facility listed as having an active exclusion by the U.S. EPA on the federalSystem for 4ward Management ("SAM").

10. [FOR APPLICANT ONLY] The Applicant will obtain from any contractors/subcontractors hiredor to be hire1 in connection with the Matter certifications equal in form and substance to those inCertificatjors (2) and (9) above and will not, without the prior written consent of the City, use any suchVer.2018-1 Page6ofls

Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the DisclosingParty or an Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, withrespect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 yearsbefore the ate of such Contractor's or Affiliated Entity's contract or engagement in connection with theMatter:

a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe,a public officer or employee of the City, the State of Illinois, or any agency of the federal governmentor of any state or local government in the United States of America, in that officer's or employee'sofficial capcity;

b. agreed o 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 9f freedom of competition by agreement to bid a fixed price or otherwise; or

c. made an admission of such conduct described in subparagraph (a) or (b) above that is a matter ofrecord, but 11iave not been prosecuted for such conduct; or

d. violated he provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a BaseWage); (a)()(Debarment Regulations); or (a)(6)(Minimum Wage Ordinance).

6. Neither he Disclosing Party, nor any Affiliated Entity or Contractor, or any of their employees,officials, agnts or partners, is barred from contracting with any unit of state or local government as aresult of engaging in or being convicted of(1) bid -rigging in violation of 720 ILCS 5133E-3; (2)bid-rotatingin violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the UnitedStates of Axierica that contains the same elements as the offense of bid -rigging or bid -rotating.

7. Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by theUnited Stats Department of Commerce, State, or Treasury, or any successor federal agency.

8. [FOR A1PLICANT ONLY] (i) Neither the Applicant nor any "controlling person" [ MCCChapter 1-2, Article I for applicability and defined terms] of the Applicant is currently indicted orcharged witl1i, 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 requirementfor doing buiness with the City. NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, thatArticle's pernanent compliance timeframe supersedes 5 -year compliance timeframes in this Section V.

9. [FOR A1PLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit theirsubcontractors to use, any facility listed as having an active exclusion by the U.S. EPA on the federalSystem for 4ward Management ("SAM").

10. [FOR APPLICANT ONLY] The Applicant will obtain from any contractors/subcontractors hiredor to be hire1 in connection with the Matter certifications equal in form and substance to those inCertificatjors (2) and (9) above and will not, without the prior written consent of the City, use any suchVer.2018-1 Page6ofls

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

11. If the Disclosing Party is unable to certifr to any of the above statements in this Part B (FurtherCertificatiohs), the Disclosing Party must explain below:

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusivelypresumed that the Disclosing Party certified to the above statements.

12. To the bst of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete list of all current employees of the Disclosing Party who were, at any time during the 12-.month pericd preceding the date of this EDS, an employee, or elected or appointed official, of the Cityof Chicago (if none, indicate with "N/A" or "none").

NONE

13. To the bst of the Disclosing Party's knowledge afterreasonable inquiry, the following is acomplete list of all gifts that the Disclosing Party has given or caused to be given, at any time duringthe 12-mon period preceding the execution date of this EDS, to an employee, or elected or appointedofficial, of tie City of Chicago. For purposes of this statement, a "gift" does not include: (i) anythingmade genertlly available to City employees or to the general public, or (ii) food or drink provided inthe course o official City business and having a retail value of less than $25 per recipient, or (iii) apolitical 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 of the City recipient.

NONE

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disólosing Party certifies that the Disclosing Party (check one){ ]is {X]isnot

a "fmancial institution" as defmed in MCC Section 2-32-455(b).

2. If the Diclosing Party IS a fmancial institution, then the Disclosing Party pledges:

"We are notand will not become a predatory lender as defined in MCC Chapter 2-32. We furtherpledge that none of our affiliates is, and none of them will become, a predatory lender as defmed inMCC Chaptr 2-32. We understand that becoming a predatory lender or becoming an affiliate of apredatory leider may result in the loss of the privilege of doing business with the City."

Ver.2018-1 Page7ofls

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

11. If the Disclosing Party is unable to certifr to any of the above statements in this Part B (FurtherCertificatiohs), the Disclosing Party must explain below:

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusivelypresumed that the Disclosing Party certified to the above statements.

12. To the bst of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete list of all current employees of the Disclosing Party who were, at any time during the 12-.month pericd preceding the date of this EDS, an employee, or elected or appointed official, of the Cityof Chicago (if none, indicate with "N/A" or "none").

NONE

13. To the bst of the Disclosing Party's knowledge afterreasonable inquiry, the following is acomplete list of all gifts that the Disclosing Party has given or caused to be given, at any time duringthe 12-mon period preceding the execution date of this EDS, to an employee, or elected or appointedofficial, of tie City of Chicago. For purposes of this statement, a "gift" does not include: (i) anythingmade genertlly available to City employees or to the general public, or (ii) food or drink provided inthe course o official City business and having a retail value of less than $25 per recipient, or (iii) apolitical 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 of the City recipient.

NONE

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disólosing Party certifies that the Disclosing Party (check one){ ]is {X]isnot

a "fmancial institution" as defmed in MCC Section 2-32-455(b).

2. If the Diclosing Party IS a fmancial institution, then the Disclosing Party pledges:

"We are notand will not become a predatory lender as defined in MCC Chapter 2-32. We furtherpledge that none of our affiliates is, and none of them will become, a predatory lender as defmed inMCC Chaptr 2-32. We understand that becoming a predatory lender or becoming an affiliate of apredatory leider may result in the loss of the privilege of doing business with the City."

Ver.2018-1 Page7ofls

If the Disclsing Party is unable to make this pledge because it or any of its affiliates (as defined inMCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explainhere (attach additional pages if necessary):

If the 1etter "NA," the word "None," or no response appears on the lines above, it will beconclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIIICATION REGARDING FINANCIAL INTEREST IN CITY BUSINESS

Any words r terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.

1. In accor1ance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledgeafter reasonble inquiry, does any official or employee of the City have a fmancial interest in his orher own nare or in the name of any other person or entity in the Matter?

[]Yes [No

NOTE: If Vou checked "Yes" to Item D(1), proceed to Items D(2) and D(3). If you checked "No"to Item D(1), skip Items D(2) and D(3) and proceed to Part B.

2. Unless s1d pursuant to a process of competitive bidding, or otherwise permitted, no City electedofficial or employee shall have a financial interest in his or her own name or in the name of anyother persoI or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold fortaxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively,"City Propejty Sale"). Compensation for property taken pursuant to the City's eminent domainpower does pot constitute a fmancial interest within the meaning of this Part D.

Does the

[]Yes

3. Ifyoucor employc

Name

involve a City Property Sale?

[X]No

ked "Yes" to Item D(1), provide the names and business addresses of the City officialshaving such fmancial interest and identify the nature of the financial interest:

Business Address Nature of Financial Interest

4. The Disèlosing Party further certifies that no prohibited fmancial interest in the Matter will beacquired by ny City official or employee.

Ver.2018-1 Page 8 of 15

If the Disclsing Party is unable to make this pledge because it or any of its affiliates (as defined inMCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explainhere (attach additional pages if necessary):

If the 1etter "NA," the word "None," or no response appears on the lines above, it will beconclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIIICATION REGARDING FINANCIAL INTEREST IN CITY BUSINESS

Any words r terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.

1. In accor1ance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledgeafter reasonble inquiry, does any official or employee of the City have a fmancial interest in his orher own nare or in the name of any other person or entity in the Matter?

[]Yes [No

NOTE: If Vou checked "Yes" to Item D(1), proceed to Items D(2) and D(3). If you checked "No"to Item D(1), skip Items D(2) and D(3) and proceed to Part B.

2. Unless s1d pursuant to a process of competitive bidding, or otherwise permitted, no City electedofficial or employee shall have a financial interest in his or her own name or in the name of anyother persoI or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold fortaxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively,"City Propejty Sale"). Compensation for property taken pursuant to the City's eminent domainpower does pot constitute a fmancial interest within the meaning of this Part D.

Does the

[]Yes

3. Ifyoucor employc

Name

involve a City Property Sale?

[X]No

ked "Yes" to Item D(1), provide the names and business addresses of the City officialshaving such fmancial interest and identify the nature of the financial interest:

Business Address Nature of Financial Interest

4. The Disèlosing Party further certifies that no prohibited fmancial interest in the Matter will beacquired by ny City official or employee.

Ver.2018-1 Page 8 of 15

E. CERTIIICATION REGARDING SLAVERY ERA BUSINESS

Please cieck either (1) or (2) below. If the DisclosingParty checks (2), the Disclosing Partymust disclose below or in an attachment to this EDS all information required by (2). Failure tocomply wi these disclosure requirements may make any contract entered into with the City inconnection With the Matter voidable by the City.

X 1. Th Disclosing Party verifies that the Disclosing Party has searched any and all records ofthe Disclosing Party and any and all predecessor entities regarding records of investments or profitsfrom slavery or slaveholder insurance policies during the slavery era (including insurance policiesissued to sláveholders that provided coverage for damage to or injury or death of their slaves), andthe Disclosing Party has found no such records.

____2. Th Disclosing Party verifies that, as a result of conducting the search in step (1) above, theDisclosing Iarty has found records of investments or profits from slavery or slaveholder insurancepolicies. The Disclosing Party verifies that the following constitutes full disclosure of all suchrecords, including the names of any and all slaves or slaveholders described in those records:

SECTION /I -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is notfederally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated bythe City an proceeds of debt obligations of the City are not federal funding.

