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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(75%) Yes 20 20 <br /> B. Purchase Materials from Local Companies(75%) Yes 20 20 <br /> C. Require Employees vs.Independent Contractors No 0 19 <br /> D. Require Prevailing Wage(Davis Bacon) No 0 22 <br /> F Require Health Benefits No 0 22 <br /> F. Require Pension Benefits No 0 18 <br /> G. Maintain Affirmative Action Plan Yes 20 20 <br /> Sub-total Construction Related: 60 141 <br /> 2 Wage&Benefit Related(Owner): <br /> A. Pay Target Wage Levels Yes 33 33 <br /> B. Provide Health Benefits Yes 34 34 <br /> C. Provide Pension Benefits Yes 29 29 <br /> D. Provide Training Yes 2B 28 <br /> E. Provide Child Care No 0 15 <br /> F. Provide Transportation Assistance No 0 14 <br /> G. Provide Employer Assisted Housing program No 0 9 <br /> Sub-total Wage&Benefit Related: 124 162 <br /> 3 Workforce Related: <br /> A. Create New Jobs Yes 42 42 <br /> B. Retain Existing Jobs Yes 41 41 <br /> C. Maintain Affirmative Action Plan Yes 35 35 <br /> D. Provide Targeted Hiring Preference 34 <br /> Sub-total Workforce Related: 118 152 <br /> 4 Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A. zoo,conservatory,museum,etc.) Yes 64 84 <br /> Name of Facility <br /> 1 $Sub-total Municipal Facility: 84 84 <br /> Sub-total from Above: 386 539 <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: _ . I../ Date: <br />