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Community & Economic Development
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1200 County -City Building, 227 West Jefferson, South Bend, Indiana 46601 -1830 Phone 574/235 -9371 Fax 574/235 -9021
To: South Bend Redevelopment Commission
From: Matthew Sikora, Economic Development Planner
Subject: Approval of Bid Specifications and Design Considerations
Former Millennium Environmental, Inc. Land Disposition
Date: June 14, 2011
Attached is the Bid Specifications and Design Considerations sheet for the disposition of
the former Millennium Environmental, Inc. The Bid Specifications clearly outline the uses
and development requirements that will be required for this site. Staff asks for the approval
of the Bid Specifications and Design Considerations for the disposition of this property.
What We Do Today Makes A Difference!
Proposal Documents and Forms
for Land Disposition
City of South Bend
Redevelopment Commission
Former Millennium Environmental, Inc.
604 S. Scott Street
Airport Economic Development Area
City of South Bend
Stephen J. Luecke
Mayor
Jeffrey V. Gibney
Executive Director
Community & Economic Development
Donald E. Inks
Director
Department of Redevelopment
Charles S. Leone
Legal Counsel
Redevelopment Commission
Marcia I. Jones
President
David Varner
Vice - President
Nancy N. King
Secretary
Gregory S. Downes
Member
Donald L. Alford
Member
Stephanie Y. Spivey
Member
Bidding Expires at 10:00 a.m. (ED7) on July 12, 2011
Index of Documents
Proposal Documents
1. Instructions to Applicants 2
2. Offering Sheet 7
3. Legal Description 8
4. Disposition Property Map 9
5. Bid Specifications & Design Considerations 10
6. Legal Notice 11
7. Resolution Regarding Prevailing Wage Rates 12
Proposal Forms
1. Proposal 1
2. Statement of Qualifications and Financial Responsibility 3
3. Statement for Public Disclosure 7
4. Affidavit of Non - Collusion
1
Instructions to Applicants
The South Bend Redevelopment Commission ( "Commission ") invites proposals for the
purchase and development of certain real property described as the former Millennium
Environmental, Inc. located at 604 S. Scott Street, within the Airport Economic
Development Area, South Bend, Indiana.
The Proposal Documents provide Applicants with essential information regarding the
Disposition process and the Project Site. Each Applicant should read this information
thoroughly before submitting a proposal to the Commission. The Proposal Forms are
required as part of any proposal submitted for the purchase of Commission -owned land. All
Forms must be complete. The Commission may reject any proposal submitted with
incomplete or missing information.
Evaluation Criteria
The Commission may use the following criteria to guide its review and acceptance or denial
of a proposal:
➢ The degree to which the Applicant's proposal meets the objectives of the
Development Plan for the Airport Economic Development Area prepared by the
Department of Redevelopment and approved by the Commission, the Area Plan
Commission, and the Common Council.
➢ The size and character of the improvements proposed to be made by the Applicant
on the real property; the Applicant's plans and ability to improve the real estate with
reasonable promptness; whether the real property, when improved, will be sold or
rented; the Applicant's proposed sale or rental prices; and any factors which will
assure the Commission that the sale or lease, if made, will further the execution of
the Airport Economic Development Plan and will best serve the interest of the
community, from the standpoint of both human and economic welfare.
➢ The financial responsibility, qualifications, experience and ability of the Applicant to
finance and complete the development.
➢ The proposal which will provide the Commission with the best possible
development, based upon the price offered for the property and consistent with the
preceding objectives.
➢ Any conflict among these criteria will be reconciled to the best interest of the
Development Area and the City of South Bend, as determined by the Commission.
2
Disposition Process
Bidding
All bids for the purchase and redevelopment of certain property in the Airport Economic
Development Area must be delivered to the Department of Redevelopment ( "Department "),
located at:
1200 County -City Building
227 West Jefferson Boulevard
South Bend, Indiana 46601
on or before 10:00 a.m. (EDT) on the 12th day of July 2011. All proposals will be opened
and made public at a public meeting of the South Bend Redevelopment Commission, held
at 4:00 p.m. (EDT) on the 12th day of July 2011 at 1308 County -City Building, 227 West
Jefferson Boulevard, South Bend, Indiana 46601.