A. CERTIFICATION REGARDING LOBBYiNG

1. List 1elow the names of all persons or entities registered under the federal LobbyingDisclosure ct of 1995, as amended, who have made lobbying contacts on behalf of the DisclosingParty with respect to the Matter: (Add sheets if necessary):NONE

(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None"appear, it wil be conclusively presumed that the Disclosing Party means that NO persons or entitiesregistered urftder the Lobbying Disclosure Act of 1995, as amended, have made lobbying contactsonbehalf of th Disclosing Party with respect to the Matter.)

2. The If)isclosing Party has not spent and will not expend any federally appropriated funds to payany person or entity listed in paragraph A(l) above for his or her lobbying activities or to pay anyperson or entity to influence or attempt to influence an officer or employee of any agency, as definedby applicable federal law, a member of Congress, an officer or employee of Congress, or an employeeVer.2018-1 Page9ofl5

E. CERTIIICATION REGARDING SLAVERY ERA BUSINESS

Please cieck either (1) or (2) below. If the DisclosingParty checks (2), the Disclosing Partymust disclose below or in an attachment to this EDS all information required by (2). Failure tocomply wi these disclosure requirements may make any contract entered into with the City inconnection With the Matter voidable by the City.

X 1. Th Disclosing Party verifies that the Disclosing Party has searched any and all records ofthe Disclosing Party and any and all predecessor entities regarding records of investments or profitsfrom slavery or slaveholder insurance policies during the slavery era (including insurance policiesissued to sláveholders that provided coverage for damage to or injury or death of their slaves), andthe Disclosing Party has found no such records.

____2. Th Disclosing Party verifies that, as a result of conducting the search in step (1) above, theDisclosing Iarty has found records of investments or profits from slavery or slaveholder insurancepolicies. The Disclosing Party verifies that the following constitutes full disclosure of all suchrecords, including the names of any and all slaves or slaveholders described in those records:

SECTION /I -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is notfederally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated bythe City an proceeds of debt obligations of the City are not federal funding.

A. CERTIFICATION REGARDING LOBBYiNG

1. List 1elow the names of all persons or entities registered under the federal LobbyingDisclosure ct of 1995, as amended, who have made lobbying contacts on behalf of the DisclosingParty with respect to the Matter: (Add sheets if necessary):NONE

(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None"appear, it wil be conclusively presumed that the Disclosing Party means that NO persons or entitiesregistered urftder the Lobbying Disclosure Act of 1995, as amended, have made lobbying contactsonbehalf of th Disclosing Party with respect to the Matter.)

2. The If)isclosing Party has not spent and will not expend any federally appropriated funds to payany person or entity listed in paragraph A(l) above for his or her lobbying activities or to pay anyperson or entity to influence or attempt to influence an officer or employee of any agency, as definedby applicable federal law, a member of Congress, an officer or employee of Congress, or an employeeVer.2018-1 Page9ofl5

of a member of Congress, in connection with the award of any federally funded contract, making anyfederally flifided grant or loan, entering into any cooperative agreement, or to extend, continue, renew,amend, or modify any federally funded contract, grant, loan, or cooperative agreement.

3. The Disclosing Party will submit an updated certification at the end of each calendar quarter inwhich there occurs any event that materially affects the accuracy of the statements and information setforth in par1graphs A(1) and A(2) above.

4. The I)isclosing Party certifies that either: (i) it is not an organization described in section501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section501(c)(4) othe Internal Revenue Code of 1986 but has not engaged and will not engage in "LobbyingActivities," as that term is defmed in the Lobbying Disclosure Act of 1995, as amended.

5. If th Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal inform and sustance to paragraphs A(1) through A(4) above from all subcontractors before it awardsany subcontract and the Disclosing Party must maintain all such subcontractors' certifications for theduration ofhe Matter and must make such certifications promptly available to the City upon request.

B. CERTIFICATION REGARDiNG EQUAL EMPLOYMENT OPPORTUNITY

If the Mtter is federally funded, federal regulations require the Applicant and all proposedcontractors to submit the following information with their bids or in writing at the outset of

Is the Discksing Party the Applicant?[JYes {]No

If "Yes," an4wer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicablefederal regulations? (See 41 CFR Part 60-2.)

{]Yes {]No

2. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal ContractCompliance Programs, or the Equal Employment Opportunity Commission all reports due under theapplicable fiflng requirements?

[ ] Yes [1 No []Reports not required

3. Have yoi participated in any previous contracts or subcontracts subject to theequal opportunity clause?

[]Yes {JNo

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

Ver.20 1 8-1 Page 10 of 15

of a member of Congress, in connection with the award of any federally funded contract, making anyfederally flifided grant or loan, entering into any cooperative agreement, or to extend, continue, renew,amend, or modify any federally funded contract, grant, loan, or cooperative agreement.

3. The Disclosing Party will submit an updated certification at the end of each calendar quarter inwhich there occurs any event that materially affects the accuracy of the statements and information setforth in par1graphs A(1) and A(2) above.

4. The I)isclosing Party certifies that either: (i) it is not an organization described in section501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section501(c)(4) othe Internal Revenue Code of 1986 but has not engaged and will not engage in "LobbyingActivities," as that term is defmed in the Lobbying Disclosure Act of 1995, as amended.

5. If th Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal inform and sustance to paragraphs A(1) through A(4) above from all subcontractors before it awardsany subcontract and the Disclosing Party must maintain all such subcontractors' certifications for theduration ofhe Matter and must make such certifications promptly available to the City upon request.

B. CERTIFICATION REGARDiNG EQUAL EMPLOYMENT OPPORTUNITY

If the Mtter is federally funded, federal regulations require the Applicant and all proposedcontractors to submit the following information with their bids or in writing at the outset of

Is the Discksing Party the Applicant?[JYes {]No

If "Yes," an4wer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicablefederal regulations? (See 41 CFR Part 60-2.)

{]Yes {]No

2. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal ContractCompliance Programs, or the Equal Employment Opportunity Commission all reports due under theapplicable fiflng requirements?

[ ] Yes [1 No []Reports not required

3. Have yoi participated in any previous contracts or subcontracts subject to theequal opportunity clause?

[]Yes {JNo

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

Ver.20 1 8-1 Page 10 of 15

SECTION Tll -- FURTHER ACKNOWLEDGMENTS AND CERTIFICATION

The Disc1oing Party understands and agrees that:

A. The cer4fications, disclosures, and acknowledgments contained in this EDS will become part of anycontract or ?ther agreement between the Applicant and the City in connection with the Matter, whetherprocurement, City assistance, or other City action, and are material inducements to the City's executionof any contiact or taking other action with respect to the Matter. The Disclosing Party understands thatit must comply with all statutes, ordinances, and regulations on which this EDS is based.

B. The Cit's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties andobligations pn persons or entities seeking City contracts, work, business, or transactions. The full textof this ordiiance and a training program is available on line at www.cityofchicago.org/Ethics, and mayalso be obtaned from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, IL 60610,(312) 744-960. The Disclosing Party must comply fully withthis ordinance.

C. If the City determines that any information provided in this EDS is false, incomplete or inaccurate,any contract or other agreement in connection with which it is submitted may be rescinded or be voidor voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded orvoid), at law, or in equity, including terminating the Disclosing Party's participation in the Matterand/or declining to allow the Disclosing Party to participate in other City transactions. Remedies atlaw for a fale statement of material fact may include incarceration and an award to the City of trebledamages.

D. It is the(request. So]available oncompletingclaims whiclcontained inin this EDS.

E. The info:Party must scontract beiiupdate this I1-23, Artichinformationby MCC Ch

Ver.20 18-1

ity's policy to make this document available to the public on its Internet site and/or uponne or all of the information provided in, and appended to, this EDS may be made publiclythe Internet, in response to a Freedom of Information Act request, or otherwise. Bynd signing this EDS, the Disclosing Party waives and releases any possible rights orlit may have against the City in connection with the public release of informationthis EDS and also authorizes the City to verifr the accuracy of any information submitted

mation provided in this EDS must be kept current. In the event of changes, the Disclosingipplement this EDS up to the time the City takes action on the Matter. If the Matter is a.g handled by the City's Department of Procurement Services, the Disclosing Party mustDS as the contract requires. NOTE: With respect to Matters subject to MCC ChapterI (imposing PERMANENT INELIGIBILITY for certain specified offenses), theDrovided herein regarding eligibility must be kept current for a longer period, as requiredLpter 1-23 and Section 2-154-020.

Page 11 of 15

SECTION Tll -- FURTHER ACKNOWLEDGMENTS AND CERTIFICATION

The Disc1oing Party understands and agrees that:

A. The cer4fications, disclosures, and acknowledgments contained in this EDS will become part of anycontract or ?ther agreement between the Applicant and the City in connection with the Matter, whetherprocurement, City assistance, or other City action, and are material inducements to the City's executionof any contiact or taking other action with respect to the Matter. The Disclosing Party understands thatit must comply with all statutes, ordinances, and regulations on which this EDS is based.

B. The Cit's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties andobligations pn persons or entities seeking City contracts, work, business, or transactions. The full textof this ordiiance and a training program is available on line at www.cityofchicago.org/Ethics, and mayalso be obtaned from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, IL 60610,(312) 744-960. The Disclosing Party must comply fully withthis ordinance.

C. If the City determines that any information provided in this EDS is false, incomplete or inaccurate,any contract or other agreement in connection with which it is submitted may be rescinded or be voidor voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded orvoid), at law, or in equity, including terminating the Disclosing Party's participation in the Matterand/or declining to allow the Disclosing Party to participate in other City transactions. Remedies atlaw for a fale statement of material fact may include incarceration and an award to the City of trebledamages.

