Summer Food Service Program_IFB - Chicago Park District

SECTION A
SUMMER FOOD SERVICE PROGRAM
INVITATION FOR BID AND CONTRACT
This document contains an invitation to bid for the furnishing of unitized meals to be served to children participating in the Summer
Food Service Program established by the United States Department of Agriculture (7 CFR Part 225), and sets forth the terms and
conditions applicable to the proposed procurement. Upon acceptance, this document shall constitute the contract between the
bidder and the sponsor.
The Illinois State Board of Education or the United States Department of Agriculture does not in any way become a party to any
contract between a sponsor and a vendor. The sponsor has full responsibility for seeing that the terms of the contract are fulfilled.
The Illinois State Board of Education or the United States Department of Agriculture has no involvement with the enforcement of the
contract; however, payment can be denied for all meals received under an invalid contract.
SOLICITING SPONSOR
1. NAME OF SPONSOR
Chicago Park District
STREET ADDRESS
541 N. Fairbanks
CITY STATE ZIP CODE
Chicago IL 60611
TELEPHONE NUMBER
312-742-7529
FOR INFORMATION CALL
Trish Melchert, 312-742-4430
2. BID NUMBER
P-11056
3. BID OPENING DATE TIME
January 18, 2012
1:00 P.M., C.S.T
BID OPENING LOCATION
541 N. Fairbanks, Chicago, IL 60611
4. CONTRACT COMMENCEMENT DATE
March 1, 2012
5. CONTRACT EXPIRATION DATE
February 28, 2013
6. MEAL TYPE
ESTIMATED SERVINGS
PER DAY
(B)
ESTIMATED NUMBER OF
SERVING DAYS
(C)
Breakfast 20,000 40
AM Supplements
n/a n/a
Lunch
20,000 40
PM Supplements
20,000 40
Supper n/a n/a
BIDDER (Complete areas enclosed in block.)
8. NAME OF BIDDER
STREET ADDRESS
UNIT PRICE (in ink)
(D)
7. Total Estimated
Amount of Bid
PROMPT PAYMENT DISCOUNT
TOTAL PRICE
See p. 5 for
instructions
CITY STATE ZIP CODE
___________% for payment within ________days
By submission of this bid, the bidder certifies that, in the event he receives an award under this solicitation, he shall operate in
accordance with all applicable, current program regulations.
________________________________
Date
________________________________________________________________
Signature of Bidder (in ink)
__________________________________________
Title
__________________________________________________________________________________
Telephone
ACCEPTANCE OF CONTRACT
_______Chicago Park District______________________________________________________________________
NAME OF SPONSOR
___P-11056_____________
CONTRACT NO.
__________________________________ ______________________________________________________________________ ____________________________
Date Signature of Sponsor Representative Title

CERTIFICATE OF INDEPENDENT PRICE DETERMINATION
SECTION B
1. Sponsor and Bidder shall execute this Certificate of Independent Price Determination.
BIDDER:
A. By submission of this bid, the bidder certifies and in the case of a joint bid, each party thereto certifies as to its own
organizations, that in connection with this procurement:
a) The prices in this bid have been arrived at independently, without consultation, communication or agreement, for the
purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor;
b) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the
bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly to any other bidder or to
any competitor;
c) No attempt has been made or will be made by the bidder to induce any person or firm to submit or not to submit, a bid for
the purpose of restricting competition.
B. Each person signing this bid certifies that:
THE BIDDER IS TO INDICATE WHICH IS APPLICABLE
SPONSOR:
a) He/she is the person in the bidder’s organization responsible within that organization for the decision as to the prices
being offered herein and that he/she has not participated, will not participate, in any action contrary to (A)(a) through (A)(c)
above.
b) He/she is not the person in the bidder’s organization responsible within that organization for the decision as to the prices
being offered herein but that he/she has been authorized in writing to act as agent for the persons responsible for such
decision in certifying that such persons have not participated and will not participate, in any action contrary to (A)(a)
through (A)(c) above and as their agent does hereby so certify: and he/she has not participated, and will not participate, in
any action contrary to (A)(a) through (A)(c) above.
In accepting this bid, the sponsor certifies that the sponsor’s officers, employees or agents have not taken any action which may
have jeopardized the independence of the bid referred to above.
(Accepting a bid does not constitute acceptance of the contract.)
____________________
Date
_______________________________________
Signature of Authorized Sponsor Representative
2. The bidder/contractor certifies that he/she is in compliance with the Public Contracts Equal Employment Opportunity/Affirmative
Action Programs of the Illinois Department of Human Rights (formerly called the Illinois Fair Employment Practices Commission).
3. A Certification of Clean Air and Water Practices must also be completed by any bidder whose bid exceeds $100,000 in
anticipated program payments. The bidder certifies as follows:
A. Any facility to be utilized in the performance of this contract has/ has not been listed on the Environmental Protection
Agency List of Violating Facilities. (check one)
B. He/she will promptly notify the contracting officer, prior to award, of the receipt of any communication from the Director,
Office of Federal Activities, U.S. Environmental Protection Agency, indicating that any facility which he/she proposed to use
for the performance of the contract is under consideration to be listed on the EPA list of violating facilities.
C. He/she will include substantially this certification in every non-exempt subcontract.
__________________________________________________________________
Signature of Authorized Representative, Food Service Management Company
_______________________
Date
________________________________
Title
2

