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Filed in Clerk's Office <br />9AY U 8 4 <br />Bianca Tircf< <br />2U?, <br />iJ <br />City Clerk, Sou fi Cit:nt.f, iN <br />Complete the table below for Real Property Tax Abatement only. <br />Sign at the bottom for all requested incentives(real AND personal property)."** <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 />Please complete the table below with the appropriate information. If <br />Qualify <br />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(75%) 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 Y 22 22 <br />E. Require Health Benefits Y 22 22 <br />F. Require Retirement Benefits N 0 18 <br />G. Maintain Affirmative Action Plan v20 20 <br />Sub-total Construction Related: 23 111 <br />2 Wage&Benefit Related(Owner)_ <br />A. Pay Target Wage Levels 33 <br />B. Provide Health Benefits N 34 <br />C. Provide Retirement Benefits N 29 <br />D- Provide Training N 28 <br />E. Provide Child Care N <br />F. Provide Transportation Assistance N 1 <br />G. Provide Employer Assisted Housing program N <br />Sub-total Wage&Benefit Related: <br />3 Workforce Related: <br />A. Create New Jobs N 42 <br />B. Retain Existing Jobs N 41 <br />C. Maintain Affirmative Action Plan N 35 <br />D. Provide Targeted Hiring Preference N 34 <br />Sub-total Workforce Related: 152 <br />4 Support a Municipal Facility: <br />Support a 58 Municipal Facility(donations to the <br />A. <br />zoo,conservatory,museum,etc.) n 84 <br />Name of Facility <br />I ISub-total Municipal Facility: 34 <br />Sub-total from Above: 23 <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 Municipalunic Cod ec.276 et seq.,for this petition state the above. <br />Submitted By: _ V./GtJ/4/. ' Wes_ Date: _ ..)`j/,n2X