D. It is the(request. So]available oncompletingclaims whiclcontained inin this EDS.

E. The info:Party must scontract beiiupdate this I1-23, Artichinformationby MCC Ch

Ver.20 18-1

ity's policy to make this document available to the public on its Internet site and/or uponne or all of the information provided in, and appended to, this EDS may be made publiclythe Internet, in response to a Freedom of Information Act request, or otherwise. Bynd signing this EDS, the Disclosing Party waives and releases any possible rights orlit may have against the City in connection with the public release of informationthis EDS and also authorizes the City to verifr the accuracy of any information submitted

mation provided in this EDS must be kept current. In the event of changes, the Disclosingipplement this EDS up to the time the City takes action on the Matter. If the Matter is a.g handled by the City's Department of Procurement Services, the Disclosing Party mustDS as the contract requires. NOTE: With respect to Matters subject to MCC ChapterI (imposing PERMANENT INELIGIBILITY for certain specified offenses), theDrovided herein regarding eligibility must be kept current for a longer period, as requiredLpter 1-23 and Section 2-154-020.

Page 11 of 15

ATION

Under penaty of perjury, the person signing below: (1) warrants that he/she is authorized to executethis EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that allcertificatiors and statements contained in this EDS, and all applicable Appendices, are true, accurateand complee as of the date furnished to the City.

LINCOLN ARK PLAZA LOFTS LLC

(Print or tye exact legal name of Disclosing Party)

(Sigrihere)

GERARD WALSH JR

(Print or type name of person signing)

IN HOUSI

(Print or tyç

Signed and

at

Nota

COUNSEL

title of person signing)

to before me on (date) f,uçr 3 a o I

County, tLNo2) (state).

Public

expires: a/O /o5

- -

______ OFFICIAL SEALPubllC - StatS of MInoS

MyCommflP1 p

FebruarY _________

Ver.2018-1 Page 12 of 15

ATION

Under penaty of perjury, the person signing below: (1) warrants that he/she is authorized to executethis EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that allcertificatiors and statements contained in this EDS, and all applicable Appendices, are true, accurateand complee as of the date furnished to the City.

LINCOLN ARK PLAZA LOFTS LLC

(Print or tye exact legal name of Disclosing Party)

(Sigrihere)

GERARD WALSH JR

(Print or type name of person signing)

IN HOUSI

(Print or tyç

Signed and

at

Nota

COUNSEL

title of person signing)

to before me on (date) f,uçr 3 a o I

County, tLNo2) (state).

Public

expires: a/O /o5

- -

______ OFFICIAL SEALPubllC - StatS of MInoS

MyCommflP1 p

FebruarY _________

Ver.2018-1 Page 12 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALSAND DEPARTMENT H1ADS

This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has adirect ownership interest in the Applicant exceeding 7.5%. It is not to be completed by any legalentity whici has only an indirect ownership interest in the Applicant.

Under ]CC Section 2-154-0 15, the Disclosing Party must disclose whether such Disclosing Partyor any "Aplicable Party" or any Spouse or Domestic Partner thereof currently has a "familialrelationship' with any elected city official or department head. A "familial relationship" exists if, as ofthe date thi EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or DomesticPartner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any citydepartment iead as spouse or domestic partner or as any of the following, whether by blood oradoption: prent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild,father-in-la1v, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson orstepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Sectionll.B.1.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the DisclosingParty is a gneral partnership; all general partners and limited partners of the Disclosing Party, if theDisclosing Iarty is a limited partnership; all managers, managing members and members of theDisclosing 1arty, if the Disclosing Party is a limited liability company; (2) all principal officers of theDisclosing Iarty; and (3) any person having more than a 7.5% ownership interest in the DisclosingParty. "Principal officers" means the president, chief operating officer, executive director, chieffinancial oflcer, treasurer or secretary of a legal entity or any person exercising similar authority.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereofcurrently haye a "familial relationship" with an elected city official or department head?

[ ]Yes {X]No

If yes, plase identify below (1) the name and title of such person, (2) the name of the legal entity towhich such person is connected; (3) the name and title of the elected city official or department head towhom such erson has a familial relationship, and (4) the precise nature of such familial relationship.

Ver.2018-1 Pagel3 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALSAND DEPARTMENT H1ADS

This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has adirect ownership interest in the Applicant exceeding 7.5%. It is not to be completed by any legalentity whici has only an indirect ownership interest in the Applicant.

Under ]CC Section 2-154-0 15, the Disclosing Party must disclose whether such Disclosing Partyor any "Aplicable Party" or any Spouse or Domestic Partner thereof currently has a "familialrelationship' with any elected city official or department head. A "familial relationship" exists if, as ofthe date thi EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or DomesticPartner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any citydepartment iead as spouse or domestic partner or as any of the following, whether by blood oradoption: prent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild,father-in-la1v, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson orstepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Sectionll.B.1.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the DisclosingParty is a gneral partnership; all general partners and limited partners of the Disclosing Party, if theDisclosing Iarty is a limited partnership; all managers, managing members and members of theDisclosing 1arty, if the Disclosing Party is a limited liability company; (2) all principal officers of theDisclosing Iarty; and (3) any person having more than a 7.5% ownership interest in the DisclosingParty. "Principal officers" means the president, chief operating officer, executive director, chieffinancial oflcer, treasurer or secretary of a legal entity or any person exercising similar authority.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereofcurrently haye a "familial relationship" with an elected city official or department head?

[ ]Yes {X]No

If yes, plase identify below (1) the name and title of such person, (2) the name of the legal entity towhich such person is connected; (3) the name and title of the elected city official or department head towhom such erson has a familial relationship, and (4) the precise nature of such familial relationship.

Ver.2018-1 Pagel3 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX B

ING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION

This Appen ix is to be completed only by (a) the Applicant, and (b) any legal entity which has a directownership iiterest in the Applicant exceeding 7.5% (an "Owner"). It is not to be completed by anylegal entity which has only an indirect ownership interest in the Applicant.

1. Pursuanto MCC Section 2-154-0 10, is the Applicant or any Owner identified as a building codescofflaw orroblem landlord pursuant to MCC Section 2-92-416?

[]Yes [No2. If the Aplicant is a legal entity publicly iraded on any exchange, is any officer or director ofthe Applicapt identified as a building code scofflaw or problem landlord pursuant to MCC Section2-92-4 16?

[ J Yes [ J No [X] The Applicant is not publicly traded on any exchange.

3. If yes to(1) or (2) above, please identiQy below the name of each person or legal entity identifiedas a building code scofflaw or problem landlord and the address of each building or buildings to whichthe pertinert code violations apply.

Ver.2018-1 Page 14 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX B

ING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION

This Appen ix is to be completed only by (a) the Applicant, and (b) any legal entity which has a directownership iiterest in the Applicant exceeding 7.5% (an "Owner"). It is not to be completed by anylegal entity which has only an indirect ownership interest in the Applicant.

1. Pursuanto MCC Section 2-154-0 10, is the Applicant or any Owner identified as a building codescofflaw orroblem landlord pursuant to MCC Section 2-92-416?

[]Yes [No2. If the Aplicant is a legal entity publicly iraded on any exchange, is any officer or director ofthe Applicapt identified as a building code scofflaw or problem landlord pursuant to MCC Section2-92-4 16?

[ J Yes [ J No [X] The Applicant is not publicly traded on any exchange.

3. If yes to(1) or (2) above, please identiQy below the name of each person or legal entity identifiedas a building code scofflaw or problem landlord and the address of each building or buildings to whichthe pertinert code violations apply.

Ver.2018-1 Page 14 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX C

ON WAGE & SALARY HISTORY SCREENING - CERTIFICATION

This Append' ix is to be completed only by an Applicant that is completing this EDS as a "contractor" asdefined in J\1CC Section 2-92-3 85. That section, which should be consulted (\vww.arnlegaLcorn),generally covers a party to any agreement pursuant to which they: (i) receive City of Chicago funds inconsideratkn for services, work or goods provided (including for legal or other professional services),or (ii) pay tlie City money for a license, grant or concession allowing them to conduct a business onCity premises.

On behalf oan Applicant that is a contractor pursuant to MCC Section 2-92-385, I hereby certify thatthe Applicait is in compliance with MCC Section 2-92-385(b)(l) and (2), which prohibit: (1) screeningjob applicaits based on their wage or salary history, or (ii) seeking job applicants' wage or salaryhistory from current or former employers. I also certify that the Applicant has adopted a policy thatincludes thcse prohibitions.

{]Yes

{JNo

[X] N/A -I am not an Applicant that is a "contractor" as defmed in MCC Section 2-92-3 85.

This certifiction shall serve as the affidavit required by MCC Section 2-92-385(c)(l).

If you checl4ed "no" to the above, please explain.

Ver.2018-1 Page 15 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX C

ON WAGE & SALARY HISTORY SCREENING - CERTIFICATION

This Append' ix is to be completed only by an Applicant that is completing this EDS as a "contractor" asdefined in J\1CC Section 2-92-3 85. That section, which should be consulted (\vww.arnlegaLcorn),generally covers a party to any agreement pursuant to which they: (i) receive City of Chicago funds inconsideratkn for services, work or goods provided (including for legal or other professional services),or (ii) pay tlie City money for a license, grant or concession allowing them to conduct a business onCity premises.

