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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 /> Qualify <br /> Please complete the table below with the appropriate information. If Earned Points Available Points <br /> you qualify for the points,please enter the full amount of available (Yes or No) <br /> points. <br /> 1 Construction Related(Contractors): <br /> - <br /> A. Employ Local Companies(75%) N/A _. <br /> B. Purchase Materials from Local Companies(75%) N/A 37) <br /> C. Require Employees vs.Independent Contractors N/A <br /> D. Require Prevailing Wage(Davis Bacon) ."NIA -_ <br /> E Require Health Benefits NIA <br /> F. Require Pension Benefits N/A IR <br /> G. Maintain Affirmative Action Plan N/A Ti) <br /> Sub-total Construction Related: G 1-it <br /> 2 Wage&Benefit Related(Owner): <br /> A. Pay Target Wage Levels YES 33 <br /> B. Provide Health Benefits "ES 34 <br /> C. Provide Pension Benefits "ES 29 79 <br /> 0. Provide Training YES 28 28 <br /> E. Provide Child Care NO C 55 <br /> F. Provide Transportation Assistance NO C _ <br /> G. Provide Employer Assisted Housing program NO 0 9 <br /> Sub-total Wage&Benefit Related: 124 -,,= <br /> 3 Workforce Related: <br /> A. Create New Jobs !ES 42 d: <br /> B. Retain Existing Jobs ii ES 41 'Ii <br /> C. Maintain Affirmative Action Plan CS 35 35 <br /> D. Provide Targeted Hiring Preference <br /> YES 34 <br /> Sub-total Workforce Related; 152 1�.' <br /> 4 Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A. zoo,conservatory,museum,etc.) IN Q d4 <br /> Name of Facility <br /> 'Sub-total Municipal Facility: SI <br /> Suh•total from Above: 3 ;_' <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.,fcr this petition state the above. <br /> Submitted By: I 1_� ,;,..,__ L�x-c-i Date: '/lt;1C/ ;?C.i;-e <br />