No. Amendment No. Vendor Name: THE CHICAGO …Contract No. 1430-13421Amendment No. 4 Vendor Name:...

Contract No. 1430-13421 Amendment No. 4Vendor Name: THE CHICAGO CONSULTANTS STUDIO, INC.

AMENDMENT NO. 4

This Amendment modifies Contract No. 1430-13421,for Urban Land Use Planning & Consulting Servicesby and between the County of Cook, illinois, herein referred to as "County" and The Chicago ConsultantsStudio, Inc., authorized to do business in the State of illinois hereinafter referred to as "Contractor":

RECITALS

Whereas, the County and Contractor have entered into a Contract approved by the County Board on March

12, 2014, (hereinafler referred to as the "Contract" ), wherein the Contractor is to provide Urban Land UsePlanning & Consuging Services (hereinafter referred to as the "Services") from March 12, 2014 through May11,2015 with one, three month renewal option, in an amount not to exceed $2,408,000.00; and

Whereas, Amendment¹ 1 was executed on May 13, 2015 for 3 months renewal beginning on May 12,

2015 through August 11,2015; and

Whereas, Amendment ¹ 2 was executed on September 15, 2015 for 81 days extension beginning onAugust 12, 2015 through October 31, 2015, in the amount of $148,671.00;and

Whereas, Amendment ¹ 3 was executed on December 1, 2015 for 7 months extension beginning onNovember 1, 2015 through May 31,2016, in the amount of $730,000.00; and

Whereas, the term of the Contract expired on May 31, 2016, and the agreed upon Services are still

required; and

Whereas, an extension is desired for the continuation of Services; and

Whereas, the County and Contractor desire to e/rend the Contract for 6 months beginning on June 1,2016; and,

Now therefore, in consideration of mutual covenants contained herein, it is agreed by and between theparties to amend the Contract as follows:

1. The Contract is extended through November 30, 2016.

2. The attached Economic Disclosures Statement are incorporated and made a part of this Contract.

3. All other terms and conditions remain as stated in the Contract.

In witness whereof, the County and Contractor have caused this Amendment No. 4 to be executed on thedate and year last wr'riten below.

Rev 1/t/15

Contract No. 1430-13421 Amendment No,eVendor Name: THE CHICAGO CONSULTANTS STUDIO, INC.

County of Cook, illinois

Chief Procurement Officer

The Chicago Consultants Studio, Inc

Lf;,~Signed

State's Attamey

Qiwhrt ~,got u3,tkA

Type or print name

p+5tb~ iTitle

i6 JanC ZOIt42

Rev 1/1/15

Contract No. 1430-13421 Amendment No, 4Vendor Name: THE CHICAGO CONSULTANTS STUDIO, INC.

ATTACHMENT

Rev t/t//5

CONTRACT NO. 1430-13421 Amendment No. 4

COOK COUNTYECONOMIC DISCLOSURE STATEMENT

AND EXECUTION DOCUMENTINDEX

Section Description Pages

Instructions for Completion of EDS EDS i - ii

CerNications

Economic and Other Disclosures, Affidavi of ChildSupport Obligations, Disclosure of Ownership Interest

and Familial Relationship Disclosure Form

Cook County Affidavit for Wage Theft Ordinance

Contract and EDS Execution Page

Cook County Signature Page

EDS 1-2

EDS 3 —12

EDS 13-14

EDS 15-17

EDS 18

CONTRACT NO. 1430-13421 Amendment No. 4SECTION 1

INSTRUCTIONS FOR COIIIIPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT

This Economic Disclosure Statement and Execution Document ("EDS") is to bs completed and executedby every Bidder on s County contract, every Proposer responding to a Request for Proposals, end everyRespondent responding to a Request for Quafiflcstions, and others as required by the Chief Procurement(Ãicer. The execution of the EDS shsfi serve asthe execution of a contract awarded bythe County. TheChief Procuremsnt Officer reserves the right to mquest that the Bidder or Proposer, or Respondentprovide an updated EDS on an annual basis.

Definitions. Terms used in this EDS and not othsrwiss defined herein shall have the meanings given tosuch terms In ths Instructions to Bidders, General Conditions, Request for Proposals, Request forQualifications, as appficsble.

Affiliate means s person that directly or indimctly through one or more intermediaries, Controls isControlled by, or is under common Control with the Person specified.

Applicant means a person who executes this EDS.

Bidder means any person who submits a Bid.

Code means the Code of Ordinances, Cook County, lfiinois available on municode.corn.

Contract shall include any written document to make Procurements by or on behalf ofCook County.

Contractor or Contracting Party means a person that enters into a Contract with theCounty,

Control means the unfettered authority to directly or indirectly manage governance,administration, work, and all other aspects of a business.

EDS means this complete Economic Disclosure Statement and Execution Document,including all sections listed in the Index and any attachments.

Joint Venture means an association of two or mors Persons proposing to perform a for-profit business enterprise. Joint Ventures must have an agresmsnt In wrifing specifyingthe terms and conditions of the relationship between the partners and their relationshipand respective responsibility for the Contract

Lobby or lobbying means to, for compensation, attempt to influence a County official orCounty employee with respect to any County matter.

Lobbyist means any person who lobbies.

Person or Persons means any individual, corporation, partnership, Joint Venture, trust,association, Limited Liability Company, sokr proprietorship or other legal entity.

Prohibited Acts means sny of the actions or occurrences which form the basis fordlsquallficafion under the Code, or under the Csrtlflcations hereinafter set forth.

Proposal means a response to an RFP.

Proposer means a person submitting a Proposal.

Response means response to an RFQ.

Respondent means a person responding to an RFQ.

RFP means a Request for Proposals issued pursuant to this Procurement Cods.

RFQ means a Request for Qualifications issued to obtain the qualifications of interested parties.

EDS-I 8/2015


INSTRUCTIONS FOR COMPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT

Section 1:Instructions, Section 1 sets forth the instructions for completing and executing this EDS.Section 2: CertiScatlons. Section 2 sets forth csrtiTications that are required for contracting parties underthe Code and other applicable laws. Execution of this EDS constitutes a warranty that all the statementsand certifications contained, and all the facts stated, in the Certifications are true, correct and complete asof the date of execution.

Section 3: Economic and Other Disclosures Statement. Section 3 is the County's required Economicand Other Disclosures Statement form. Execution of this EDS constitutes a warranty that all theInformation provided in the EDS is true, correct and complete as of the date of execution, and binds theApplicant to the warrantlss, representations, sgrssmsnts and acknowledgements contained therein.

Required Updates. The Applicant is required to keep all informafion provided in this EDS current andaccurate. In the event of any change in the Information provided, including but not limited to any changewhich would render Inaccurate or incomplete sny certification or statement made in this EDS, theApplicant shall supplement this EDS up to the time the County takes action, by filing an amended EDS orsuch other documentation as is required.

Additional Information. The County's Governmental Ethics and Campaign Financing Ordinancesimpose certain dufies and obligations on persons or entities seeking County contracts, work, business, ortransactions, and the Applicant Is expected to comply fully with these ordinances. For further informationplease contact the Director of Ethics at (312) 603<304 (69 W. Washington St. Suite 3040, Chicago, IL60602) or visit the wsb-site at cookcountyll.gov/ethics-board-of.