On behalf oan Applicant that is a contractor pursuant to MCC Section 2-92-385, I hereby certify thatthe Applicait is in compliance with MCC Section 2-92-385(b)(l) and (2), which prohibit: (1) screeningjob applicaits based on their wage or salary history, or (ii) seeking job applicants' wage or salaryhistory from current or former employers. I also certify that the Applicant has adopted a policy thatincludes thcse prohibitions.

{]Yes

{JNo

[X] N/A -I am not an Applicant that is a "contractor" as defmed in MCC Section 2-92-3 85.

This certifiction shall serve as the affidavit required by MCC Section 2-92-385(c)(l).

If you checl4ed "no" to the above, please explain.

Ver.2018-1 Page 15 of 15

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CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT

AND AFFIDAVIT

SECTION I -- GENERA]L INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:

LINCOLN PARK PLAZA LLC

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:1. {)(j the Applicant

OR2. [1 aLlegal 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'tMatter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legalname:

O1

3. { ] a legal entity with a direct or indirect right of control of the Applicant (see Section II(B)(l))State the legal name of the entity in which the Disclosing Party holds a right of control:

B. Business address of the Disclosing Party:

C. Telephone: (847) 720-7906 Fax:

D. Name ofcontact person: Gerard P. Walsh, Jr.

14 Main St., Park Ridge, Ii 60068

Email: gpw@gpwalshlaw.com

E. Federal Employer Identification No. (if you have one): 01-0815041

F. Brief description of the Matter to which this EDS pertains. (Include project number and location ofproperty, if applicable):

Amend Planned Development for retail buildout

G. Which City agency or department is requesting this EDS?Dept. of Planned Development

If the Mattexj is a contract being handled by the City's Department of Procurement Services, pleasecomplete the following:

Specification # and Contract #

Ver.2018-1 Page 1 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT

AND AFFIDAVIT

SECTION I -- GENERA]L INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:

LINCOLN PARK PLAZA LLC

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:1. {)(j the Applicant

OR2. [1 aLlegal 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'tMatter"), a direct or indirect interest in excess of 7.5% in the Applicant. State the Applicant's legalname:

O1

3. { ] a legal entity with a direct or indirect right of control of the Applicant (see Section II(B)(l))State the legal name of the entity in which the Disclosing Party holds a right of control:

B. Business address of the Disclosing Party:

C. Telephone: (847) 720-7906 Fax:

D. Name ofcontact person: Gerard P. Walsh, Jr.

14 Main St., Park Ridge, Ii 60068

Email: gpw@gpwalshlaw.com

E. Federal Employer Identification No. (if you have one): 01-0815041

F. Brief description of the Matter to which this EDS pertains. (Include project number and location ofproperty, if applicable):

Amend Planned Development for retail buildout

G. Which City agency or department is requesting this EDS?Dept. of Planned Development

If the Mattexj is a contract being handled by the City's Department of Procurement Services, pleasecomplete the following:

Specification # and Contract #

Ver.2018-1 Page 1 of 15

SECTION II-- DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:{ J Person [xl Limited liability company[ii Publicly registered business corporation [ J Limited liability partnership[] Privately held business corporation [ J Joint venture{ J Sole proprietorship [I Not -for-profit corporation{ J General partnership (Is the not -for-profit corporation also a 501 (c)(3))?[ ] Limited partnership [ J Yes [ ] No[] Trust { ] Other (please specifr)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to dobusiness in he State of Illinois as a foreign entity?

{ ] Yes [1 No [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 ofthe entity; (i) for not -for-profit corporations, all members, if any, which are legal entities (if thereare no such members, write "no members which are legal entities"); (iii) for trusts, estates or othersimilar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general orlimited partnerships, limited liability companies, limited liability partnerships or joint ventures,each genera' partner, managing member, manager or any other person or legal entity that directly orindirectly cntrols the day-to-day management of the Applicant.

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

Name TitleDonal P. Barry Sr. President

2. Please piovide the following infonnation concerning each person or legal entity having a direct orindirect, cur1ent or prospective (i.e. within 6 months after City action) beneficial interest (includingownership) in excess of 7.5% of the Applicant. Examples of such an interest include shares in acorporation,partnership interest in a partnership or joint venture, interest of a member or manager in a

Ver.2018-1 Page2ofl5

SECTION II-- DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:{ J Person [xl Limited liability company[ii Publicly registered business corporation [ J Limited liability partnership[] Privately held business corporation [ J Joint venture{ J Sole proprietorship [I Not -for-profit corporation{ J General partnership (Is the not -for-profit corporation also a 501 (c)(3))?[ ] Limited partnership [ J Yes [ ] No[] Trust { ] Other (please specifr)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to dobusiness in he State of Illinois as a foreign entity?

{ ] Yes [1 No [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 ofthe entity; (i) for not -for-profit corporations, all members, if any, which are legal entities (if thereare no such members, write "no members which are legal entities"); (iii) for trusts, estates or othersimilar entities, the trustee, executor, administrator, or similarly situated party; (iv) for general orlimited partnerships, limited liability companies, limited liability partnerships or joint ventures,each genera' partner, managing member, manager or any other person or legal entity that directly orindirectly cntrols the day-to-day management of the Applicant.

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

Name TitleDonal P. Barry Sr. President

2. Please piovide the following infonnation concerning each person or legal entity having a direct orindirect, cur1ent or prospective (i.e. within 6 months after City action) beneficial interest (includingownership) in excess of 7.5% of the Applicant. Examples of such an interest include shares in acorporation,partnership interest in a partnership or joint venture, interest of a member or manager in a

Ver.2018-1 Page2ofl5

limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none,state "None."

NOTE: Each legal entity listed below may be required to submit an EDS on its own behalf.1. James Purcell- 14 Main St., Park Ridge, Ii 60068 - owns 20%

Name Business Address Percentage Interest in the Applicant2. Donal P. Barry, Sr- 14 Main St., Park Ridge, 1160068 - owns 20%

3. Donal P. Barry, Jr- 14 Main St., Park Ridge, 1160068 - owns 20%

4. Sean T. Barry - 14 Main St., Park Ridge, Ii 60068 - owns 20%

5. Margaret BarW- 14 Main St., Park Ridge, 1160068 - owns 20% Total: 100%

SECTION ifi -- INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTEDOFFICIALS

Has the Disclosing Party provided any income or compensation to any City elected official during the12 -month period preceding the date of this EDS? [1 Yes [XJ No

Does the Disclosing Party reasonably expect to provide any income or compensation to any Cityelected official during the 12 -month period following the date of this EDS?

{ I Yes [Xj No

If "yes" to either of the above, please identi±' below the name(s) of such City elected official(s) anddescribe such income or compensation:

Does any City elected official or, to the best of the Disclosing Party's knowledge after reasonableinquiry, any City elected official's spouse or domestic partner, have a fmancial interest (as defined inChapter 2-156 of the Municipal Code of Chicago ("MCC")) in the DisclosingParty?

[ JYes {XJNo

If "yes," plese identif' below the name(s) of such City elected official(s) and/or spouse(s)/domesticpartner(s) ad describe the financial interest(s).

SECTION IV -- DISCLOSUR] OF SUBCONTRACTORS AN]) OTHER RETAINED PARTIES

The Disclosing Party must disclose the name and business address of each subcontractor, attorney,lobbyist (as kiefined in MCC Chapter 2-156), accountant, consultant and any other person or entitywhom the Dsclosing Party has retained or expects to retain in connection with the Matter, as well asthe nature of the relationship, and the total amount of the fees paid or estimated to be paid. TheDisclosing }arty is not required to disclose employees who are paid solely through the DisclosingParty's regular payroll. If the Disclosing Party is uncertain whether a disclosure is required under thisSection, the Disclosing Party must either ask the City whether disclosure is required or make thedisclosure.

Ver.2018-1 Page3ofl5

limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none,state "None."

NOTE: Each legal entity listed below may be required to submit an EDS on its own behalf.1. James Purcell- 14 Main St., Park Ridge, Ii 60068 - owns 20%

Name Business Address Percentage Interest in the Applicant2. Donal P. Barry, Sr- 14 Main St., Park Ridge, 1160068 - owns 20%

3. Donal P. Barry, Jr- 14 Main St., Park Ridge, 1160068 - owns 20%

4. Sean T. Barry - 14 Main St., Park Ridge, Ii 60068 - owns 20%

5. Margaret BarW- 14 Main St., Park Ridge, 1160068 - owns 20% Total: 100%

SECTION ifi -- INCOME OR COMPENSATION TO, OR OWNERSHIP BY, CITY ELECTEDOFFICIALS

Has the Disclosing Party provided any income or compensation to any City elected official during the12 -month period preceding the date of this EDS? [1 Yes [XJ No

Does the Disclosing Party reasonably expect to provide any income or compensation to any Cityelected official during the 12 -month period following the date of this EDS?

{ I Yes [Xj No

If "yes" to either of the above, please identi±' below the name(s) of such City elected official(s) anddescribe such income or compensation:

Does any City elected official or, to the best of the Disclosing Party's knowledge after reasonableinquiry, any City elected official's spouse or domestic partner, have a fmancial interest (as defined inChapter 2-156 of the Municipal Code of Chicago ("MCC")) in the DisclosingParty?

[ JYes {XJNo

If "yes," plese identif' below the name(s) of such City elected official(s) and/or spouse(s)/domesticpartner(s) ad describe the financial interest(s).

SECTION IV -- DISCLOSUR] OF SUBCONTRACTORS AN]) OTHER RETAINED PARTIES

The Disclosing Party must disclose the name and business address of each subcontractor, attorney,lobbyist (as kiefined in MCC Chapter 2-156), accountant, consultant and any other person or entitywhom the Dsclosing Party has retained or expects to retain in connection with the Matter, as well asthe nature of the relationship, and the total amount of the fees paid or estimated to be paid. TheDisclosing }arty is not required to disclose employees who are paid solely through the DisclosingParty's regular payroll. If the Disclosing Party is uncertain whether a disclosure is required under thisSection, the Disclosing Party must either ask the City whether disclosure is required or make thedisclosure.