Proposals with completed forms and without any missing information will be reviewed by
the Commission according to the Evaluation Criteria as stated above. The Commission
reserves the right to reject any bid and may make awards to the highest and best bidder.
Notice of acceptance or rejection will be mailed to each of the bidders via US Mail to the
address stated on the Proposal Forms.
All offers will be subject to the requirements of the Contract for Sale of Land as referenced
on Page 7.
After the Bidding Period
Once the bidding period has expired, proposals may be made to the Commission for the
remaining property available, if any.
All Applicants should familiarize themselves with the Proposal Forms and any proposal
submitted after the bidding period has expired shall be completed utilizing the Proposal
Forms. Proposals after the termination of the bidding period are to be submitted to the
Department for review and consideration. The Commission will review proposals based
upon the Evaluation Criteria as stated above. The Commission reserves the right to reject
any proposal. Notice of acceptance or rejection will be mailed to each of the Applicants via
US Mail to the address as stated on the Proposal Forms.
Proposals
All proposals must be complete and include the information and documentation requested
in the Proposal Forms. Proposals that are submitted with incomplete or missing
information will not be accepted. Applicant must use the Proposal Forms as provided by
the Department.
3
Proposal Forms
The Proposal Forms must be complete before the Commission will review the
proposal. The first and second pages of the Proposal Forms describe the
Applicant's offer for the real property. Applicants shall fill in all applicable spaces
and sign accordingly.
Each Applicant shall submit the following as part of the Applicant's proposed offer:
➢ Narrative Description
(Proposal Forms, page 1)
A Narrative Description of the Applicant's proposed development project for
the real property must be submitted as part of the proposal. The Narrative
Description should note the exact nature, character and use of the proposed
improvements. Maps, plans and drawings shall be included to clearly
indicate the location, size, materials, style of structures, parking lots, and
other improvements. All proposed improvements and uses must conform to
the Bid Specifications and Design Considerations and the Airport Economic
Development Area Development Plan. The maps, plans and drawings as
submitted will be examined by the Commission to determine whether, in the
Commission's sole opinion, the Applicant's proposal conforms to the Bid
Specifications and the Airport Economic Development Plan. The
Commission may reject any offer which does not conform to said
Specifications, Guidelines and /or Plan.
➢ Proposed Site Plan
(Proposal Forms, page 1)
All Applicants must submit a site plan for the real property on which the
Applicant has made an offer. This site plan should be included as Exhibit "A"
of the proposal. If the Applicant's proposal is accepted, the Applicant will be
required to formalize the site plan with Commission Staff as part of the final
documentation.
➢ Faithful Performance Guaranty
(Proposal Forms, page 2)
All proposals must be submitted with a Faithful Performance Guaranty in an
amount not less than 10% of the total purchase price offered for the property.
The Faithful Performance Guaranty will secure the execution of the Contract
and the development of the proposed improvements. The Faithful
Performance Guaranty may be in the form of a certified or cashier's check or
other security as approved by the Department. No offer will be considered
unless it is accompanied by the required guaranty. All checks should be
made payable to the City of South Bend, Department of Community &
Economic Development.
4
➢ Statement of Qualifications and Financial Responsibility
(Proposal Forms, pages 3 -6)
The Commission shall have the right to make such investigations as it deems
necessary to determine the ability of the Applicant to perform the obligations
of the proposed offer. The Commission reserves the right to reject any
proposed offer where the evidence or information does not satisfy the
Commission that the Applicant is qualified to properly carry out the
obligations of the proposed offer, or where the Applicant refuses to cooperate
or assist the Commission in making such investigation.
➢ Statement for Public Disclosure
(Proposal Forms, pages 7 -8)
The Commission shall have the right to make such investigations as it deems
necessary to determine the completeness of the Applicant's disclosure. The
Commission reserves the right to reject any proposed offer where the
available evidence or information does not satisfy the Commission that the
Applicant has made a full disclosure, or where the Applicant refuses to
cooperate and assist the Commission in making such investigation, or the
Commission otherwise determines said Statement to be unsatisfactory.