Authorized Signers of Contract and EDS Execution Page. If the Applicant is a corporation, thePresident and Secretary must execute the EDS. In the event that this EDS is executed by someone otherthan the President, attach hereto a certified copy of that section of the Corporate By-Laws or otherauthorization by the Corporation, satisfactory to the County that permits ths person to execute EDS forsaki corporation. If the corporation is not registered in ths State of illinois, a copy of the Certificate ofGood Standing from the state of incorporation must be submitted with this Signature Page.If the Applicant is a partnership or joint venture, all partners or joint venturers must execute the EDS,unless one partner or joint ventum has been authorized to sign for the partnership or joint ventute, inwhich case, the partnership agreement, resolution or evidence of such authority satisfactory to the Officeof the Chief Procurement Officer must be submitted with this Signature Page.

If the Applicant is a member-managed LLC all members must execute the EDS, unless otherwiseprovided in the operating agrsemsnt, resolution or other corporate documents. If the Applicant is amanager-managed LLC, the manager(s) must execute the EDS. Ths Applicant must attach either acertiTied copy of the operating agreement, resolugon or other authorization, satisfactory to the County,demonstrating such person has the authority to execute the EDS on behalf of the LLC. If the LLC is notregistered in the State of illinois, a copy of a current Certificate of Good Standing from the state ofincorporation must be submitted with this Signature Page.

If the Applicant is e Sole Proprietorship, the sole proprietor must execute the EDS.

A "Partnership" "Joint Venture" or Sole Proprietorship" operating under an Assumed Name must beregistered with the illinois county in which it is located, as provided in 605 ILCS 405 (2012), anddocumentation evidencing registration must be submitted with the EDS.

EDS-ii N2015

SECTION 2

CERTIFICATIONS


THE FOLLOWING CERTIFICATIONS ARE MADE PURSUANT TO STATE LAW AND THE CODE THE APPLICANT IS CAUTIONEDTO CAREFULLY READ THESE CERTIFICATIONS PRIOR TO SIGNING THE SIGNATURE PAGE. SIGNING THE SIGNATUREPAGE SHALL CONSTITUTE A WARRANlY BY THE APPLICANT THAT ALL THE STATEMENTS, CERTIFICATIONS ANDINFORMATION SET FORTH WITHIN THESE CERTIFICATIONS ARE TRUE, COMPLETE AND CORRECT AS OF THE DATE THESIGNATURE PAGE IS SIGNED. THE APPLICANT IS NOTIFIED THAT IF THE COUNTY LEARNS THAT ANY OF THEFOLLOWING CERTIFICATIONS WERE FALSELY MADE, THAT ANY CONTRACT ENTERED INTO WITH THE APPUCANT SHALLBE SUBJECT TO TERMINATION.

A. PERSONS AND ENTITIE8 SUBJECT TO DISQUALIFICATION

No person or business entity shab be awarded a contract or sub-contract, ibr a period of five (5) years from the date ofconviction or sntiy of a plea or admission of guilt, civil or criminal, if that pemon or business enfity:

1) Has been convicted of an act committed, within the State of Ulinois, of briibery or attempting to bribe an ofticer oremployee of a unit of state, federal or local government or school district in the State of lfilnols in that office's oremployee's official capacity;

2) Has been convicted by federal, state or local government of an act of bid-rigging or attempting to rig bids as definedin the Sherman Anti-Trust Act and Clayton Act. Act. 15 U.S.C. Sschon 1 et seqq

Has been convicted of bidwigging or attempting to rig bids under the laws of federal, state or local government;

Has been convicted of an act committed, within the State, of price-fixing or attempting to fix prices as defined by theSherman Anfi-Trust Act snd the Clayton Act. 15 U.S.C, Section 1, st ssqq

Has been convicted of price-fixing or attempting to fix prices under the laws the State;

Has been convicted of defrauding or attempting to defraud any unit of state or local government or school districtwithin the Sate of illinois;

5)

6)

7) Has made an admission of guilt of such conduct as sst forth in subsections (1) through (6) above which admission isa matter of record, whether or not such person or business entity was subject to prosecution for the offens oroffenses admitted to; or

B. BID4BGGING OR BID ROTATING

THE APPLICANT HEREBY CERTIFIES THAT: In accordance with T20 ILCS fir33 E-II, neither the Applicant nor snyAlfflialsd Entity is based from award of ibis Contract as a result of s conviMon for the violation of State laws prohibiting bid-rlggmg or ixif iotstiiig.

8) Has entered a plea of no/o contendere to charge of bribery, prics-fixlng, bid-rigging, or fraud, es set forth in sub.paragraphs (1)through (6) above.

In the case of bribery or attempting to bribe, a business sntily may not be awarded a contract if an official, agent or employeeof such business snfity committed the Prohibited Act on behalf of the business entity and pursuant to the direction orauthorization of an officer, director or other responsible official of the business entity, and such Prohibited Act occurred withinthree years prior to the award of the contract. In addition, a business entity shall be disqualNed If an owner, partner orshareholder controlling, directly or Indirectly, 20%%u or mors of ths business entity, or an oflicer of the business entity haspsriormed any Prohibited Act within five years prior to the award of the Contract.

THEAPPLICANT HEREBY CERTIFIES THAT: The Applicant has read the pmvisions of Secbon A, Persons and EnfitiesSubject to Disqualification, that the Applicant has not committed any Prohibited Act set forth in Section A, and that award ofths Contract to the Applicant would not violate ths provisions of such Section or of the Code.

C. DRUG FREE WORKPLACE ACT

THE APPLICANT HEREBY CERTIFIES THAT The Applicant will provide s drug free workplace, as required by (30 ILCS 580/3).

EDS-1 8/2015

CONTRACT NO. 1430-13421 Amendment No. 4DELINQUENCY IN PAYMENT OF TAXES

THE APPLICANT HEREBY CERTIFIES THAT: The Appeal is noi an owner or s party responsible for the payment of any tsxor fee adminislersd by Cook County, by a local municipality, or by the illinois Department of Revenue, which such fsx or fes isdelinquent, such as bsr sward of s contract or subcontract pursuant to the Code, Chapter 34, Sscifon 34-171.

HUMAN RIGHTS ORDINANCE

No person who is a party to a contract with Cook County ("County" ) shall engage in unlawful discrimination or sexual harassmentagainst any individual in the terms or conditions of employment, credit, public accommodations, housing, or provision of Countyfacilities, services or programs (Code Chapter 42, Section 42-30 el seq.).

ILLINOIS HUMAN RIGHTS ACT

THE APPLICANT HEREBY CERTIHES THAT: Itis in compliance with the illinois Human Rights Act (775 ILCS 572-105), andagrees to abide by the mquirsmsnts cf the Act as part offfs contractual obligations.

INSPECTOR GENERAL (COOK COUNTY CODE, CHAPTER 34, SECTION 34-174 snd Secdon 34-250)

The Applicant has not wlllfuffy failed to cooperate in an investigation by the Cook County Independent Inspector General or toreport to the Independent Inspector General any snd ell information concerning conduct which they know to Involve corruption, orother criminal activity, by another county employee or offfcial, which concerns his or her oifice of employment or County relatedtransaction.

The Applicant has reported directly and without any undue delay any suspected or known fraudulent activity in the County'sProcurement process to the Offfcs of the Cook County inspector General.

CAMPAIGN CONTRIBUTIONB (COOK COUNTY CODE, CHAPTER 2, SECTION 2.585)

THE APPLICANT CERTIFIES THAT: It hss read and shall comply with the Cook County's Ordinance concerning campaigncontributions, which is codified at Chapter 2, Division 2, Subdivision 0, Section 585, and can be read in ils entirety atwww.municode.corn.

GIFT BAN, (COOK COUNTY CODE, CHAPTER 2, SECTION 2474)

THE APPLICANT CERTIFIES THAT: It has reed and shall comply with the Cook County's Ordinance concerning receiving sndsoliciting glffs and favom, which is codiffed at Chapter 2, Division 2, Subdivision II, Section 574, and can be read In its entirety atwww.municode.corn.

