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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 /> Please complete the table below with the appropriate information. If qualify 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 Indeperid'enCor>t-ractors Yes 19 19 <br /> D Require Prevailing Wage(Davis Bacon) Yes 22 22 <br /> E. Require Health Benefits Yes 22 22 <br /> F. Require Pension Benefits No 18 <br /> G Maintain Affirmative Action Plan No G0 <br /> ISub-total Construction Related: 103 141 <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 28 28 <br /> E Provide Child Care No 15 <br /> F Provide Transportation Assistance No 14 <br /> G Provide Employer Assisted Housing program No 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 Yos c1 41 <br /> C Maintain Affirmative Action Plan Yes 35 35 <br /> 0 Prov de Targeted Hiring Preference f4' 34 <br /> Sub-total Workforce Related: ,1E :52 <br /> 4 Support a Municipal Facility: <br /> Support a SB Municipal Facility(donations to the <br /> A Yes 84 <br /> zoo,conservatory,museum,etc.) <br /> 84 <br /> Name of Facility <br /> I ISub-total Municipal Facility: 54 84 <br /> Sub-total from Above. 429 539 <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 sep.,for this petition state the above. <br /> Submitted By: :_c) 17_p____:-_, Date: /Lw7/7/5— <br />