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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 /> (Yes or No) <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(1S'A] Y 20 20 <br /> B. (Purchase Materials from Local Companies(75%) Y 20 20 <br /> C. Require Employees vs.Independent Contractors Y 19 19 <br /> D. Require Prevailing Wage N 0 22 <br /> E. Require health Benefits N 0 22 <br /> F. Require Retirement Benefits N 0 18 <br /> G. Maintain Affirmative Action Plan N C 20 <br /> }Sub-total Construction Related: 59 141 <br /> 2 Wage&Benefit Related(Owned` <br /> A. Pay Target Wage Levels Y 33 33 <br /> B. Provide Health Benefits N 0 34 <br /> C. !Provide Retirement Benefits N 0 29 <br /> D. Provide Training Y 28 28 <br /> E. Provide Child Care N 0 15 <br /> F. Provide Transportation Assistance N 0 14 <br /> G. Provide Er-ployer Assisted Housing program N 0 9 <br /> I Sub-total Wage&Benefit Related: 61 162 <br /> 3 Workforce Related: <br /> A. Create New Jobs Y 42 42 <br /> B. Retain Existing Jobs N 0 41 <br /> C. Maintain Affirmative Action Plan Y 35 35 <br /> 1 <br /> D. Provide Targeted hiring Preference <br /> }Sub-total Workforce Related: Y 34 34 <br /> 111 152 <br /> 4 Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A. y >.y <br /> zoo,conservatory,museum,etc.) ! N' k7 84 <br /> Name of Facility <br /> 1 !Sub-total Municipal Facility: Q / <br /> '/ 84 <br /> Sue-total from Above: ?3'r 3/,5 539 <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: \,�--,\ s1..)`-5' Date: oCz 1 o 1 202-1 <br />