➢ Affidavit of Non - Collusion
(Proposal Forms, page 9)
The form of Affidavit of Non - Collusion is included in the Proposal Forms, and
the Applicant must use the form provided. The Affidavit is to the effect that
the Applicant has not colluded, conspired, connived, or agreed with any other
Applicant or person, firm or corporation in regard to any offer submitted to the
Commission. The failure of any Applicant to submit the Affidavit of
Non - Collusion shall be cause for rejection of the offer.
Except as otherwise herein noted, the Faithful Performance Guaranty of all
unsuccessful Applicants will be returned as soon as practicable after notice
of rejection.
The Faithful Performance Guaranty will be refunded to the successful
Applicant at such time that the Commission deems that Applicant has
completed all improvements to the real property, as proposed, and the
Commission has issued a Certificate of Completion evidencing same.
➢ Corrections
Erasures or other changes to the Proposal Forms must be explained or
noted over the signature of the Applicant.
➢ Withdrawal of Proposals
Proposals submitted prior to the scheduled public opening of the bids may be
withdrawn upon written request of the Applicant if such request is received by
the Department not less than twenty-four (24) hours prior to said public
opening. Unopened bids will be returned promptly.
5
Commission's Rights
The Commission reserves the right to accept or reject any or all proposals and to waive any
formalities in bidding which are not mandatory requirements.
Execution of Contract
Upon award of the bid by the Commission, the successful Applicant shall enter into a
Contract for Sale of Land with the Commission for the purchase and development of said
property within 30 days of notice of acceptance. The Contract for Sale of Land will provide
for the conveyance of the property therein purchased by quit -claim deed, together with title
insurance policy showing good and merchantable title, upon payment of the full purchase
price.
Additional Information
For further information as to the disposition program of the South Bend Redevelopment
Commission, interested parties should contact the following staff member:
Matthew Sikora
Economic Development Planner
Division of Economic Development
1200 County -City Building
227 West Jefferson Boulevard
South Bend, Indiana 46601
(574) 235 -5834 (Office Phone)
(574) 235 -9021 (Office Fax)
msikora - southbendin.gov
[-1
Offering Sheet
Property
Size
Minimum Offering
Price
proposed Re -Use
Former Millennium
Site
Any use that is
Environmental, Inc.
2.6 Acres
$42,500
permitted within the
"GI" General
604 S. Scott Street
Industrial District
zoning designation.
018- 3043 -1655
Preference will be
given to those uses
that are related to
information
technology and
capitalize on the
transcontinental fiber
optic network that is
adjacent to the site.
Plat of Survey and Legal Description
BOUNDARY LEGAL DESCRIPTION
FORMER MILLENNIUM ENVIRONMENTAL, INC.
604 S. Scott Street
LEGAL DESCRIPTION
PARCEL I: Lot Numbered One (1) swept the South 20 feet thereof, and Lots Numbered Two (2), Three (3)
and Four (4) in Ford's Subdivision of the South part of Barre Out Lot Numbered ftty (60) In the First Plat of Out
Lots of the Town, now City of South Send, platted by the State Bank of Indiana,
PARCEL It: A part of Bank Out Lot Numbered Sbdy (60) In the City of South Sand as platted by the State Bank
of Indiana, and more particularly described as follows: Beginning on the West Me of Prairie Avenue es wdsted
on December 31, 19M and the North IN of Lot Numbered 3 as shmm on the recorded Plat of Ford's
Subdivision of a part of Bank out Lot Numbered W as recorded on August 20,1873 In Plat Sook 3, page 31, in
the Me of the Recorder of SL Joseph Comity, lndisela; thence Westerly along the North line of Lots
NumborW 3 and 4 in Ford's Subdivision a distenbe of 142 feet b the East tune of Scott Skeet thence North and
along the least line of Scott Shod 22Tleel thence Northeastetty at right angles to the twat #no of t; w# Street
288 feet, more or low, to the West be of Prakle Avenue as wasted on December 31,1980; thence boutherly
and along saki West line 254 feet, incme ar Ides to the place of beptrmhV-
.r �-