LMNG WAGE ORDINANCE PREFERENCE (COOK COUNTY CODE, CHAPTER 34, SECTION 34-180;

Unless expressly waived by ths Cook County Board of Commissioners, the Code requires that a living wage must be paid toindndduals employed by a Contractor which has a County Contract snd by all subcontractors of such Contractor under a CountyContract, throughout the duration of such County Contract. The amount of such living wage is annually by ths Chief FinancialOtffcsr of the County. and shall be posted on ths Chief Prmxtrement Officer's website.

The term "Contract" as used in Section 4, I, of this EDS, specilicslly excludes contracts with ths foffowing;

1) Not-For Pmfft Organizations (deffned as a corporation having tax exempt status under Section 501(C)(3)of the UnitedStets Internal Revenue Code and recognized under ths illinois State not-for -profit lew);

2) Community Development Block Grants;

3) Cook County Works Department;

4) Sherlff's Work Alternative Program; snd

5) Department of Correction inmates.

8/2015

CONTRACT NO. 1430-13421 Amendment No, 4

SECTION 3

REQUIRED DISCLOSURES

1, DISCLOSURE OF LOBBYIST CONTACTS

List all pemons that have made lobbying contacts on your behalf with respect to this contract;

Name

—F4A—Address

2. LOCAL BUSINESS PREFERENCE STATEMENT (CODE, CHAPTER 34, SECTION 34-230)

Local business means a Person, including a foreign corporation authorized to transact business in illinois, having a bona fideestablishment located within the County at which it is transacting business on the date when a Bid is submitted to the County, andwhich employs the majority of ils regular, full-bme work force within the County. A Joint Venture shall consbriuts a Local Business if oneor more Persons that qualify as a "Local Business" hold interests totaling over 50 penmnt in ths Joint Venture, even if the Joint Venturedoes not, st the time of the Bid submittal, have such a bona fide establishment within the County.

a) ls Applicant a "Local Business" as defined abovey

Yes: No:

b) If yss, list business addresses within Cook County:

jl Souci List s'q. Kc rii.8'))I.I

CAt' .(LLtsvwvi Cry 4 srq

c) Does Applicant employ the majority of its regular ftN-time workforce within Cook County7

3. THE CHILD SUPPORT ENFORCEMENT ORDINANCE (CODE, CHAPTER 34, SECTION 34.172)

Every Applicant for a County Privilege shall bs in full compliance with any child support outer before such Applicant is entitled to receive orrenew a County Privilege. When delinquent child support exists, the County shall not issue or renew any County Privilege, snd mayrevoke any County Privilege.

All Applicants are required to review the Cook County Affidavit of Child Support Obligations aNached to this EDS (EBS') andcomplete ths Affldavit, based on the instructions in the AffldavS.

EDS-3 5/2015

CONTRACT NO. 1430-13421 Amendment No. 44. REAL ESTATE OWNERSHIP DISCLOSURES.

The Applicant must indicate by checking the appropriate provision below and providing afi required information that either:

a) The fofiowing is a complete list of ail reel estate owned by the Appficant in Cook County:

PERMANENT INDEX NUMBER(S): Adrs WK

(ATTACH SHEET IF NECESSARY TO LIST ADDITIONAL INDEXNUMBERS)

OR:

b) ~The Applicant owns no real estate In Cook County.

5, EXCEPTIONS TO CERTIFICATIONS OR DISCLOSURES.

If the Applicant is unable to certify to any of the CerfiTications or any other statements contained in this EDS and not explained elsewhere in

this EDS, fite Applicant must explain below:

If the letters, "NA", the word "None" or "No Response" appears above, or if the space is lait blank, it will be conclusively presumed that theApplicant certifie to afi Cerfificafions end other statements contained in this EDS.

EDS-4 8/201 5

CONTRACT NO. 1430-13421 Amendmsnt No. 4

COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATEMENT

The Cook County Code of Ordinances ([)2-810 si ssq.) requires that any Appficant for any County Action must disclose Informationconcerning ownership Interests in the Appficant. This Disclosure of Ownership Interest Statement must be completed with afiinformation cunent as of the date this Statement is signed. Furthermore, this Statement must be kept current, by filing an amendedStatement, until such time as the County Board or County Agency shall take action on the application. The information contained inthis Statement will be maintained in a database and made available for public viewing.

If you ars asked to list names, but there ars no applicable names to list, you must state NONE. An incomplete Statement wfil bereturned and sny action regarding this contract will be delayed. A failure to fully comply with the ordinance may result in the actiontaken by ths County Board or Couniy Agency being voided.

"App//cant" means any Entity or person making an application to the County for any County Action.

"County Act/on means any schon by a County Agency, a County Department, or the County Board regarding an ordinance orordinance amendment, a County Board approval, or other County agency approval, with respect to contracts, leases, or sale orpurchase of mel estate.

"Person" "Enfi/y" or "Legs/ Entity" means a sole proprietorship, corporation, partnership, association, business trust, estate, two ormore persons having s ]oint or oommon Interest, trustee of s land trust, other commercial or legal entity or sny beneficiary orbeneficiaries thereof.

This Disclosure of Ownership Interest Statement must be submitted by:

1. An Applicant for County Action and

2. A Person that holds stock or a beneficial Interest in the Applicant Stfi[ is fistsd on the Applicant's Statement (a "Holder" ) must file aStatement and complete fitt only under Ownership Interest Declaration.

Please print or type responses clearly snd legibly. Add additional pages if needed, being careful to Identify each porfion of the form towhich each addiTional page refers.

This Statement Is being made bythe [ +]Applicant or [ ] Stock/Beneficial Interest Hokler

ZlpCode: (sQ6 o 5

Email: CCfi S Ccat<slo4I c.rgem

This Statement ls an: [ ] Original Statement or [ ~]Amended Statement

Identifying Information:

Name 1tkE CtkvtAsvr coMSu i/tvhrs"iri 5"tnawvo rocD/B/A: C C S FEIN NOc

street Address: [gi S . ~MLtJk sr;.City: (-Uvl ~sPhone Noc %11- 5'tv%.'LSS+

Cook County Business Registrsfion Number:(Sole Proprietor, Joint Vsntum Partnership)

Corporate File Number (if appficsble):

Form of Legal Entity:

[ ] Sole Proprietor [ ] Partnership Corporation [ ] Trustee of Land Trust

[ ] Business Trust [ ] Estate [ ] Association [ ] Joint Venture

[ ] Other (describe)

EDS-8 8/2015

CONTRACT NO. 1430-13421 Amendment No. 4Ownership Interest Declaration:

1. List the name(s), address, and percent ownership of each Person having a legal or beneficial interest (including ownership) ofmore than five percent (5%) in the Applicant/Holder.

Name Address Percentage Interest in

Applicant/Holder

1 [ 8 ~ CMficrrrfrv lt 646sg

too�'[.

If the interest of any Person listed in (1)above is held as an agent or agents, or s nominee or nominees, list the name andaddress of the principal on whose behalf ths interest is held.

Name of Agent/Nominee

—fdPv-Name of Principal Principal's Address

Is the Applicant constructively controfied by another person or Legal Entity? [ ] Yes [ 2f' No

If yes, state the name, address and percentage of beneficial interest of such person, snd the relationship under which suchcontrol ls being or may be exercised.