Ver.2018-1 Page3ofl5

Name (indipate whether Business Relationship to Disclosing Party Fees (indicate whetherretained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.Jack Parrino Thompson Coburn LLC, 55 E. Monroe St., Chicago, Ii - Attorney -Est. $10,000

(Add sheets if necessary)

[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.

SECTION V -- CERTIFICATIONS

A. COJRT-ORDERFD CHILD SUPPORT COMPLIANCE

Under MC Section 2-92-415, substantial owners of business entities that contract with the City mustremain in compliance with their child support obligations throughout the contract's term.

Has any peison who directly or indirectly owns 10% or more of the Disclosing Party been declared inarrearage on any child support obligations by any Illinois court of competent jurisdiction?

{ ] Yes {x] No [1 No person directly or indirectly owns 10% or more of the Disclosing Party.

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

{]Yes []No

B. FURThER CERTIFICATIONS

1. [This paragraph 1 applies only if the Matter is a contract being handled by the City's Department ofProcurement Services.] In the 5 -year period preceding the date of this EDS, neither the DisclosingParty nor any Affiliated Entity [see definition in (5) below] has engaged, in connection with theperformanc of any public contract, the services of an integrity monitor, independent private sectorinspector geperal, 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 theactivity of specified agency vendors as well as help the vendors reform their business practices so theycan be consdered for agency contracts in the future, or continue with a contract in progress).

2. The Dis9losing Party and its Affiliated Entities are not delinquent in the payment of any fme, fee,tax or other ource of indebtedness owed to the City of Chicago, including, but not limited to, waterand sewer c1iarges, license fees, parking tickets, property taxes and sales taxes, nor is the DisclosingParty delinquent in the payment ofany tax administered by the Illinois Department of Revenue.

Ver.2018-1 Page4ofl5

Name (indipate whether Business Relationship to Disclosing Party Fees (indicate whetherretained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.Jack Parrino Thompson Coburn LLC, 55 E. Monroe St., Chicago, Ii - Attorney -Est. $10,000

(Add sheets if necessary)

[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.

SECTION V -- CERTIFICATIONS

A. COJRT-ORDERFD CHILD SUPPORT COMPLIANCE

Under MC Section 2-92-415, substantial owners of business entities that contract with the City mustremain in compliance with their child support obligations throughout the contract's term.

Has any peison who directly or indirectly owns 10% or more of the Disclosing Party been declared inarrearage on any child support obligations by any Illinois court of competent jurisdiction?

{ ] Yes {x] No [1 No person directly or indirectly owns 10% or more of the Disclosing Party.

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

{]Yes []No

B. FURThER CERTIFICATIONS

1. [This paragraph 1 applies only if the Matter is a contract being handled by the City's Department ofProcurement Services.] In the 5 -year period preceding the date of this EDS, neither the DisclosingParty nor any Affiliated Entity [see definition in (5) below] has engaged, in connection with theperformanc of any public contract, the services of an integrity monitor, independent private sectorinspector geperal, 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 theactivity of specified agency vendors as well as help the vendors reform their business practices so theycan be consdered for agency contracts in the future, or continue with a contract in progress).

2. The Dis9losing Party and its Affiliated Entities are not delinquent in the payment of any fme, fee,tax or other ource of indebtedness owed to the City of Chicago, including, but not limited to, waterand sewer c1iarges, license fees, parking tickets, property taxes and sales taxes, nor is the DisclosingParty delinquent in the payment ofany tax administered by the Illinois Department of Revenue.

Ver.2018-1 Page4ofl5

3. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entitiesidentified irk Section ll(B)(1) of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarilyexcluded frDm any transactions by any federal, state or local unit of government;

b. have not, during the 5 years before the date of this EDS, been convicted of a criminal offense,adjudged giiilty, 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 apublic transction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery;bribery; falsification or destruction of records; making false statements; or receiving stolen property;

c. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal,state or loca!1) with committing any of the offenses set forth in subparagraph (b) above;

d. 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

e. have nol during the 5 years before the date of this EDS, been convicted, adjudged guilty, or foundliable in a civil proceeding, or in any criminal or civil action, including actions concerningenvironmental violations, instituted by the City or by the federal government, any state, or any otherunit of local government.

4. The Disclosing Party understands and shall comply with the applicable requirements of MCCChapters 2-$6 (Inspector General) and 2-15 6 (Governmental Ethics).

5. Certifications (5), (6) and (7) concern: the Disclosing Party;o any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party inconnection with the Matter, including but not limited to all persons or legal entities disclosedunder Section W, "Disclosure of Subcontractors and Other Retained Parties");o any "Affihiated Entity" (meaning a person or entity that, directly or indirectly: controls theDisclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, undercommon control of another person or entity). Indicia of control include, without limitation:interlocling management or ownership; identity of interests among family members, sharedfacilitiest and equipment; common use of employees; or organization of a business entity followingthe ineligibility of a business entity to do business with federal or state or local government,including the City, using substantially the same management, ownership, or principals as theineligible entity. With respect to Contractors, the term Affiliated Entity means a person or entitythat directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, isunder comon control of another person or entity;o any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or anyother official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity,acting pursuant to the direction or authorization of a responsible official of the Disclosing Party,any Confractor or any Affiliated Entity (collectively "Agents").

Ver.2018-1 Page5ofl5

3. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entitiesidentified irk Section ll(B)(1) of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarilyexcluded frDm any transactions by any federal, state or local unit of government;

b. have not, during the 5 years before the date of this EDS, been convicted of a criminal offense,adjudged giiilty, 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 apublic transction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery;bribery; falsification or destruction of records; making false statements; or receiving stolen property;

c. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal,state or loca!1) with committing any of the offenses set forth in subparagraph (b) above;

d. 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

e. have nol during the 5 years before the date of this EDS, been convicted, adjudged guilty, or foundliable in a civil proceeding, or in any criminal or civil action, including actions concerningenvironmental violations, instituted by the City or by the federal government, any state, or any otherunit of local government.

4. The Disclosing Party understands and shall comply with the applicable requirements of MCCChapters 2-$6 (Inspector General) and 2-15 6 (Governmental Ethics).

5. Certifications (5), (6) and (7) concern: the Disclosing Party;o any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party inconnection with the Matter, including but not limited to all persons or legal entities disclosedunder Section W, "Disclosure of Subcontractors and Other Retained Parties");o any "Affihiated Entity" (meaning a person or entity that, directly or indirectly: controls theDisclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, undercommon control of another person or entity). Indicia of control include, without limitation:interlocling management or ownership; identity of interests among family members, sharedfacilitiest and equipment; common use of employees; or organization of a business entity followingthe ineligibility of a business entity to do business with federal or state or local government,including the City, using substantially the same management, ownership, or principals as theineligible entity. With respect to Contractors, the term Affiliated Entity means a person or entitythat directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, isunder comon control of another person or entity;o any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or anyother official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity,acting pursuant to the direction or authorization of a responsible official of the Disclosing Party,any Confractor or any Affiliated Entity (collectively "Agents").

Ver.2018-1 Page5ofl5

Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the DisclosingParty or any Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, withrespect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 yearsbefore the date of such Contractor's or Affiliated Entity's contract or engagement in connection with theMatter:

a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe,a public officer or employee of the City, the State of Illinois, or any agency of the federal governmentor of any stte or local government in the United States of America, in that officer's or employee'sofficial capacity;

b. 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 pf freedom of competition by agreement to bid a fixed price or otherwise; or

c. made an admission of such conduct described in subparagraph (a) or (b) above that is a matter ofrecord, but have not been prosecuted for such conduct; or

d. violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a BaseWage); (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 aresult of engaging in or being convicted of(l) bid -rigging in violation of 720 ILCS 5/33E-3; (2)bid-rotatingin violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the UnitedStates of America that contains the same elements as the offense of bid -rigging or bid -rotating.

7. Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by theUnited States Department of Commerce, State, or Treasury, or any successor federal agency.

8. [FOR APPLICANT ONLY] (1) Neither the Applicant nor any "controlling person" [ MCCChapter 1-2, Article I for applicability and defmed terms] of the Applicant is currently indicted orcharged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for,any criminai 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 requirementfor doing btsiness with the City. NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, thatArticle's peianent compliance timeframe supersedes 5 -year compliance timeframes in this Section V.

9. [FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit theirsubcontractOrs to use, any facility listed as having an active exclusion by the U.S. EPA on the federalSystem for ward Management ("SAM").

10. [FOR APPLICANT ONLY] The Applicant will obtain from any contractors/subcontractors hiredor to be hirel in connection with the Matter certifications equal in form and substance to those inCertifications (2) and (9) above and will not, without the prior written consent of the City, use any suchVer.2018-1 Page6ofls

Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the DisclosingParty or any Contractor, nor any Agents have, during the 5 years before the date of this EDS, or, withrespect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the 5 yearsbefore the date of such Contractor's or Affiliated Entity's contract or engagement in connection with theMatter:

a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe,a public officer or employee of the City, the State of Illinois, or any agency of the federal governmentor of any stte or local government in the United States of America, in that officer's or employee'sofficial capacity;

b. 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 pf freedom of competition by agreement to bid a fixed price or otherwise; or

c. made an admission of such conduct described in subparagraph (a) or (b) above that is a matter ofrecord, but have not been prosecuted for such conduct; or

d. violated the provisions referenced in MCC Subsection 2-92-320(a)(4)(Contracts Requiring a BaseWage); (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 aresult of engaging in or being convicted of(l) bid -rigging in violation of 720 ILCS 5/33E-3; (2)bid-rotatingin violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the UnitedStates of America that contains the same elements as the offense of bid -rigging or bid -rotating.