PARCEL Ill: That part of Bank out Lot Numbered.8txly (ea) ae platted and recorded by the State Bank of
indiarre, WcgWd in the Cl y of South Bend, whj* iiiij North of the North One of a pwrA of land- coweyed try The
Lake Shen S SwAhem Rftu)r �piwto die Sbmdw d 011 Company by dead dated Auk 14th,
1893, rowded In Book A peso 348 of the the Recorder of tat. Joseph County, and which lies South
of a fins begiruring at a point in the Easterly One of Street In the said City of South Bend 18.8 feat, more or
teas, Southerly tithe center of the trade of The Mw York Central Rakosd Company lyfna South of the four
main trades ofsaid railroad company, me astsod along the East Wo of said Scott Street, sold point being distant
3 feet Southerly, measured along geld street the at sidewalk levol,.from the Southerly edge of the
8outhessterly pylon of the Wkbo of The New York Central Railroad Company over Scott Street, said point also
being 1 W.22 het more or leas, NoM of they InterseaSon of the test One of Scott Street with the North line of
land conveyed to The Standard CM Carnpany by dead dated August 14th, 1893, as aforesaid, measured along
the East One of said Scrota Atreet; gIonae§aut wt rly along a eirelght One forming are angle of 7941'
mearured from South to East WM skid East Is of Scott Street, a distance of 311.7 yeast to a pobrtwhlch Is 14.6
feet southerly of said track of-The New'ltork Central RAIlroad Company measured at right angles to said
straight ilne, sak! being also .1 tbet North* of ths'Nord weetedy comer of the top of retalning wall
"Ielft W�frorn the $atwmg* pylon clone bridge of The New York Centroi Rafiroe d Company aww
prabie Street, said One passes ltaroush o point marked by s drN hole placed in Ere face of the nshi dng wall
situated an to East side of mid Soot! Street at point 3 feat above sbwMk level; thane Southerly along a
sit fight tine forming an angle of 84W to last descabed might line, measured from West to South, a distance
of 4.6 feet to a point distant 275 feet by reotrpuler meiorruareterrt Southeastertyirom the face of the roWtft
wag altrressid, thence sestertyatonp s strafghtlins per" tomid robdningweA a dislance of 31.8 feet, more
or less, to a paint In the Westerly One of Prairie Avenue and forming an argue of 88°30' with the said Weete dy
line of Pm kb Avenue measured ft m. West to $cuts said Point In the Westertyr One of Pn*I& Avwm being
18,9 feet, more or less. Somrthmsierlyot the tx,*s kw of said track of The NewYork Central Railroad
Company measured along the Bald Westerly Ike of Plaid* Avow*, said point afso being 112.8 feed more or
less, Northeasterly of the intersection of said Westerly line of Prairie Avenue with the Northerly litre of sold
parcel of land conveyed to the Standard ON Company by dead dated August 14th, 1893, as aforesaid.
1111.51
i
Disposition Property Map
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6
Bid Specifications & Design Considerations
Sale of Redevelopment Owned Property
Former Millennium Environmental, Inc.
604 S. Scott Street
Airport Economic Development Area
1. All of the provisions of I.C. 36- 7 -14 -22 will apply to the bidding process.
2. All offers must meet the minimum price listed on the Offering Sheet (page 8).
3. Any use that is permitted within the "GI" General Industrial District zoning
designation. All proposals must conform to the existing zoning provisions set
forth for the "GI" General Industrial District as outlined in the South Bend Zoning
Ordinance Title 21 of the City of South Bend Municipal Code.
Preference will be given to those uses that are related to information technology
and capitalize on the transcontinental fiber optic network that is adjacent to the
site.
4. Proposals for the reuse of the property must include a basic reuse plan for the
site and a project timeline detailing aspects of the site redevelopment and site
improvements. During the review process, emphasis will be placed on
compatibility with the goals and objectives of the Development Plan for the
Airport Economic Development Area.
5. All other provisions of the Airport Economic Development Area Development
Plan must be met.
10
Notice of Intended Disposition of Property
AIRPORT ECONOMIC DEVELOPMENT AREA
Former Millennium Environmental, Inc.