Name Address Percentage ofBeneficia Interest

Relationship

Corporate Officers, Membem and Partners Information:

For all rxtrpomtions, list the names, addresses, and terms for all corporate officers. For afi limited liability companies, list the names,addresses for all members. For all partnerships and joint ventures, list the names, addresses, for each partner or joint venture.

Name Address Title (specify title of Term of OfflceOffice, or whether manageror partner/joint venture)

QtttgxbrL w 6oLxx')k/v )9 S Udafbr4hx CMtbva 6c6ch ffh(Lfi."a(bfiro<

Declaration (check the applicable box):

[g I stale under oath that the Applicant has withheld no disdosure as to ownemhip interest In the Applicant nor reservedany information, data or plan as to ths intended use or purpose for which the Applicant seeks County Board or other County

Agency action.

[fJ I slate under oath that the Holder has withheld no disclosure esto ownership interest nor reserved any information required tobe disclosed.

EDS-T 8/2015

CONTRACT NO, 1430-13421 Amendment No. 4

COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATEMENT SIGNATURE PAGE

4b48LAri. T. tnaiuattcp PILLSI bau.Nome of Authorized Applicant/Holder Reprsssntadve (please print or type) Title

(~C r-Signaturs Date

SI>.SS+ ~ lSQWCcns e ccSvuoro rr4C ~ CwmE-mail address Phone Number

SARSARA J LANDOWSNIHnTARY PUBLIC

+STATE OF WISCONStH

Subsoribed to and sworn before ms My commission expires:

x W kll~fh. 4 @~Ltd'lN x r rrS ~ r i~pectg ws

EDS-8 8/2015


COOK COUNTY BOARD OF ETHICS69 W. WASHINGTON STREET, SUITE 3040

CHICAGO, ILLINOIS 60602312/603-4304 Office 312/603-9988 Fax

FAMILIAL RELATIONSHIP DISCLOSURE PROVISION

N«notisni Disclosure Reuuirement:

Doing a significant amount of business with the County requires that you disolose to the Board of Ethics the existence of auy fmnilial

relationships with any County employee or any person holcling elective office in the State of Illinois, the County, or in any

municipality within the County. The Ethics Ordinance defines a significant amount of business for the purpose of this disclosure

require<nant as more than $25,000 ii'I aggl'egate County leases, conuucts, purchases or sales in any calendar year.

If you are unsure of ivhether the business you do with the County or a County agency will cross this threshold, err on the side ofcaution by completing the attached familial disclosure fomi because, among other potential penalties, any person found guilty offailing to make a required disclosure or knowingly filing a false, misleading, or incomplete disclosure will be prohibiced froin doing

any business with the County for a period of three years. The required disclosure should be filed with the Board of Ethics by January

I of each calendar year in which you are doing business with the County and again with each bid/proposal/quotation to do business

with Coolc County. The Board ofEthics may assess a late filing fee of 8100 per day alter an initial 30-day grace period.

The person that is doing business with the County must disclose his or her familial relationships. If the person on the County lease orcontract or purchasing fiom or selling to the County is.a business entity, then the business entity must disclose the fiunilial

relationships of the individuals who are an<i, during the year prior to doing business with the County, were:

its board of directors,v its officers,« its employees or independent contractors responsible for the general administration of tlie entity,

its agents authorized to execute documents on behalf of the entity, and

~ its employees who directly engage or engaged in doing work with the County on behalf of the entity.

Do not hesitate to contact the Board of Ethics at (312) 603-4304 fiir assis(ance in determining the scope of any required familial

relationship disclosure.

Additional Defiuitions:

"Farci/iai re/ai/onsgip" means a person who is a spouse, domestic partner or civil union partner of a County employee or State,

County or municipal official, or any person who is related to such an employee or official, whether by blood, marriage or adoption, as'i:

L Parent0 Child0 BrotherC SisterLl Aunt

0 Uncle0 Niece0 Nephew

GrandparentGrandchild

0 Father-in-law

0 Mother-in-law0 Son-in-Iaw0 Daughter-in-law

0 Brother-in-iaiv0 Sister-in-law

0 StepfatherU Stepmother0 Stepson0 StepdaughterU Stepbrother0 Stepsister0 Half-brother

0 Half-siraer

EDS-0 8/2015

CONTRACT NO. 1430-13421 Amendment No. 4COOK COUNTY BOARD OF ETHICS

FAMILIAL RELATIONSHIP DISCLOSURE FORM

A. PERSON DOING OR SEEKING TO DO BUSINESS WITH THE COUNTY

Name of person Doing Business with the County: Is'-Iktdhitrt- 1 . SaltxL k4 I ChttILsct'm ois<~ STtkhro kite/

Address of Person Doing Business withthe County: W 5 ~ khtksdsg Vi Cth t iuicda 1 t- 6 r~ta3

Phone number of Person Doing Business with the County: 'L'l1. ' S+ '55 3Email address ofperson Doing Business with the County; ccI ip cc g TtsBI e 1 w r ~ co&

If Person Doing Business with the County is a Business Entity, provide the name, title snd contact information for theindividual completing this disclosure on behalf of the Person Doing Business with the County:

t-Iindhbtt T, MLtshlcat (yllLgt~T sit %% ICSW cthe ccsTvttbtawc.iersnt

DESCRIPTION OF BUSINESS WITH THE COUNTYAppend additional pages as needed and for each County lease, contract purchase or sale sought andtor obtainedduring the calendar year of this disclosure (or the proceeding calendar year ifdisclosure is made on January I),identify:

The lease number, contract number, purchase order number, request for proposal number snd/or request for qualificationnumber associated with the business you are doing or seeking to do with the County: ie-hcr —

thawer I

The aggregate dollar value of the business you are doing or seeking to do with the County: I

The name, title and contact information for the County offiicial(s) or employee(s) involved in negotiating the business you aredoing or seeking to do with the County:

The name, title and contact information for the County oflicial(s) or employee(s) involved in managing the business you aredoing or seeking to do with the County:

C. DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE. COUNTY ORMUNICIPAL ELECTED Oli'O'ICIALS

Check the box that applies and provide related information where needed

0 The Person Doing Business with the County is an individual and there is ae familial relationship between this individualand any Cook County employee or any person holding elective office in the State of IUinois, Cook County, or anymunicipality within Cook County.

The Person Doing Business with the County ls a business entity and there is no famlUal relationship between any memberof this business entity's board of directors, officers, persons responsible for general administration of the business entity,agents authorized to execute documents on behalf of the business entity or employees directly engaged in connuchtal workwith the County on behalf of the business entity, and any Cook County employee or any person holding elective ofiice in theState of Illinois, Cook County, or any municipality within Cook County.