7. Neither the Disclosing Party nor any Affiliated Entity is listed on a Sanctions List maintained by theUnited States Department of Commerce, State, or Treasury, or any successor federal agency.

8. [FOR APPLICANT ONLY] (1) Neither the Applicant nor any "controlling person" [ MCCChapter 1-2, Article I for applicability and defmed terms] of the Applicant is currently indicted orcharged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for,any criminai 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 requirementfor doing btsiness with the City. NOTE: If MCC Chapter 1-23, Article I applies to the Applicant, thatArticle's peianent compliance timeframe supersedes 5 -year compliance timeframes in this Section V.

9. [FOR APPLICANT ONLY] The Applicant and its Affiliated Entities will not use, nor permit theirsubcontractOrs to use, any facility listed as having an active exclusion by the U.S. EPA on the federalSystem for ward Management ("SAM").

10. [FOR APPLICANT ONLY] The Applicant will obtain from any contractors/subcontractors hiredor to be hirel in connection with the Matter certifications equal in form and substance to those inCertifications (2) and (9) above and will not, without the prior written consent of the City, use any suchVer.2018-1 Page6ofls

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

11. If the Disclosing Party is unable to certify to any of the above statements in this Part B (FurtherCertifications), the Disclosing Party must explain below:

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusivelypresumed that the Disclosing Party certified to the above statements.

12. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete lis of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the date of this EDS, an employee, or elected or appointed official, of the Cityof Chicago if none, indicate with "N/A" or "none").

NONE

13.To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete lisp of all gifts that the Disclosing Party has given or caused to be given, at any time duringthe 12 -month period preceding the execution date of this EDS, to an employee, or elected or appointedofficial, of 4ie City of Chicago. For purposes of this statement, a "gift" does not include: (i) anythingmade generily available to City employees or to the general public, or (ii) food or drink provided inthe course of official City business and having a retail value of less than $25 per recipient, or (iii) apolitical coitribution otherwise duly reported as required by law (if none, indicate with "N/A" or"none"). Asto any gift listed below, please also list the name of the City recipient.

NONE

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Dis4losing Party certifies that the Disclosing Party (check one){ ]is [X]isnot

a "fmancial institution" as defined in MCC Section 2-32-455(b).

2. If the Diclosing 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 furtherpledge that none of our affiliates is, and none of them will become, a predatory lender as defined inMCC Chaptr 2-32. We understand that becoming a predatory lender or becoming an affiliate of apredatory lender may result in the loss of the privilege of doing business with the City."

Ver.2018-1 Page 7 of 15

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

11. If the Disclosing Party is unable to certify to any of the above statements in this Part B (FurtherCertifications), the Disclosing Party must explain below:

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusivelypresumed that the Disclosing Party certified to the above statements.

12. To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete lis of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the date of this EDS, an employee, or elected or appointed official, of the Cityof Chicago if none, indicate with "N/A" or "none").

NONE

13.To the best of the Disclosing Party's knowledge after reasonable inquiry, the following is acomplete lisp of all gifts that the Disclosing Party has given or caused to be given, at any time duringthe 12 -month period preceding the execution date of this EDS, to an employee, or elected or appointedofficial, of 4ie City of Chicago. For purposes of this statement, a "gift" does not include: (i) anythingmade generily available to City employees or to the general public, or (ii) food or drink provided inthe course of official City business and having a retail value of less than $25 per recipient, or (iii) apolitical coitribution otherwise duly reported as required by law (if none, indicate with "N/A" or"none"). Asto any gift listed below, please also list the name of the City recipient.

NONE

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Dis4losing Party certifies that the Disclosing Party (check one){ ]is [X]isnot

a "fmancial institution" as defined in MCC Section 2-32-455(b).

2. If the Diclosing 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 furtherpledge that none of our affiliates is, and none of them will become, a predatory lender as defined inMCC Chaptr 2-32. We understand that becoming a predatory lender or becoming an affiliate of apredatory lender may result in the loss of the privilege of doing business with the City."

Ver.2018-1 Page 7 of 15

If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined inMCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explainhere (attacl additional pages if necessary):

If the letters "NA," the word "None," or no response appears on the lines above, it will beconclusively presumed that the Disclosing Party certified to the above statements.

D. CERTllICATION REGARDING FINANCIAL iNTEREST IN CITY BUSINESS

Any words r terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.

1. In accordance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledgeafter reasonble inquiry, does any official or employee of the City have a financial interest in his orher own naiie or in the name of any other person or entity in the Matter?

[JYes [NoNOTE: If you checked "Yes" to Item D(1), proceed to Items D(2) and D(3). If you checked "No"to Item D(1), skip Items D(2) and D(3) and proceed to Part E.

2. Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City electedofficial or ep1oyee shall have a fmancial interest in his or her own name or in the name ofanyother person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold fortaxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively,"City Property Sale"). Compensation for property taken pursuant to the City's eminent domainpower does iot constitute a fmancial interest within the meaning of this Part D.

Does the Mtter involve a City Property Sale?

{]Yes {XJNo

3. If you cFecked "Yes" to Item D(1), provide the names and business addresses of the City officialsor employes having such fmancial interest and identify the nature of the financial interest:

Name Business Address Nature of Financial Interest

4. The Disilosing Party further certifies that no prohibited fmancial interest in the Matter will beacquired by ny City official or employee.

Ver.2018-1 Page8ofls

If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined inMCC Section 2-32-455(b)) is a predatory lender within the meaning of MCC Chapter 2-32, explainhere (attacl additional pages if necessary):

If the letters "NA," the word "None," or no response appears on the lines above, it will beconclusively presumed that the Disclosing Party certified to the above statements.

D. CERTllICATION REGARDING FINANCIAL iNTEREST IN CITY BUSINESS

Any words r terms defined in MCC Chapter 2-156 have the same meanings if used in this Part D.

1. In accordance with MCC Section 2-156-110: To the best of the Disclosing Party's knowledgeafter reasonble inquiry, does any official or employee of the City have a financial interest in his orher own naiie or in the name of any other person or entity in the Matter?

[JYes [NoNOTE: If you checked "Yes" to Item D(1), proceed to Items D(2) and D(3). If you checked "No"to Item D(1), skip Items D(2) and D(3) and proceed to Part E.

2. Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City electedofficial or ep1oyee shall have a fmancial interest in his or her own name or in the name ofanyother person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold fortaxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively,"City Property Sale"). Compensation for property taken pursuant to the City's eminent domainpower does iot constitute a fmancial interest within the meaning of this Part D.

Does the Mtter involve a City Property Sale?

{]Yes {XJNo

3. If you cFecked "Yes" to Item D(1), provide the names and business addresses of the City officialsor employes having such fmancial interest and identify the nature of the financial interest:

Name Business Address Nature of Financial Interest

4. The Disilosing Party further certifies that no prohibited fmancial interest in the Matter will beacquired by ny City official or employee.

Ver.2018-1 Page8ofls

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Please check either (1) or (2) below. If the Disclosing Party checks (2), the Disclosing Partymust disclose below or in an attachment to this EDS all information required by (2). Failure tocomply wi these disclosure requirements may make any contract entered into with the City inconnection with the Matter voidable by the City.

X 1. Th Disclosing Party verifies that the Disclosing Party has searched any and all records ofthe Disclosing Party and any and all predecessor entities regarding records of investments or profitsfrom slavery or slaveholder insurance policies during the slavery era (including insurance policiesissued to slaveholders that provided coverage for damage to or injury or death of their slaves), andthe Disclosing Party has found no such records.

____2. Th Disclosing Party verifies that, as a result of conducting the search in step (1) above, theDisclosing Party has found records of investments or profits from slavery or slaveholder insurancepolicies. Tle Disclosing Party verifies that the following constitutes full disclosure of all suchrecords, inciuding the names of any and all slaves or slaveholders described in those records:

SECTION TI -- CERTIFICATIONS FOR FEDERALLY FU]DED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. lithe Matter is notfederally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated bythe City an proceeds of debt obligations of the City are not federal funding.

A. CERTIFICATION REGARDING LOBBYING

1. List 1elow the names of all persons or entities registered under the federal LobbyingDisclosure 4ct of 1995, as amended, who have made lobbying contacts on behalf of the DisclosingParty with respect to the Matter: (Add sheets if necessary):

NONE

(If no explaiiation appears or begins on the lines above, or if the letters "NA" or if the word "None"appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entitiesregistered uiider the Lobbying Disclosure Act of 1995, as amended, have made lobbying contacts onbehalf of the Disclosing Party with respect to the Matter.)

2. The 1Msclosing Party has not spent and will not expend any federally appropriated funds to payany person 9r entity listed in paragraph A(1) above for his or her lobbying activities or to pay anyperson or entity to influence or attempt to influence an officer or employee of any agency, as definedby applicabl federal law, a member of Congress, an officer or employee of Congress, or an employeeVer.2018-1 Page9ofl5

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Please check either (1) or (2) below. If the Disclosing Party checks (2), the Disclosing Partymust disclose below or in an attachment to this EDS all information required by (2). Failure tocomply wi these disclosure requirements may make any contract entered into with the City inconnection with the Matter voidable by the City.