604 S. Scott Street
South Bend, Indiana
Notice is hereby given that the Redevelopment Commission of the City of South Bend, Indiana, will receive sealed offers for the
purchase of certain property situated in the South Bend Central Development Area until 10:00 a.m. (EDT) on the 12th day of July
2011 in the Office of the Department of Redevelopment, 1200 County -City Building, 227 West Jefferson Boulevard, South Bend,
Indiana, 46601. All offers will be publicly opened and read aloud at 4:00 p.m. (EDT) on the 12th day of July 2011 at the Regular
Meeting of the Redevelopment Commission to be held that date and time in Room 1308 County-City Building, 227 West Jefferson
Boulevard, South Bend, IN 46601. Bid proposals for the purchase of the property offered will be considered.
The property being offered is located at 604 S. Scott Street, in the Airport Economic Development Area, South Bend, Indiana. Any
proposal submitted must be for the entire parcel being offered. The required re -use for the parcel is any use that is permitted within
the "GI" General Industrial District zoning designation. Preference will be given to those uses that are related to information
technology and capitalize on the transcontinental fiber optic network that is adjacent to the site. Strong emphasis will be placed
during the review process on compatibility with the goals and objectives of the Airport Economic Development planning area.
A packet containing bid forms, the offering sheet and other pertinent information may be picked up at the Department of
Community and Economic Development, 1200 County-City Building, 227 West Jefferson Boulevard, South Bend, IN 46601. A bid
packet may also be accessed online at http: / /www.southbendin.gov /business /city bids /redevelopment commission bids.aso
The Commission reserves the right to reject any and all bids, and to make the award to the highest and best bidder. In determining
the best bid, the Commission will take into consideration the following:
1. The size and character of the improvements proposed to be made by each bidder on the property
2. Each bidder's ability to improve the property with reasonable promptness
3. Each bidder's proposed purchase price
4. Any factors which will assure the Commission that the sale, if made, will furtherthe carrying out of the Development Plan
for the Airport Economic Development Area and will best serve the interest of the community from the standpoint of
human and economic welfare
5. The ability of each bidder to finance the proposed improvements to the property with reasonable promptness
The Commission further reserves the right to waive any formalities in bidding which are not mandatory requirements.
A bid submitted by a trust (as defined in IC 30- 4- 1 -1(a)) must identify each:
(A) beneficiary of the trust; and
(B) settlor empowered to revoke or modify the trust.
To secure the execution of the disposition agreement, the purchase of the property and the redevelopment thereof in accordance
with the agreement, the bidder must submit with the proposal a faithful performance guaranty, in the sum of ten percent (10 %) of
the amount offered for the purchase of the property. The guaranty sum may be in the form of a certified check, a cashier's check,
or surety bond, letter of credit from a bank or trust company as approved by the Redevelopment Commission, or by other sufficient
security, but the form, substance and terms of the performance guaranty must be approved as satisfactory by the Redevelopment
Commission. The performance guaranty, if by certified check, shall be deposited in any account of the Department of
Redevelopment, City of South Bend, in a bank or trust company selected by the Redevelopment Commission.
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF REDEVELOPMENT
Donald E. Inks, Director
Publish Dates: June 24 and July 1, 2011
11
Resolution Regarding Prevailing Wage Rates
*MtJTICM 40, GU
W-SOXTION REGMtXG PREVAILM, JdW stATt$
We", the $ftm Sew ,ftdt"lopment CAMOSSISO VCbmiSS100) his
estabi fsw rod t arm within 0* Cite of South saw and has
w"Immkon 44MV1,04S with U thwe *rwmt'a"d
*(USA' #4 '"e"' part *If tftt #Ctivit► Ift►Tv" the 1,116 Of land
for wfvAtQ d"Olopm"t, ww
WHOW, the Commislien "gim" that such Sale Of land and private
development Should have the maxi om positive JwV4c* Possible On th4 rosi-
*MC3 of Ow $":A 1w"S Community-0 and
WHEIMAS. thew C~11519" has determined that the Sftth $*#W communtty
will benefit from having local contractors coffsuw.
ting the private V"4-
eCt3 and being paid in accwdsoct wish %h# prevailing wage rlkt#s of St.-O
Jose" Coup ty.
