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Complete below for Real or Personal Property Tax Abatement only. <br />Please sign for all requested incentives. <br />Public Benefit Item: <br />Information is required on both the construction companies and the <br />companies which will provide materials purchased for this project. <br />Please complete the table below with the appropriate information. if <br />you qualify for the points, please enter the full amount of available <br />points. <br />Qualify (Yes or No) <br />Earned Points <br />Available Points <br />1 <br />Construction Related (Contractors): <br />A. <br />Employ Local Companies (75 %) <br />Yes <br />20 <br />20 <br />B. <br />Purchase Materials from Local Companies (75 %) <br />Yes <br />20 <br />20 <br />C. <br />Require Employees vs. Independent Contractors <br />Yes <br />19 <br />19 <br />D. <br />Require Prevailing Wage (Davis Bacon) <br />No <br />22 <br />E. <br />Require Health Benefits <br />Yes <br />22 <br />22 <br />F. <br />Require Pension Benefits <br />No <br />18 <br />G. <br />Maintain Affirmative Action Plan <br />Yes <br />20 <br />20 <br />Sub -total Construction Related: <br />101 <br />141 <br />2 <br />Wage & Benefit Related (Owners: <br />A. <br />Pay Target Wage Levels <br />Yes <br />33 <br />33 <br />B. <br />Provide Health Benefits <br />Yes <br />34 <br />34 <br />C. <br />Provide Pension Benefits <br />No <br />29 <br />D. <br />Provide Training <br />Yes <br />28 <br />28 <br />E. <br />Provide Child Care <br />No <br />Is <br />F. <br />Provide Transportation Assistance <br />Yes <br />14 <br />14 <br />G. <br />Provide Employer Assisted Housing program <br />No <br />9 <br />Sub -total Wage & Benefit Related: <br />109 <br />162 <br />3 <br />Workforce Related: <br />A. <br />Create New lobs <br />Yes <br />42 <br />42 <br />B. <br />Retain Existing Jobs <br />N/A <br />41 <br />C. <br />Maintain Affirmative Action Plan <br />Yes <br />35 <br />35 <br />D. <br />Provide Targeted Hiring Preference <br />Yes <br />34 <br />34 <br />Sub -total Workforce Related: <br />111 <br />152 <br />4 <br />Support a Municipal Facility: <br />A <br />Support a SB Municipal Facility (donations to the <br />zoo, conservatory, museum, etc.) <br />YES <br />84 <br />84 <br />Name of Facility <br />sub -total Municipal Facility: <br />ern <br />84 <br />5ub -total from Above: <br />405 <br />539 <br />The undersigned owner(s) of real property, located within the City of South Bend, herby petition the Common Council of the City <br />Of 50Uth bend for a real and /or personal property tax abatement consideration and pursuant to I.C., 6- 1.1- 12.1 -1, et seq., and <br />South Bend Municipal Code Sec. 2 -76 et se g. for this petition state the above. <br />I Submitted Bv: I /l /�_' - -E—' I Date: I -z- (j l <br />