EDS-10 8/2015

CONTRACT NO. 1430-13421 Amendment No. 4COOK COUNTY BOARD OF ETHICS

FAMILIAL RELATIONSHIP DISCLOSURE FORM

tj The Person Doing Business with the County is an individual and there is a famffial relationship between this individualsnd at least one Cook County employee and/or a person or persons holding elective office in the State of Illinois, CookCounty, and/or sny municipality within Cook County, The familial relationships are as foUows:

Name of Individual DoingBusiness widt the County

Name of Related County Title and Position of Related Nature of FamilialEmployee or State, County or County Employee cr State, County RelationshipMunicipal Elected Official or Municipal Elected Offlciat

Ifmors space is needed, attach on additional skeet followtng the above format,

The Person Doing Business with the County is a business entity and there is a famfflal relationship between at least onemember of this business entity's board ofdirectors, officers, persons responsible for general administration of the businessentity, agents authorized to execute documents on behalf of the business entity and/or employees directly engaged incontractual work with the County on behalf of the business entity, on the one hand, and at least one Cook County employeeand/or a person holding elective office in the State of Illinois, Cook County, and/or any municipality within Cook County, onthe other. The familial relationships are as follows:

Name of Member ofBoardof Director for BusinessEntity Domg Business with

the County

Name of Related County Title and Position of RelatedEmployee or State, County or County Employee or State, CountyMunicipal Elected Otffcist or Municipal Elected Oflicial

Nature ofFamilialRelationship

Nmne of0Entity Dointhe County

Nature of Familial

ty Relationship

EDS-11 8/2015

Name of Pmson Responsiblefor the OenerslAdministration of theBusiness Entity DoingBusiness with tbe County

CONTRACT NO. 1430-13421 Ametsdrnent No. 4Name ofRelated County Title snd Position ofRelated Nature ofFamilialEmployee or State, County or County Employee or State, County RelationshipMunicipal Elected Oflicial or Municipal Elected OtEcisl

Name of Agent Ato Execute DocumBusiness Enuty DBusiness with th

tie and Position of Related Nature of Familialounty Employee or State, County RelationshipMunicipal Elected 0$icisl

Name ofEmployee ofBusiness Entity DirectlyEngaged in Doing Businesswith the County

Name of Related County Title and Position of REmployee or State, County or County Employee or SMunicipal Elected Otgcial or Municipal Elected 0

ifmore space is needed, attach an additional sheet following the above format

VERIFICATION: To the best of my knowledge, the information I have provided on this disclosure form is accurate and complete. Ia)knowledge that an inaccurate or incomplete disclosure is punishable by law, including but not limited to tines and debarment.

I' I. &) FSignature ofRecipient Date

SUBMIT COMPLETED FORM TO: Cook County Board ofEthics69 West Washington Street, Suite 3040, Chicago, Iginois 60602OIEce (312) 6034304- Fax (312) 603-9988CookCounty.Ethics@cookcountyihgov

Spouse, domestic partner, civil union partner or parent, child, stbling, aunt, uncle, niece, nephew, grandparent or grandchildby blood, marriage (i.s, in laws and step relations) or adoption.

EOS-12 8/2015


COOK COI/NTY AFFIDAVIT FOR WAGE THAT ORDINANCE

Effective May 1, 2016, every Person, Inorudlno Sulrsernrrei Ownsm, seeking a Contract with Cook County must comply with ths Cook County Wage Thenordinance set forth In chapter 34, Article Iv, ssotkm 179. Any petsotvsubstsntlsl owner, who falls to comply with cook county wage Theft ordinance,msy request that ths cltlef procurement offlosr grant a reduction or waiver in accordance with secuon 34-179(d).

"Conrrecr means any written document to make Procurements by or on behalf of Cock County.

"Person" means sny individual, corporation, partnership, Joint Venture, trust, association, limited liability company, sole proprietorship or other legal entity.

"ProcummenC means obtaining supplies, equipment, goods, or services of any kind.

"Subsienller Owner" mesne sny person or persons who own or hold s twenty-five percent (26%) or more percentage of Interest in any business entllyseeking e County Privilege, Including those shareholders, general or tknited partners, beneffctedes snd principals; except where a business entity Is anindividual or sole proprietorship, Substantial Owner means that individual or sole proprietor.

Aff Persons/Substantial Owners ars required to complete this affidavit and comply with the Cook County Wage Thstt Ordinance before any Contract Isawarded. Signature of this farm constitutes s certlficsffon the information provkled below is cermet and complete, snd that the individual(s) signing this formhas/have personal knowledoe of such Information.

I. Contract Information:

Contract Number: I cl>(7—

County Using Agency (rsquesting procurement): (btJ ORAu c f j)xt(3E/C IJ(AJtfv8244/EssC

II. Person/8ubstsntial Owner Information:

Person (Corporate Entity Name): Tlkff O4LLAdvo Co rxSu t/Dkux 1 S eetts bte, I xi C

Substantial Owner Complete Name: letw Edwin 'F. (Oto LLJ tx(LAr

FEIN8 ate —~ (5'l 1 LO

Date of Sirth: E-mail address: CCS (I CCSttkote t<c ~ (Jt pt

street Addmss: Iq E . Lhs/ulu. E., 'Eu t-tlt 804

City: CLLICAeo

HomePhone: ~t 6 (3 - t% 44%

IS. Compgancs with Wage Laws:

state: l I-Driver's License No:

Zip: (P O 4 rp 5

Within the past five years has the Person/Substantial Owner, in any judicial or administrative proceeding, been convicted of, entered aplea, made an admission of guilt or liability, or had an administraftve ffnding made for committing a repealed or willful violabon of any ofthe following lawm

I/I/no/s Wage Paymeni and Collection Acl, 820 ILCS 115/1 et seq., YES or(Q5

//finola Minimum Wage Act, 820 ILCS 105/1 ef seq., YES onli/inois Worker Adjustment and Retraining Noliilcaffon Acf, 820 ILCS 88rf el seq., YES or ld(b

Employee Classification Aci, 820 ILCS 185/1 et seq., YESorgyFair Labor Standards Acl of 1838, 28 I/.S.C. 201, et seq., YES or lg)Any compsreb/e state statute or regu/affon of any state, which governs the payment of wages YES or~

If the Pemon/Substantial Owner answered "Yes" to any of the questions above, it 8 ineligible to enter into a Contract with CookCounty, but can request a reduction or waiver under Section IV.

EDS-13 8/2016


IV. Request for Waiver or Reduction

if Person/Substantial Owner answered "Yes" to any of the questions above, it mey request a reduction or waiver inaccordance reduction of waiver Is made on the basis of ons or more ofthe following

Thais hasYES or HO

DisciplinaryYESor NO

Remedial sYES or NO

Other factorsYES or NO

ntrol of the ineligible Person or Substanfisl Owner

responsible for the acts giving rise to the violation

the acts giving rise to the dlsquallflcadon or dehiult

vent.

The Person/Substanasl Owner must submit documentation to auonon the heals of /ts reenact for a mductlcn or waiver The ChiefProcurement Ofpcer reserves the rloht tc ma/rs add/Venal inoulrles end raouest add/dona/ documentation.

V. AfgrmatlonThe Person/Subsbrnbsf Owner affirms that all statements contained

Signature:

Name of Person signing (Print): ICl yt gahit. 'T ~ Gw IA4tkh-

Subscrlbsd and swop togefore me this ~ay of

x W S )m~<,&,uyrk0lilotary'utyltg Signature

Nate: The above informs ls subject fo verification prior lo the s

in the Affidavit are true, accurate and complete.

Ost: 4'f.'Ot 8TINe: Y 464I SEE s

,20

EDS-14 8/2015


CONTRACT AND EDS EXECUTION PAGEPLEASE EXECUTE THREE ORIGINAL PAGES OF EDS

The Applicant hereby certifies snd warrants that all of the statements, certiflcatlons and representations set forth In this EDS are true,complete and correct; that Ihe Appficant is in full compfiance and will continue to be in compfiance throughout the term of the Contract orCounty Privilege issued to the Applicant with all the policies and requirements set forth in this EDS; and that afi facts and informationprovided by the Applicant in this EDS are true, complete and correct. The Applicant agrees to inform the Chief Procurement Officer inwriting if any of such statements, certifications, representations, facts or information becomes or is found to bs untrue, incomplete orincorrect during the term of the Contract or County Privilege.

