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C04S <br /> Complete below for Real or Personal Property Tax Abatement only. <br /> • Please sign for all requested incentives. <br /> Pu (it 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 (Yes or es or NN o) 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%) 20 <br /> B. Purchase Materials from Local Companies(75%) Y 20 20 <br /> - C. Require Employees vs.Independent Contractors y 19 19 <br /> a- Require Prevailing Wage(Davis Bacon) 22 <br /> E. Require Health Benefits 22 <br /> F. ' Require Pension Benefits . is <br /> : .G. Maintain Affirmative ACtIOn Plan- ' y 20 20 <br /> I1Sub-total Construction Related: 59 141 <br /> • Wage&Benefit Related(Owned: <br /> • . A. Pay Target Wage Levels y 33 33 <br /> •B. Provide Health Benefits y 34 34 <br /> Provide Pension Benefits y 29 29 <br /> D. Provide Training - . ; y 28 28 <br /> E. • Provide Child Care --.. - - 15 <br /> F. Provide Transportation Assistance 14 <br /> .G. Provide Employer_Assisted Housing program 9 <br /> I - Sub-total Wage&Benefit Related; 124 162 <br /> 3 Workforce Related: <br /> A. Create New Jobs .- y 42 42 <br /> B. Retain Existing Jobs 41 <br /> C. Maintain Affirmative Action Plan Y 35 35 <br /> D. Provide Targeted Hiring Preference 34 <br /> Sub-total Workforce Related: 77 _ 152 <br /> b Support.a my/1.00l-Ei! fEly, <br /> Support a 513 Municipal Facility(donations to the <br /> A. zoo,conservatory,museum,etc.) .- . 84 <br /> Name ofFarlrrty - <br /> ISub-total Municipal Facility: 84 <br /> Sub-total from Above: 260 539 <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: �A lam date: ._ 9/18/15 <br />