NOW. n"FOU. K IT 4MVIED. that the C*MjjSjoA ancmr#9" all
VWrCS&%#rS Of land ac4mired, tltarvd 4114 Sold bjP the Coomission in rw-
#"W1o`"St 'are" to *** Iftal C*ntr*Ct*" and local *AMpOWqf J,Md pay
prevailing we" rues.
A"VtSd At the Uplar Meating if the South Bead Redevelcpa"t Comts.
slom* held On the Ord day of April* IMZ# in aip Off jCq Of tb# *ed&v#loo_
went Comissfoo. Xom 12M. Covaty-Cfty Sullefro]. w *1.
South ler4, Indiana 4ml. i Jeff&.$= loulaward.
Ar-,ES7,-
A(
A. P*tsr-DWjTFS-0ft. Ot
#A'
te
UV OF SWTjj SM. tXIDIAKA
KPANTHM or REXM"CNT
12
Proposal Forms
To: South Bend Redevelopment Commission
1200 County-City Building
227 West Jefferson Boulevard
South Bend, Indiana 46601
Commissioners:
The Undersigned having familiarized itself with the present conditions of the Project Site as
hereinafter designated and legally described and with the Proposal Documents and Forms; and certifying
its desire to participate in the development of the said property pursuant to Federal, State and Local
ordinances and regulations, and the Development Plan as approved by the Redevelopment Commission;
hereby offers and proposes to purchase or lease all or part of the Disposition Parcel identified in Exhibit
"A" made part of this proposal.
The Applicant's offer is described as follows:
Project Area
Disposition Parcel Number Total Acres
Offer is for: ❑ Entire Parcel
❑ Part of Parcel
Form of Contract: ❑ Purchase
❑ Lease
Term
Dollars $
Purchase Price
Dollars $
Annual Lease Payment
A Narrative Description of the proposed development on the Disposition Parcel identified in
Exhibit "A ", describing the exact nature and character of the improvements proposed and their use;
together with maps and plans sufficiently complete to indicate the general improvements to be made is
attached and is to be considered a part of this proposal. (Maps and plans must be of sufficient scale to
indicate clearly the location of the structures and other proposed improvements and should provide
information on building elevations and materials.)
The Proposal Forms as provided by the Department of Community & Economic Development/Division of
Economic Development (Department) have been completed and are considered a part of this proposal. The
Proposal Forms include: (1) a Statement of the Qualifications and Financial Responsibility; (2) a Statement
for Public Disclosure, and; (3) a sworn Affidavit of Non - Collusion. It is the understanding of the
Applicant that the Statement of the Qualifications and Financial Responsibility is confidential and to be
used solely by the South Bend Redevelopment Commission and the Department.
A Faithful Performance Guaranty in the sum of
Dollars ($ ), an amount equal to at least 10% of the total amount offered for
the real property described in Exhibit "A ", it being understood by the Applicant that the Faithful
Performance Guaranty shall guarantee the Applicant's execution of and performance of the purchase or
lease agreement. The Faithful Performance Guaranty will be refunded to the successful Applicant at such
time the Commission deems that the improvements to the land, as proposed, have been completed and the
Commission as evidenced by a Certificate of Completion issued by the Commission. The Faithful
Performance Guaranty will be refunded in the event this offer is rejected.
Acceptance or rejection of Applicant's proposal shall be made by depositing such notification in
the US Mail addressed to the undersigned (Applicant) at the address set forth below.
In submitting this offer to purchase or lease, it is understood that the right to reject such offer is
reserved by the Commission. The undersigned further agrees to execute a contract for the purchase or
lease of land for development in the form prepared by the Department within thirty (30) days after
notification of acceptance of this offer and to develop and use the above identified parcel(s) of land in
conformity with the Federal, State and Local ordinances and regulations; applicable Development Plan; the
Bid Specifications & Design Considerations; and the Narrative Description and maps and plans as
submitted herein, with amendments, if any, as approved by the Commission.
Dated
Respectfully submitted,
ATTEST- (BY SECRETARY OF A Corporation) Address:
Signature
Name (type)
Title
Address:
Name of Individual or Corporation
Signature
Name (type)
Title
Statement of Qualifications and Financial Responsibility
Applicant:
Address:
1. Is the Applicant a subsidiary of or affiliated with any other corporation or corporations or
any other firm or firms?