~ CLHTAtfio I'-c /xfitxA~Corporation's Name

85 1 jsS+Telephone

Secretary Signature

Execution by Corporation

c W ~ma.t. a ~sr-vPresident's Printed Name and Signature

W% C? Q'.STILOI o I uo CexA

Email

Date

Execution by LLC

LLC Name 'Member/Manager Printed Name and Signature

Date Telephone and Email

Execution by Partnership/Joint Venture

Partnership/Joint Venture Name *Partner/Joint Venturer Printed Name and Signature


Execution by Sole Proprietorship

Printed Name Signature Assumed Name (if applicable)


Subscribed and sworn to before me this

day of ~VLJihrL% 20+

K >ll~~k. %~1k'f64My commission expires ~

t BARBARA J LANDDtfifBKII

Notary Public Signature Notary Seal

"If the operagng agreement, partnership agreement or governing documents rsquinng execution by mulhple members, managsm,partners, or joint venturers, please complete and execute additional Contract and EDS Execution Pages,

EDS-15 8/2015

OFFICE OF THE CHIEF PROCUREMENT OFFICER

SHANNON E. ANDREWS

CHIEF PROCUREMENT OFFICER

118 North Clark Street, Room 1018e Chicago, Illinois 60602 e (312) 603-5370

TONI PRECKWINKLS

PRESIDENT

Cook Cotrntlr Beard

ef Commissioners

RICHARD R. BOYKIN

1st District

ROBERT STEELF.

2nd District

JUN 1 {3 20)II

Mr. Kimbal T. Goluska, President

The Chicago Consultants Studio, Inc.

19S.LaSalle Street, Suite 603Chicago, lfiinois 60603

JERRY BUTLER

3rd District

STANLEY MOORE

4th District

DEBORAH SIMS

5th District

JOAN PATRICIA MURPHY .6th District

JESUS G. GARCIA

7th District

LIES ARROYO JR

8th District

PETER N. SR.VESTRI

9th District

RE: Notice of Contract Amendment No. 4Contract Number: 1430-13421Urban Land Use Planning & Consulting Services

Dear Mr. Goiuska

This correspondence is to serve as nofice that the County of Cook has amended the above-menfioned contract.

Attached is a copy of the Contract Amendment and Purchase Order for your records. Pleaserefer to the contract number above when inquiring about this amendment. Please do notprovide service until your firm has been notified by a representative of the using department,

If you have any questions, please contact Cho Ng, Assistant Procurement Officer at {312)603-2391 or via email at [email protected].

BRIDGET GAINER

loih DistdictSincerely,

JOHN P. DALEY

11th District

JOHN A. FRITCHFY

12th District

IARRY SUFFREDIN

13th District

GREGG GOSUN

14th Diahict

Shannon E. Andrews

Chief Procurement Oflicer&

SEA/cn

cc: Contract File

Capital Planning & Policy

TIMOTHY O. SCHNBDER

15th Distrkt

JEFFREY R. TOBDLSRI

16tlt District

SEAN M. MORRISON

17th DiatriCI $ Fiscai Responsibility grnttovative LeadsrEIiip Nt Transparency & AEEDUntsbiiity < IFnproved services

e cree/ca

DATE

6/I 5/2016F.O.B.PO'INT

PURCHASE ORDERED ISSUED TO

852225

The Chicago Consultants Studio Inc19 South LaSalle Street Suite 803Chicago IL 60603

OFFICE OF THE CHIEF PROCUREMENT OFFICERCOUNTY OF COOK118 NORTH CI.ARK ST. ROOM 1018CHICAGO, ILLINOIS 60602-1375(312) 603-5370 PURCHASE ORDER NO.

195sS62 - 000- OPREQUISITION NO.

001241 59 07

SHIP TO Capital Planning 81 Policy

69 W Washington St 30th Fl

Chicago IL 60602-3007 75003047001 Opage I of 2

COOK COUNTY FEISS: 36.6006541ILLINOIS SANS TAX EXEMFf: E 9998-2013-04FEDERAl EXCISE TAX EXEMPT CERT: 36-75-0038K

DELIVERY INSTRUCTIONS

Elaine Lockwood Bean 312-603-0303

UREANLAND USE PLANING ttCONSULTING SERVICESAS PER CONTRACT NO. 1430-13421AS AUTHORIZED BY THE COUNTY BOARD ON MARCH 12,2014ORIGINAL CONTRACT PERIOD: MARCH 12, 2014 THROUGHMAY 11,2015AMOUNT AUTHORIZED BY THE BOARDr $2,408,000.00en********RENEWAI. PER AMENDMENT NO. IAMENDMENT PERIOD: MAY 12, 2015 THROUGH AUGUST 11,2015AS AUTHORIZED BY THE CPO ON MAY 13, 2015******ees~EXTENSION AND INCREASE PER AMENDMENT NO. 2AMENDMENT PERIOD: AUGUST 12, 2015 THROUGH OCTOBER31, 2015AMENDMENT AMOUNTr $ 148,671.00TOTAL REVISED AMOUNT AUTHORIZED: $2,556+71.00AS AUTHORIZED BY THE CPO ON SEPTEMBER 15, 2015

EXTENSION AND INCREASE PER AMENDMENT NO. 3AMENDMENT PERIODr NOVEMBER I, 2015 THROUGH MAY 31,2016AMENDMENT AMOUNT: $730,000.00TOTAL REVISED AMOUNT AUTHORIZED: $3,286,671.00AS AUTHONZED BY THE COUHTY BOARD ON NOVEMBER 18,2015*********EXTENSION PER AMENDMENT NO. 4AMENDMENT PERIOD: IUNE I, 2016 THROUGH NOVEMBER

30, 2016***e*ee*enAMOUNT ENCUMBERED ON P.O. NO. 187972;$2,003,000.00AS PART OF THE BOND RESTRUCfURING PROjECT,REMAINING BALANCE OFPO NO. 187972 WAS MOVED TO A NEW PO NO. 189611

0.00 " 0.0000

NOTE; VENDOR AGREES Nor To EXCEED THE QUANTITY OR DOLLAR AMOUNT OF THIS ORDER WITHOUT WRDTEN AUTHORIZATION FROM THE CHIEF PROCUREMENT OFFICER

Authorised Slanaerrnr Dace

RECEIPT CERTIPICATIOIB (POR DEPARTBIEIET USE ONLY)I hereby cerdfy that I have received the geode/services rationed above and that theItems referenced are in full conformity whh the purchase order/contract.

I hereby cerdry dns rhls purchase Is In seunnuu wlhh dre requlsldun

W ~~L IGSunc zhun

Nisei'URCHASE

ORPER NCI.I95442 - QOO- OP

REQUISITION NO.00124159 O7

DATE

6/I 5/2016F.O.B.POINT852225

The Chicago Consultants Studio Inc19 South LaSalle Street Suite 803Chicago IL 60603 Page 2 012

COOK COUNTY FEIME 36-6006548ILI.INOIS SALES TAX EXEMPT: E-9998-2013-06FEDERAL EXCISE TAX EXEMPT CERT: 36 75 D030K

WS "'""5"'«-':"'n %"''SWAN:"'~~I~F'********4

AMOUNT ENCUMBERED ON P.O. NO. 188063r $ 138,000.00AS PART OF THE BOND RESTRUCTURING PROIECT,REMAINING BALANCE OF

PO NO. 188063 WAS MOVED TO A NEW PO NO. 189612Cook Connry,Dose rlntlon**********AMOUNT ENCUMBERED ON P.O. NO. 192083: $267,000.00AMOUNT ENCUMBERED.ON P.O. NO. 193076:$2 88,671.00AMOUNT ENCUMBERED ON P.O. NO; .I93804; $730 000,00****In**n*TOTAL PREVIOUSLY ENCUMBERED $3,286,671.00AMOUNT ENCUMBERED ON THIS P.oo $0TOTAL ENCUMBERED AMOUNT INCLUDING THIS P.oo

BALANCE ON THIS P.O.