X 1. Th Disclosing Party verifies that the Disclosing Party has searched any and all records ofthe Disclosing Party and any and all predecessor entities regarding records of investments or profitsfrom slavery or slaveholder insurance policies during the slavery era (including insurance policiesissued to slaveholders that provided coverage for damage to or injury or death of their slaves), andthe Disclosing Party has found no such records.

____2. Th Disclosing Party verifies that, as a result of conducting the search in step (1) above, theDisclosing Party has found records of investments or profits from slavery or slaveholder insurancepolicies. Tle Disclosing Party verifies that the following constitutes full disclosure of all suchrecords, inciuding the names of any and all slaves or slaveholders described in those records:

SECTION TI -- CERTIFICATIONS FOR FEDERALLY FU]DED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. lithe Matter is notfederally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated bythe City an proceeds of debt obligations of the City are not federal funding.

A. CERTIFICATION REGARDING LOBBYING

1. List 1elow the names of all persons or entities registered under the federal LobbyingDisclosure 4ct of 1995, as amended, who have made lobbying contacts on behalf of the DisclosingParty with respect to the Matter: (Add sheets if necessary):

NONE

(If no explaiiation appears or begins on the lines above, or if the letters "NA" or if the word "None"appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entitiesregistered uiider the Lobbying Disclosure Act of 1995, as amended, have made lobbying contacts onbehalf of the Disclosing Party with respect to the Matter.)

2. The 1Msclosing Party has not spent and will not expend any federally appropriated funds to payany person 9r entity listed in paragraph A(1) above for his or her lobbying activities or to pay anyperson or entity to influence or attempt to influence an officer or employee of any agency, as definedby applicabl federal law, a member of Congress, an officer or employee of Congress, or an employeeVer.2018-1 Page9ofl5

of a member of Congress, in connection with the award of any federally funded contract, making anyfederally fuided grant or loan, entering into any cooperative agreement, or to extend, continue, renew,amend, or nodify any federally funded contract, grant, loan, or cooperative agreement.

3. The Disclosing Party will submit an updated certification at the end of each calendar quarter inwhich thereoccurs any event that materially affects the accuracy of the statements and information setforth in pa9graphs A(l) and A(2) above.

4. The Disclosing Party certifies that either: (i) it is not an organization described in section501(c)(4) o'the Internal Revenue Code of 1986; or (ii) it is an organization described in section501(c)(4) othe Internal Revenue Code of 1986 but has not engaged and will not engage in "LobbyingActivities," as that term is defined in the Lobbying Disclosure Act of 1995, as amended.

5. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal inform and sustance to paragraphs A(1) through A(4) above from all subcontractors before it awardsany subcontract and the Disclosing Party must maintain all such subcontractors' certifications for theduration of the Matter and must make such certifications promptly available to the City upon request.

B. CERTIFECATION REGARDING EQUAL EMPLOYMENT OPPORTUMTY

If the Mtter is federally funded, federal regulations require the Applicant and all proposedsubcontractors to submit the following information with their bids or in writing at the outset ofnegotiations.

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

If "Yes," anwer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicablefederal regulations? (See 41 CFR Part 60-2.)

[]Yes {JNo

2. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal ContractCompliancePrograms, or the Equal Employment Opportunity Commission all reports due under theapplicable filing requirements?

[1 Yes{ I No [ii Reports not required

3. Have yoi.i participated in any previous contracts or subcontracts subject to theequal oppor6nity clause?

[IYes {]No

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

Ver.2018-1 Page 10 of 15

of a member of Congress, in connection with the award of any federally funded contract, making anyfederally fuided grant or loan, entering into any cooperative agreement, or to extend, continue, renew,amend, or nodify any federally funded contract, grant, loan, or cooperative agreement.

3. The Disclosing Party will submit an updated certification at the end of each calendar quarter inwhich thereoccurs any event that materially affects the accuracy of the statements and information setforth in pa9graphs A(l) and A(2) above.

4. The Disclosing Party certifies that either: (i) it is not an organization described in section501(c)(4) o'the Internal Revenue Code of 1986; or (ii) it is an organization described in section501(c)(4) othe Internal Revenue Code of 1986 but has not engaged and will not engage in "LobbyingActivities," as that term is defined in the Lobbying Disclosure Act of 1995, as amended.

5. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal inform and sustance to paragraphs A(1) through A(4) above from all subcontractors before it awardsany subcontract and the Disclosing Party must maintain all such subcontractors' certifications for theduration of the Matter and must make such certifications promptly available to the City upon request.

B. CERTIFECATION REGARDING EQUAL EMPLOYMENT OPPORTUMTY

If the Mtter is federally funded, federal regulations require the Applicant and all proposedsubcontractors to submit the following information with their bids or in writing at the outset ofnegotiations.

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

If "Yes," anwer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicablefederal regulations? (See 41 CFR Part 60-2.)

[]Yes {JNo

2. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal ContractCompliancePrograms, or the Equal Employment Opportunity Commission all reports due under theapplicable filing requirements?

[1 Yes{ I No [ii Reports not required

3. Have yoi.i participated in any previous contracts or subcontracts subject to theequal oppor6nity clause?

[IYes {]No

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

Ver.2018-1 Page 10 of 15

SECTION VII-- FURTHER ACKNOWLEDGMENTS AND CERTIFICATION

The Disclosing Party understands and agrees that:

A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of anycontract or 9ther agreement between the Applicant and the City in connection with the Matter, whetherprocurement, City assistance, or other City action, and are material inducements to the City's executionof any contract or taking other action with respect to the Matter. The Disclosing Party understands thatit must comply with all statutes, ordinances, and regulations on which this EDS is based.

B. The City's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties andobligations on persons or entities seeking City contracts, work, business, or transactions. The full textof this ordiiance and a training program is available on line at www.cityofchicago.orEthics, and mayalso be obtained from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, IL 60610,(312) 744-960. The Disclosing Party must comply fully with this ordinance.

C. If the City determines that any information provided in this EDS is false, incomplete or inaccurate,any contract or other agreement in connection with which it is submitted may be rescinded or be voidor voidable,1 and the City may pursue any remedies under the contract or agreement (if not rescinded orvoid), at law, or in equity, including terminating the Disclosing Party's participation in the Matterand/or decliiing to allow the Disclosing Party to participate in other City transactions. Remedies atlaw for a fase statement of material fact may include incarceration and an award to the City of trebledamages.

D. It is the pty's policy to make this document available to the public on its Internet site and/or uponrequest. Some or all of the information provided in, and appended to, this EDS may be made publiclyavailable oi the Internet, in response to a Freedom of Information Act request, or otherwise. Bycompleting and signing this EDS, the Disclosing Party waives and releases any possible rights orclaims which it may have against the City in connection with the public release of informationcontained in this EDS and also authorizes the City to verifr the accuracy of any information submittedin this EDS.

E. The infcrxnation provided in this EDS must be kept current. In the event of changes, the DisclosingParty must supplement this EDS up to the time the City takes action on the Matter. If the Matter is acontract beiig handled by the City's Department of Procurement Services, the Disclosing Party mustupdate this EDS as the contract requires. NOTE: With respect to Matters subject to MCC Chapter1-23, Articth I (imposing PERMANENT INELIGIBILITY for certain specified offenses), theinfonnation provided herein regarding eligibility must be kept current for a longer period, as requiredby MCC Chapter 1-23 and Section 2-154-020.

Ver.2018-1 Page 11 of 15

SECTION VII-- FURTHER ACKNOWLEDGMENTS AND CERTIFICATION

The Disclosing Party understands and agrees that:

A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of anycontract or 9ther agreement between the Applicant and the City in connection with the Matter, whetherprocurement, City assistance, or other City action, and are material inducements to the City's executionof any contract or taking other action with respect to the Matter. The Disclosing Party understands thatit must comply with all statutes, ordinances, and regulations on which this EDS is based.

B. The City's Governmental Ethics Ordinance, MCC Chapter 2-156, imposes certain duties andobligations on persons or entities seeking City contracts, work, business, or transactions. The full textof this ordiiance and a training program is available on line at www.cityofchicago.orEthics, and mayalso be obtained from the City's Board of Ethics, 740 N. Sedgwick St., Suite 500, Chicago, IL 60610,(312) 744-960. The Disclosing Party must comply fully with this ordinance.

C. If the City determines that any information provided in this EDS is false, incomplete or inaccurate,any contract or other agreement in connection with which it is submitted may be rescinded or be voidor voidable,1 and the City may pursue any remedies under the contract or agreement (if not rescinded orvoid), at law, or in equity, including terminating the Disclosing Party's participation in the Matterand/or decliiing to allow the Disclosing Party to participate in other City transactions. Remedies atlaw for a fase statement of material fact may include incarceration and an award to the City of trebledamages.

D. It is the pty's policy to make this document available to the public on its Internet site and/or uponrequest. Some or all of the information provided in, and appended to, this EDS may be made publiclyavailable oi the Internet, in response to a Freedom of Information Act request, or otherwise. Bycompleting and signing this EDS, the Disclosing Party waives and releases any possible rights orclaims which it may have against the City in connection with the public release of informationcontained in this EDS and also authorizes the City to verifr the accuracy of any information submittedin this EDS.

E. The infcrxnation provided in this EDS must be kept current. In the event of changes, the DisclosingParty must supplement this EDS up to the time the City takes action on the Matter. If the Matter is acontract beiig handled by the City's Department of Procurement Services, the Disclosing Party mustupdate this EDS as the contract requires. NOTE: With respect to Matters subject to MCC Chapter1-23, Articth I (imposing PERMANENT INELIGIBILITY for certain specified offenses), theinfonnation provided herein regarding eligibility must be kept current for a longer period, as requiredby MCC Chapter 1-23 and Section 2-154-020.