❑ Yes
❑ No
If yes, list each corporation or firm by name and address, specify its relationship to the Applicant,
and identify the officers and directors or trustees common to the Applicant and such other
corporation or firm:
2. The financial condition of the Applicant, as of , , is as
reflected in the attached financial statement.
Name and address of auditor or public accountant who performed the audit on which said financial
statement is based:
(NOTE: Attach to this statement a certified financial statement showing the assets and the liabilities, fully itemized in
accordance with accepted accounting standards and based on a proper audit. !f the date of the certified financial
statement precedes the date of this submission by more than six months, also attach an interim balance sheet not more
than 60 days old.)
3. If funds for development of the land are to be obtained from sources other than the
Applicant's own funds, a statement of the Applicant's plan for financing the acquisition
and development of the land:
4. Sources and amount of cash available to Applicant to meet equity requirements of the
proposed undertaking:
a. In banks:
Name and Address of Bank Amount
b. By loans from affiliated or associated corporations or firms:
Name and Address of Bank Amount
C. By sale of readily salable assets:
Description Market Value Mortgages or Liens
5. Names and addresses of bank references:
6. Has the Applicant or (if any), the parent corporation, or any subsidiary or affiliated
corporation of the Applicant or said parent corporation, or any of the Applicant's officers
or principal members, shareholders or investors, or other interested parties (as listed in
items 5, 6, and 7 of the Statement for Public Disclosure and referred to herein as
principals of the Applicant) been adjudged bankrupt, either voluntary or involuntary,
within the past 10 years?
0 Yes
❑ No
If yes, give date, place and under what name:
7. Has the Applicant or anyone referred to above as principals of the Applicant been indicted
for or convicted of any felony within the past 10 years?
0 Yes
❑ No
If yes, give for each case (1) date, (2) charge, (3) place, (4) Court, (5) action taken. Attach any
explanation deemed necessary.
8. Undertakings, comparable to the proposed development, which have been completed by
the Applicant or any of the principals of the Applicant, including a brief description of
each project and date of completion:
4
9. If the Applicant, or any principals of the Applicant, has ever been an employee, in a
supervisory capacity, for a construction contractor or builder on undertakings comparable
to the proposed development, the name of such employee, name and address of employer,
title, and brief description of work:
10. If the Applicant or a parent corporation, a subsidiary, an affiliate, or a principal of the
Applicant is to participate in the development of the land as a construction contractor or
builder:
a. Name and address of such contractor or builder:
b. Has such contractor or builder within the last 10 years ever failed to qualify as a
responsible bidder, refused to enter into a contract after an award has been made, or
failed to complete a construction or development contract?
❑ Yes
❑ No
If yes, explain:
Total amount of construction or development work performed by such contractor or
builder during the last three years: $
General description of such work:
d. Construction contracts or developments now being performed by such contractor or
builder:
Identification of Date to be
Contract or Development Location Amount Completed
11. Brief statement regarding equipment, experience, financial capacity, and other resources
available to such contractor or builder for the performance of the work involved in the
development of the land, specifying particularly the qualifications of the personnel, the
nature of the equipment and the general experience of the contractor:
5
12. Does any member of the South Bend Redevelopment Commission or any officer or
employee of the City of South Bend Department of Redevelopment have any direct or
indirect personal interest in the Applicant or the development of the land as proposed?
❑ Yes
❑ No
If yes, explain:
13. Does any member of the governing body of the City of South Bend or any public official
or employee of the City of South Bend have any direct or indirect personal interest in the
applicant or the development of the land as proposed?
If yes, explain:
14. Statements and other evidence of the Applicant's qualifications and financial
responsibilities (other than the financial statement referred to above) are attached hereto
and hereby made a part hereof as follows:
Certification
I (We), Certify that this Statement of Qualifications
and Financial Responsibility and the attached evidence of the Applicant's qualifications and financial
responsibility, including financial statements, are true and correct to the best of my (our) knowledge and
belief.