OFFICE OF THE CHIEF PROCUREMENT OFFICERCOUNTY OF COOK118 NORTH CLARK ST. ROOM 1018CHICAGO, ILLINOIS 60602-1375(312) 603-5370PURCHASE ORDERED ISSUED TO

** Tolnl Order 0.00

OFFICE OFTHE CHIEF PROCUREMENT OFFICER

SHANNON E. ANDREWS


118 North Ciark Street, Room 1018 ~ Chicago, Illinois 60602 o (312) 603-5370

TONI PRECKWINKLE

PRESIDENT

Cook County Board

of Commissioners

RICHARD R. BOYKIN

1st District

ROBERT STEFLF.

2nd Distdict

JUN16 20lII



19S.LaSalle Street, Suite 603Chicago, illinois 60603

JERRY BUTLER

3rd District

STANLEY MOORE

4th District

DEBORAH SIMS

5th District

JOAN PATRICIA MURPHY

6th District

JESUS G. GARCIA

7th District

LULS ARROYO JR

stir DIstnct

PETER N. SILVESTRI

9th District

RE: Notice of Contract Amendment No. 4Contract Number: 1430-13421Urban Land Use Planning 8 Consulting Services

Dear Mr. Goluska:

This correspondence is to serve as notice that the County of Cook has amended the above-mentfoned contract.

Attached is a copy of the Contract Amendment and Purchase Order for your records. Pleaserefer to the contract number above when inquiring about this amendment. Please do notprovide service until your firm has been notified by a lepresentative of the using department,

If you have any questions, please contact Cho Ng, Assistant Procurement Officer at (312)603-2391 or via email at [email protected].

BRIDGET GAINER

10th District

JOHN P. DALEY

11th District

JOHN A FRITCHFY

12th District

LARRY SUFFREDIIsi

13th District

GREGG GOSUN

14th District

Sincerely,

i9 9 IILShannon E. Andrews

Chief Procurement Oflicer

SEAJlcn

cc: Contract File


DMOTHY 0. SCHNEIDER

15th District

JEFFREY R. TOBOLSIG

16th District

SEAN M. MORRI50N

17th Distnct $ Fiscal ResponsibilityfInnovativa Leadership Il Transparency O'. Accovntabilityg Improved services

s „sees/se

R mN:.'Ly","". ', " ',"

PURCHASE ORDER NOI95sI62 - 000- Op

TREQUISITION NO.

0012aII 59 07

DATE

6/15/201 6F.O.B.POIN


852225

The Chicago Consultants Studio inc19 South LaSalle Street Suite 803Chicago IL 60603

OFFICE OF THE CHIEF PROCUREMENT OFFICECOUNTY OF COOK118 NORTH CLARK ST. ROOM 1018CHICAGO, ILLINOIS 60602-1375(312) 603-5370

SHIP TO Capital Planning Bt Policy

69 W Washington St 30th Fi

Chicago ii 60602-3007 75003047001 OPage 1 of 2

COOK COUIITT FEIN: 36-6006562II I IMOIS SALES TAX EXKNPTi K 999K-KDI 3-06FEDERAL EXCISE TAX KXENFT CERT: 36.7S.D038K


Elaine Lockwood Bean 312-603-0303

1.00 URBAN-LAND USE KANNING at

CONSULTING SERVICES

AS PER CONTRACT NO. 1430-13421AS AUTHORIZED BY THE COUNTY BOARD ON MARCH 12,2014ORIGINAL CONTRACT PERIOD MARCH 12, 2014 THROUGHMAY 11,2015AMQUNT AUTHQRIXED BY THE BoARD: 52,408,000.00****a e e**aRENEWAL PER AMENDMENT No. IAMENDMENT PERIOD: MAY 12, 2015 THROUGH AUGUST 11,2015AS AUTHORIZED BY THE CPO ON NAY 13, 2015********a*EXTENSION AND INCREASE PER AMENDMENT NO. 2AMENDMENT PERIOD: AUGUST 12, 2015 THROUGH OCTOBER31, 2015AMENDMENT AMOUNT: 5148,671.00TOTAL REV5ED AMOUNT AUTHORIZED: 52,556,671.00AS AUTHORIZED BY THE CPO ON SEPTEMBER 15, 2015a*******eEXTENSION AND INCREASE PER AMENDMENT NO. 3AMENDMENT PERIODt NOVEMBER I, 2015 THROUGH MAY 31,2016AMENDMENT AMQUNT: 5730,000.00TQTAL REY5ED ANQUNT AUTHQRIzED: 53,286,671.00AS AUTHORIZED BY THE COUNTY BOARD ON NOVEMBER 18,2015*******a**EXTENSION PER AMENDMENT No. 4AMENDMENT PERIOD: IUNE I, 2016 THROUGH NOVEMBER

30, 2016***a ******AMOUNT ENCUMBERED ON P.O. NO. 187972;fi2,003,000.00AS PART OF THE BOND RESTRUCTURING PROJECT,REMAINING BALANCE OFPO NO. 187972 WAS MOVED TO A NEW PO NO. 189611

0.00 " 0.0000

NOYF„VENDOR AGREES Not To EXCEED THE QUANTITY OR DOLLAR AMOUNT OF THIS ORDER WITHOUT WRITTEN AUTHORIZATION FROM THE CHIEF PROCURIMINY QFFICIR

REcEIPT cERTIFIGATIoig IFQR DEPARTNEIET USE oNI.Y) I hereby eatery that thlt nerchee lt In ataatnent with the rennltftienfll thMn n * nlt eh 4 n

I hereby certify that I have received the goods/services regeoed above and that dec CHIEF PROCUREMENT OFFICER Date:items referenced am in Full conformity with the purchase order/contract

Aethodsed Slgnaten t Date IGJane 2O ue

EMENT OFFICEROFFICE OF THE CHIEF PROCURCOUNTY OF COOKI I S NORTH CLARK ST. ROOM I 0 I 0CHICAGO, ILLINOIS 60602-1375(312) 603-5370PURCHASE ORDERED ISSUED TO

852225The Chicago Consultants Studio Inc19 South LaSalle Stleet Suite 803Chicago IL 60603

4F'*n***

***AMOUNT ENCUMBERED ON P.o.NO. 188063r 3138,000.00AS PART OF THE BOND RESTRUCTURING PROIECT,REMAINING BALANCE OFPO NO. 188063 WAS MOVED TO A NEW PO NO. 189612Cook Conntv,Description**e**e*eAMOUNT ENCUMBERED ON P.O. NO. 192083: 3267,000.00AMOUblT ENCUMBERED ON P.O. NO. 193076r SS48,671.00AMOUNT ENCUMBERED ON P.O. NO. 193804:8730,000,00ee**e*leeeTOTAL PREVIOUSLY ENCUMBERED: 33,286,671.00AMOUNT ENCUMBERED ON TH5 F.oo SO

TOTAL ENCUMBERED AMOUNT INCLUDING TH5 P.ooI3,286,67125**********BALANCE ON THIS P.O.

