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Complete below for Real or Personal Property Tax Abatement only. <br /> Please sign for all requested incentives. <br /> I 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 Qualify(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(Contractors): <br /> A. Employ Local Companies(75%) yes 20 20 <br /> 1 B. IPurchase Materials from Local Companies(75%) I yes 1 20 1 20 <br /> IC. )Require Employees vs.Independent Contractors 1 yes 1 19 1 19 1 <br /> I D. IRequire Prevailing Wage(Davis Bacon) 1 no 1 0 1 22 <br /> E. IRequire Health Benefits 1 yes I 22 1 22 <br /> F. IRequire Pension Benefits 1 no 1 0 ( 18 1 <br /> G. IMaintain Affirmative Action Plan 1 yes 1 20 ( 20 1 <br /> I I I I <br /> I I ISub-total Construction Related: 1 ( 101 1 141 1 <br /> I I I I <br /> 2 Wage&Benefit Related tOwner): <br /> A. Pay Target Wage Levels no 33 <br /> 1 B. (Provide Health Benefits 1 no I I 34 1 <br /> 1 C. (Provide Pension Benefits I no 1 1 29 1 <br /> 1 0. (Provide Training 1 no I 1 28 1 <br /> E. (Provide Child Care 1 no 1 1 15 1 <br /> 1 F. 1Provide Transportation Assistance 1 no 1 I 14 1 <br /> 1 G. (Provide Employer Assisted Housing program 1 no 1 1 9 1 <br /> 1 I I <br /> Sub-total Wage&Benefit Related: 1 I 0 1 162 1 <br /> 3 I Workforce Related: I I I I <br /> A. (Create New Jobs I yes 1 42 I 42 1 <br /> 1 B. 1Retain Existing Jobs I n/a 1 I 41 1 <br /> C. Maintain Affirmative Action Plan yes 35 35 <br /> 0. Provide Targeted Hiring Preference 34 <br /> ISub-total Workforce Related: 1 1 77 I 152 1 <br /> 4 I Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A. zoo,conservatory,museum,etc.) I Yes 1 84 84 <br /> Name of Facility MLK Statue+Potawatomi Zoo <br /> Sub-total Municipal Facility: e4 84 <br /> I I I <br /> Sub-total from Above: 1 1 262 1 539 1 <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 sea.,and <br /> South Bend Municipal Code Sec.2-76 et sea.•for this petition state the above. <br /> Submitted By: � ��� Date: 5/11/2022 <br />