Name
Signature
Title
Date
Name
Signature
Title
Date
(If the Applicant is an individual, this statement should be signed by such individual; if a partnership, by one of the partners; if a
corporation or other entity, by one of its chief ofcers having knowledge of the facts required by this statement.)
Statement for Public Disclosure
Applicant:
Address:
Taxpayer ID #:
1. Applicant proposes to enter into contract for the purchase or lease of land from the South
Bend Redevelopment Commission. Said land is more accurately described in Exhibit
«A„
2. Organizational Status of Applicant:
❑ An individual
❑ A corporation
❑ A not - for - profit corporation or charitable institution
❑ A partnership known as:
❑ A business association or a joint venture known as:
■
A Federal, State or Local government or instrument thereof
Other (explain):
3. Organized and operating under the laws of
4. Date of Organization:
5. Names, addresses, and title of principal officers, investors, members or shareholders of
Applicant, as follows: (attach additional sheets if necessary)
a. CORPORATION: the officers, directors or trustees, and each stockholder
owning more than 10% of any class stock
b. NOT - FOR - PROFIT: the members who constitute the board of trustees or board
of directors or similar governing body
C. PARTNERSHIP: each partner, whether a general or limited partner, and the
nature and percent of interest
d. BUSINESS ASSOCIATION OR JOINT VENTURE: each participant and the
nature and percent of interest
7
e. OTHER ENTITY: the officers, the members of the governing body, and each
person having an interest of more than 10%
Name & Address
Title and nature and percent of interest
6. Names, addresses, and the nature and percent of interest of each person or entity (not
named in Item 5) who has a beneficial interest in any of the shareholders or investors
named in Item 5 which gives such person or entity more than a computed 10% interest in
the Applicant (for example, more than 20% of the stock in a corporation which holds 50%
of the stock of the Applicant; or more than 50% of the stock in a corporation which holds
20% of the stock of the Applicant).
Name & Address
Title and nature and percent of interest
7. Names of officers and directors, or trustees of any corporation or firm listed under Item 5
or Item 6 above.
Name & Address
Certification
Title and nature and percent of interest
I (We), Certify that this Statement for Public
Disclosure is true and correct to the best of my (our) knowledge and belief.
Name
Signature
Title
Date
Name
Signature
Title
Date
(/f the Applicant is an individual, this statement should be signed by such individual; if a partnership, it should be signed by one
of the partners; if a corporation or other entity, it should be signed by one of its chief officers having knowledge of the facts
required by this statement.)
L
Affidavit of Non - Collusion
State of Indiana
MIA
County of St. Joseph
The undersigned, being first fully sworn, deposes and says that:
He /she is:[] owner, ❑ partner, ❑ officer, ❑ representative,
❑ agent, of
(applicant);
2. He /she is fully informed respecting the preparation and contents of the attached offer and
of all pertinent circumstances respecting such offer;
Such offer is genuine and not a collusive or sham offer;
4. Neither said Applicant nor any of its officers, partners, owner's agents, representatives,
employees, or parties in interest, including this affiant, has in any way colluded,
conspired, connived, or agreed directly or indirectly, with any other Applicant, firm or
person to submit a collusive or sham offer in connection with the Contract for which the
attached offer has been submitted or to refrain from making an offer in connection with
such Contract, or has in any manner, directly or indirectly, sought by agreement or
collusion or communication or conference with any other Applicant, firm or person to fix
the price or prices in the attached offer, or of any other Applicant, or to fix any overhead,
profit, or cost element of the offering price of any other Applicant, or to secure through
any collusion, conspiracy, connivance or unlawful agreement any advantage against the
City of South Bend and/or its Department of Redevelopment and/or the South Bend
Redevelopment Commission person interested in the proposed Contact; and
The price or prices quoted in the attached offer are fair and proper and are not tainted by
any collusion, conspiracy, connivance, or unlawful agreement on the part of the Applicant
or any of its agents, representatives, owners, employees or parties in interest, including
this affiant.
Before me, the undersigned, a Notary Public,
Non - Collusion on this
(Seal)
A resident of
day of
County,
0
Afant
Signature
Title
subscribed and swore to this Affidavit of
Notary Public