DATE PURCHASE ORDER NO.6/15/2016 195462 - QOQ. OPF.O.B.POINT

REQUISITION NO.00124159

Page 2 of2COOK COUIITY FEIMI 36-600654 IILLIIEOIS SALES TAX EXEMPT: E-9990-2013-OrsFEDERAl EXCISE TAX EXEMPT CERT: 36-73-D03$K

Teel'Fr'0;"~x~~'iii' "'71IV~AT':.'%+

Total Order *0.00

OFFICE OF THE CHIEF PROCUREMENT OFFICER

SHANNON E. ANDREWS


118 North Clark Street, Room 1018e Chicago, Illinois 60602 e (312) 603-5370

TONI PRECKVVINKLE

PRESIDENT

Cook County Board

of Cominissioners

RICHARD R. BOYKIN

1st District

ROBERT STFFLF.

2nd District

JW16 Mll



19 S. LaSalle Street, Suite 803Chicago, illinois 60603

JERRY BUTLER

3rci Dlstfict

STANLEY MOORE

4th District

DEBORAH SIMS

5th District

JOAN PATRICIA MURPHY

6th Di tiict

JESUS G. GARCIA

7th District

LUIS ARROYO JR.

8th Distrii.t

PETER N. SILVESTRI

Sth District

RE: Notice of Contract Amendment No. 4Contract Number: 1430-13421Urban Land Use Planning 8 Consulting Services

Dear Mr. Goluskal.

This correspondence is to serve as notice that the County of Cook has amended the above-

mentioned contract.

Attached is a copy of the Contract Amendment and Purchase Order for your records. Pleaserefer to the contract number above when inquiring about this amendment. Please do not

provide service until your firm has been notified by a representative of the using department.

If you have any questions, please contact Cho Ng, Assistant Procurement Ofticer at (312) 603-2391 or via email at cho.ngcookcountyil,gov,

BRIDGET GAINER

10th DistriciSincerely,

JOHN P. DALEY

11th District

JOHN A. FRITCHEY

12th District

IARRY SUFFREDIN

13tii Dlstltct

GRECG GOSUN

14th Liistiict

Shannon E, Andrews

Chief Procurement Officer

SEAfcn

cc: Contract File


TIMOTHY O. SCI-INEIDER

15th District

JEFFREY R. I OBOLSKI

16tii District

SEAN M MORRISON

17'tll Distr'ict $ Fiscal Responsibility/Innovative Leadership III Transparency at Accountability g~ Improved services

\tea/is

DATE

6/I 5/2016F.O.B.POINT


852225

The Chicago Consultants Studio Inc19 South LaSalle Street Suite 803Chicago IL 60603

OFFICE OF THE CHIEF PROCUREMENT OFFICERCOUNTY OF COOK118 NORTH CLARK ST. ROOM 1018CHICAGO, ILLINOIS 60602-1375(312) 603-5370 PURCHASE ORDER NO

195aS62 - 000- OP

REQUISITION NO.

00124159 07

SHIP TO Capital Planning Bt Policy69 W Washington St 30th Fl

Chicago IL 60602-3007 7500304700s Opage I of 2

COOK COLINTY FEINI 36-6006541ILLINOIS SALES TAX EXEtuiPT: E.9998-2013.04FEDERAL EXCISE TAX EXEItIPT CERT: 36-75.D038K


Elaine Lochvood Bean 312-603-0303

URBAN LAND USE PLANNING IX

CONSULTING SERVICESAS PER CONTRACT NO. 1430-13421AS AUTHORIZED BY THE COUNTY BOARD ON MARCH 12,2014ORIGINAL CONTRACT PERIOD: MARCH 12, 2014 THROUGHMAY 11, 2015AMOUNT AUTHORI2ED BY THE BOARD: $2,408,000.00n n *~ **n e ~ n

RENEWAL PER AMENDMENT No. IAMENDMENT PERIOD: MAY 12, 2015 THROUGH AUGUST 11,2015AS AUTHORIZED BY THE CPO ON MAY 13, 2015'a *e *******EXTENSION AND INCREASE PER AMENDMENT NO. 2AMENDMENT PERIOD: AUGUST 12, 2015 THROUGH OCTOBER31, 2015AMENDMENT AMOUNT: $ 148,671.00TOTAL REVISED AMOUNT ALITHORIZED: 12,556,671.00AS AUTHORIZED BY THE CPO ON SEPTEMBER 15, 201S

EXTENSION AND INCREASE PER AMENDMENT NO. 3AMENDMENT PERIOD; NOVEMBER I, 2015 THROUGH MAY 31,2016AMENDMENT AMOUNTi $730,000.00TOTAL REVISED AMOUNT AUTHORIZED: $3,286,671.00AS AUTHORIZED BY THE COUNTY BOARD ON NOVEMBER 18,2015

EXTENSION PER AMENDMENT NO. 4AMENDMENT PERIODi JUNE I, 2016 THROUGH NOVEMBER

30, 2016ee*e***a*aAMOUNT ENCUMBERED ON P.o. NO. 187972:$2,003,000.00AS PART OF THE BOND RESTRUCTURING PROJECT,REMAINING BALANCE OFPO NO. 187972 WAS MOVED To A NEW PO NO. 189611

0.00 " 0.0000

NOTF VENDOR AGREES NOT TO EXCEED THE QUANTITY OR DOLLAR AMOUNT OF THIS ORDER WITHOUT WRITTEN AUTHORIZATION FROM THE CHIEF PROCUREMENT OFFICER

RECEIPT CERTIFICATION (FOR DEPARTIriENT USE ONLY)I hereby certify that I have received the goods/services refleded above and that theItems referenced are in full conformity with the purchase order/contract.

I hereby certil'y mat thh purchase is In agreement with the renuisitlnn

Authorized Signature Date: IGJuri<

Z.OVAL

OFFICE OF THE CHIEF PROCUREMENT OFFICERCOUNTY OF COOK118 NORTH CLARK ST. ROOM 1018CHICAGO, ILLINOIS 60602-1375(312) 603-5370PURCHASE ORDERED ISSUED TO

PURCHASE ORDER NOI95462 .000- OP

REQUISITION NO.00124159 O7

DATE

6/IS/2016F.O.B.POINT852225

The Chicago Consultants Studio Inc19 South LaSalle Street Suite 803Chicago IL 60603 Page 2 of 2

COOK COUNTY FEIN: 36-6006541ILLINOIS SALES TAX EXEMPT: 8.9998-2013.04FEDKRAI. EXCISE TAX EXEMPT CERT: 36-75.D038K

-:.'EPEE'8'.:':.";":::::.""'"':gj'NI'EI'u

i''E'PER3'***I*****

AMOUNT ENCUMBERED ON P 0 NO I 880631 I I 38r000 00AS PART OF THE BOND RESTRUCTURING PROIECT,REMAINING BALANCE OFPO NO. 188063 WAS MOVED TO A NEW PO NO. 189612Cook County,

Description**********AMOUNT ENCUMBERED ON P.O. NO. 192083: $267,000.00AMOUNT ENCUMBERED ON P.O. NO. 193076:$ 148,671.00AMOUNT ENCUMBERED ON P.O. NO. 193804: $730,000.00*no*null**TOTAL PREVIOUSLY ENCUMBERED: $3,286,671.00AMOUNT ENCUMBERED ON THIS P.ou $0TOTAL ENCUMBERED AMOUNT INCLUDING THIS P.ou$3,286,671.00******s***BAI.ANCE ON THIS P.O.

ss*n ss Totot Praol **Io**0.00

IiI

IJ

I

p:s:

1

0

Idyll t

VlCQ

IL0

'R

O

V

V.g Q

s

I

I [I

ZI

ig

$ 1,

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189 I

No. Amendment No. Vendor Name: THE CHICAGO …Contract No. 1430-13421Amendment No. 4 Vendor Name:...

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Transcript of No. Amendment No. Vendor Name: THE CHICAGO …Contract No. 1430-13421Amendment No. 4 Vendor Name:...