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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 end the <br /> con'panics which will provide materials purchased for this project. <br /> Pleas i complete the table below with the appropriate information. If Quality gamed Points Available Points <br /> you qualify for the points,please enter the full amount of available lyes or No) <br /> points. <br /> Construction Related jContractorsl: <br /> A. Employ Local Companies(75%) Yes 20 20 <br /> 8. Purchase Materials from Local Companies(75%) Yes 20 20 <br /> C. Require Employees vs.Independent Contractors Yes 19 19 <br /> D. Require Prevailing Wage(Davis Bacon) Yes 22 22 <br /> E. Require Health Benefits Yes 22 22 <br /> F. Require Pension Benefits Yes 18 18 <br /> G. Maintain Affirmative Action Plan No 20 <br /> ISub-total Construction Related: 121 141 <br /> 2 Want&Benefit Related iOwnerl: <br /> A. Pay Target Wage Levels Yes 33 33 <br /> B. Provide Health Benefits Yes 34 34 <br /> C. Provide Pension Benefits Yes 29 29 <br /> D. Provide Training Yes 28 28 <br /> E. Provide Child Care No 15 <br /> F. Provide Transportation Assistance No 14 <br /> G. Dray:de Employer assisted Housing program No 9 <br /> ISub-total Wage&Benefit Related: 124 162 <br /> A Workforce Related: <br /> A. Create New Jobs Yes 42 42 <br /> B. Retain Existing Jobs Yes 41 41 <br /> C. Maintain Affirmative Action Plan No 35 <br /> D. Provide Targeted Hiring Preference Yes 34 34 <br /> Su b-total Workforsa Related: 117 152 <br /> 4 Support a Municipal Facility: <br /> A Support a SB Munlc!pal Facility(donations to the l <br /> coo,conservatory,museum,etc.) Yes 34 1 84 <br /> Name of Facility South Bend Zoo <br /> _ 1 1S0-total Municipal Facility: 54 34 <br /> Sub-total from Above: 445 539 <br /> The urderslgned owner(s)of real property,located within the City o'South Bend,herby petition the Common Council of the City <br /> of South Bend for areal and/or personal roperty x abatement consideration and pursuant to I.C.,6-1.1-12.1-1,ejp.,and <br /> South Bend Mu cipal de Sec. -gt sea.,for this petition state the above. <br /> Submitted By: / Date. ti/ <br />