Ver.2018-1 Page 11 of 15

CERTIFIATION

Under penaty of perjury, the person signing below: (1) warrants that he/she is authorized to executethis EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that allcertifications and statements contained in this EDS, and all applicable Appendices, are true, accurateand complete as of the date furnished to the City.

LINCOLN PARK PLAZA LLC

(Print or type exact legal name of Disclosing Party)

here

GERARD P WALSH JR

(Print or type name of person signing)

IN HOUSE COUNSEL

(Print or tyçe title of person signing)

Signed and wom to before me on (date) A u&usT / /_oIatCook County, L3i'crr (state).

/v/ctNot4y Public

Commissioli expires: Oa/

LANSA NASLR

bic.Stateot UnOlS

2.2025

mmlSSi0fl ExpweS

Ver.2018-1 Page 12 of 15

CERTIFIATION

Under penaty of perjury, the person signing below: (1) warrants that he/she is authorized to executethis EDS, and all applicable Appendices, on behalf of the Disclosing Party, and (2) warrants that allcertifications and statements contained in this EDS, and all applicable Appendices, are true, accurateand complete as of the date furnished to the City.

LINCOLN PARK PLAZA LLC

(Print or type exact legal name of Disclosing Party)

here

GERARD P WALSH JR

(Print or type name of person signing)

IN HOUSE COUNSEL

(Print or tyçe title of person signing)

Signed and wom to before me on (date) A u&usT / /_oIatCook County, L3i'crr (state).

/v/ctNot4y Public

Commissioli expires: Oa/

LANSA NASLR

bic.Stateot UnOlS

2.2025

mmlSSi0fl ExpweS

Ver.2018-1 Page 12 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMIIJIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALSAND DEPARTMENT HEADS

This Appe4dix is to be completed only by (a) the Applicant, and (b) any legal entity which has adirect ownership interest in the Applicant exceeding 7.5%. It is not to be completed by any legalentity which has only an indirect ownership interest in the Applicant.

Under ICC Section 2-154-0 15, the Disclosing Party must disclose whether such Disclosing Partyor any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familialrelationship' with any elected city official or department head. A "familial relationship" exists if, as ofthe date thi EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or DomesticPartner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any citydepartment iead as spouse or domestic partner or as any of the following, whether by blood oradoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild,father -in -la!, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson orstepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicjble Party" means (1) all executive officers of the Disclosing Party listed in SectionII.B.1.a., ifhe Disclosing Party is a corporation; all partners of the Disclosing Party, if the DisclosingParty is a gneral partnership; all general partners and limited partners of the DisclosingParty, if theDisclosing Iarty is a limited partnership; all managers, managing members and members of theDisclosing 1arty, if the Disclosing Party is a limited liability company; (2) all principal officers of theDisclosing Iarty; and (3) any person having more than a 7.5% ownership interest in the DisclosingParty. "Principal officers" means the president, chief operating officer, executive director, chieffinancial oficer, treasurer or secretary ofa legal entity or any person exercising similar authority.

Does th Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereofcurrently ha'e a "familial relationship" with an elected city official or department head?

[ JYes [X]No

If yes, plase identify below (1) the name and title of such person, (2) the name of the legal entity towhich such person is connected; (3) the name and title of the elected city official or department head towhom such person has a familial relationship, and (4) the precise nature of such familial relationship.

Ver.2018-1 Page 13 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMIIJIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALSAND DEPARTMENT HEADS

This Appe4dix is to be completed only by (a) the Applicant, and (b) any legal entity which has adirect ownership interest in the Applicant exceeding 7.5%. It is not to be completed by any legalentity which has only an indirect ownership interest in the Applicant.

Under ICC Section 2-154-0 15, the Disclosing Party must disclose whether such Disclosing Partyor any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familialrelationship' with any elected city official or department head. A "familial relationship" exists if, as ofthe date thi EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or DomesticPartner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any citydepartment iead as spouse or domestic partner or as any of the following, whether by blood oradoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild,father -in -la!, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson orstepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicjble Party" means (1) all executive officers of the Disclosing Party listed in SectionII.B.1.a., ifhe Disclosing Party is a corporation; all partners of the Disclosing Party, if the DisclosingParty is a gneral partnership; all general partners and limited partners of the DisclosingParty, if theDisclosing Iarty is a limited partnership; all managers, managing members and members of theDisclosing 1arty, if the Disclosing Party is a limited liability company; (2) all principal officers of theDisclosing Iarty; and (3) any person having more than a 7.5% ownership interest in the DisclosingParty. "Principal officers" means the president, chief operating officer, executive director, chieffinancial oficer, treasurer or secretary ofa legal entity or any person exercising similar authority.

Does th Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereofcurrently ha'e a "familial relationship" with an elected city official or department head?

[ JYes [X]No

If yes, plase identify below (1) the name and title of such person, (2) the name of the legal entity towhich such person is connected; (3) the name and title of the elected city official or department head towhom such person has a familial relationship, and (4) the precise nature of such familial relationship.

Ver.2018-1 Page 13 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX B

BuILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION

This Appenix is to be completed only by (a) the Applicant, and (b) any legal entity which has a directownership interest in the Applicant exceeding 7.5% (an "Owner"). It is not to be completed by anylegal entity which has only an indirect ownership interest in the Applicant.

1. Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building codescofflaw or problem landlord pursuant to MCC Section 2-92-416?

[ JYes {)No

2. If the Applicant is a legal entity publicly traded on any exchange, is any officer or director ofthe Applicant identified as a building code scofflaw or problem landlord pursuant to MCC Section2-92-416?

[1 Yes [1 No [XJ The Applicant is not publicly traded on any exchange.

3. If yes to (1) or (2) above, please identifr below the name of each person or legal entity identifiedas a building code scofflaw or problem landlord and the address of each building or buildings to whichthe pertinent code violations apply.

Ver.201 8-1 Page 14 of 15

CITY OF CHICAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX B

BuILDING CODE SCOFFLAW/PROBLEM LANDLORD CERTIFICATION

This Appenix is to be completed only by (a) the Applicant, and (b) any legal entity which has a directownership interest in the Applicant exceeding 7.5% (an "Owner"). It is not to be completed by anylegal entity which has only an indirect ownership interest in the Applicant.

1. Pursuant to MCC Section 2-154-010, is the Applicant or any Owner identified as a building codescofflaw or problem landlord pursuant to MCC Section 2-92-416?

[ JYes {)No

2. If the Applicant is a legal entity publicly traded on any exchange, is any officer or director ofthe Applicant identified as a building code scofflaw or problem landlord pursuant to MCC Section2-92-416?

[1 Yes [1 No [XJ The Applicant is not publicly traded on any exchange.

3. If yes to (1) or (2) above, please identifr below the name of each person or legal entity identifiedas a building code scofflaw or problem landlord and the address of each building or buildings to whichthe pertinent code violations apply.

Ver.201 8-1 Page 14 of 15

CITY OF CifiCAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX C

PROIEHEITION ON WAGE & SALARY ifiSTORY SCREEMNG - CERTIFICATION

This Appeidefined in:generally c

or (ii) payCity prem:

is to be completed only by an Applicant that is completing this EDS as a "contractor" asC Section 2-92-385. That section, which should be consulted (www.am!egaLcom),rs a party to any agreement pursuant to which they: (1) receive City of Chicago funds infor services, work or goods provided (including for legal or other professional services),City money for a license, grant or concession allowing them to conduct a business on

On behalf o an Applicant that is a contractor pursuant to MCC Section 2-92-385, I hereby certif' thatthe Applicait is in compliance with MCC Section 2-92-385 (b)(1) and (2), which prohibit: (i) screeningjob applicants based on their wage or salary history, or (ii) seeking job applicants' wage or salaryhistory fron current or former employers. I also certifr that the Applicant has adopted a policy thatincludes th9se prohibitions.

[JYes

[jNo

[XJ N/A-I m not an Applicant that is a "contractor" as defined in MCC Section 2-92-385.

This certifiation shall serve as the affidavit required by MCC Section 2-92-385(c)(1).

If you checled "no" to the above, please explain.

Ver.2018-1 Page 15 of 15

CITY OF CifiCAGOECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX C

PROIEHEITION ON WAGE & SALARY ifiSTORY SCREEMNG - CERTIFICATION

This Appeidefined in:generally c

or (ii) payCity prem:

is to be completed only by an Applicant that is completing this EDS as a "contractor" asC Section 2-92-385. That section, which should be consulted (www.am!egaLcom),rs a party to any agreement pursuant to which they: (1) receive City of Chicago funds infor services, work or goods provided (including for legal or other professional services),City money for a license, grant or concession allowing them to conduct a business on

On behalf o an Applicant that is a contractor pursuant to MCC Section 2-92-385, I hereby certif' thatthe Applicait is in compliance with MCC Section 2-92-385 (b)(1) and (2), which prohibit: (i) screeningjob applicants based on their wage or salary history, or (ii) seeking job applicants' wage or salaryhistory fron current or former employers. I also certifr that the Applicant has adopted a policy thatincludes th9se prohibitions.

[JYes

[jNo

[XJ N/A-I m not an Applicant that is a "contractor" as defined in MCC Section 2-92-385.

This certifiation shall serve as the affidavit required by MCC Section 2-92-385(c)(1).

If you checled "no" to the above, please explain.

Ver.2018-1 Page 15 of 15