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i <br /> i <br /> 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. Qualify <br /> Please complete the table below with the appropriate information. If (Yes or No) Earned Points Available Points <br /> you qualify for the points,please enter the full amount of available <br /> points. <br /> 1 Construction Related(Contractorsl: <br /> A. Employ Local Companies(755') Y 20 20 <br /> B. I Purchase Materials from Local Companies(75%) Y 20 20 <br /> C. Require Employees vs.Independent Contractors Y 19 19 <br /> D. Require Prevailing Wage(Davis Bacon) Y 22 22 <br /> E. Require Health Benefits Y 22 22 <br /> F. Require Pension Benefits Y 18 18 <br /> G. Maintain Affirmative Action Plan Y 20 20 <br /> Sub-total Construction Related: 141 1,1 . <br /> 2 Wage&Benefit Related(Owner): <br /> A. Pay Target Wage Levels n 0 33 <br /> B. Provide Health Benefits n 0 34 <br /> C. Provide Pension Benefits n 0 29 <br /> D. Provide Training n 0 28 <br /> E. Provide Child Care n 0 IS <br /> F. Provide Transportation Assistance n 0 14 <br /> G. Provide Employer Assisted Housing program n 0 9 <br /> Sub-total Wage&Benefit Related: 0 162 <br /> 3 Workforce Related: <br /> F C. Create New Jobs Y 42 »2 <br /> Retain Existing Jobs Y 41 41 <br /> Maintain Affirmative Action Plan y 35 35 <br /> Y a4 <br /> D. Provide Targeted Hiring Preference 34 <br /> Sub-total Workforce Related: 152 152 <br /> 4 Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A' zoo,conservatory,museum,etc.) n 0 g; <br /> Name of Facility <br /> Sub-total Municipal Facility: - 8. <br /> Sub-total from Above: 2 539 <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 South 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 seq.•for this petition state the above. <br /> Submitted By: I Anne Hayes I Date: 1 03/2812018 <br />