SECTION C
INSTRUCTIONS TO BIDDERS
1. Definitions
As used herein:
A. The term “bid” means an offer to perform the work described in the Invitation for Bid at the fixed unit price specified in
accordance with the terms and conditions of the solicitation.
B. The term “bidder” means a food service management company submitting a bid in response to this Invitation for Bid.
C. The term “contractor” means a successful bidder who is awarded a contract by a Sponsor under the Summer Food Service
Program under the U.S. Department of Agriculture.
D. The term “food service management company” means an organization, other than a public or private nonprofit school, with
which a sponsor may contract for preparing and, unless otherwise provided for, delivering unitized meals, with or without milk,
for use in the program.
E. The term “Invitation for Bid”, hereafter referred to as IFB, means the document soliciting bids through the formal advertising
method of procurement. In the case of this program, the IFB becomes the contract upon acceptance by the Sponsor.
F. The term “Sponsor” means the Summer Food Service Program Sponsor which issues this IFB.
G. The term “unitized meal” means an individual pre-portioned meal consisting of a combination of foods meeting the complete
meal requirements, delivered as a unit and served as a unit, with or without milk.
Other terms shall have the meanings ascribed to them in the Summer Food Service Program regulations.
2. Submission of Bids
A. Bidders are expected to examine carefully the specifications, exhibits, attachments, terms and conditions of this IFB. Failure
to do so shall be at the bidder’s risk.
B. Bids shall be executed and submitted in triplicate. If accepted, this IFB will become the contract and one copy of the contract
will be forwarded to the successful bidder with the notice of award. No change in the specifications or general conditions are
allowed. Bidders may make any explanation they wish by memorandum or letter attached to the bid. Erasures on this bid
shall be initialed by the bidder prior to submission.
C. A copy of a current State or local health certificate for the food preparation facilities shall be submitted with the bid.
D. All certifications contained herein must be signed and submitted with the bid.
Failure to comply with any of the above shall be reason for rejection of the bid.
3. Explanation to Bidders
Any explanation and/or answer to any questions desired by a bidder regarding the meaning or interpretation of the IFB
specifications, etc., must be requested in writing prior to bid opening and with sufficient time allowed for a reply to reach all
bidders before bid opening. Oral explanations or instructions given before the award of the contract shall not be binding. Any
information given to a prospective bidder concerning an IFB shall be furnished to all prospective bidders as an amendment to the
IFB if such information is necessary to bidders in submitting bids on the IFB or if the lack of such information would be prejudicial
to uninformed bidders.
4. Acknowledgement of Amendments to IFBs
Receipt of an amendment to an IFB by a bidder must be acknowledged by signing and returning the amendment. Such
acknowledgement must be received prior to the hour and date specified for bid opening.
5. Discounts
Although a blank is provided for a time discount, prompt payment discounts offered for payment in less than twenty calendar days
will not be considered in evaluating bids for award. However, offered discounts of less than twenty days will be taken if payment is
made within the discount period even though not considered in the evaluation of bids.
6. Bidders Having Interest in More Than One Bid
If more than one bid is submitted by any one person, by or in the name of a clerk, partner, or other person, all such bids shall be
rejected.
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7. Time for Receiving Bids
Sealed bids shall be deposited at the address specified on the IFB of the sponsor no later than the exact time and date indicated
on the face of this IFB. Bids received prior to the time of opening will be securely kept, unopened.
8. Error in Bids
Bidders or their authorized representatives are expected to fully inform themselves as to the conditions, requirements and
specifications before submitting bids; failure to do so shall be at the bidder’s own risk and he/she cannot secure relief on the plea
of error.
9. Bonding Requirements
A. Bid Bond: Bidder shall submit with his bid a bid bond in the amount of *_5 percent__ of the value of the contract. Bid
bonds will be returned to the successful bidder upon execution of such further contractual documents.
B. Performance Bond: The successful contractor shall provide the Sponsor with a performance bond in the amount of 10
percent of the contract price. The bond shall be furnished not later than ten days following the award of the contract.
The bid bond and performance bond must be obtained from one of the companies listed in the Department of
Treasury Circular 570.
* (This amount must be not less than 5 percent nor more than 10 percent. The actual percentage must be determined by the
Sponsor.)
10. Award of Contract
A. The contract will be awarded to the lowest responsible bidder conforming to all material terms and conditions of the Invitation
for Bid. Consideration shall be given to such matters as contractor integrity, compliance with public policy, record of past
performance and financial and technical resources. See the Bidder Responsibility and Bid Responsiveness Criteria included
in this bid packet.
B. The Sponsor reserves the right to reject any or all bids when there are sound documented business reasons in the best
interest of the Program and to waive informalities and minor irregularities in bids received.
C. The Sponsor reserves the right to reject the bid of a bidder who has previously failed to perform properly or complete on time
contracts of a similar nature, or the bid of a bidder who investigation shows is not in a position to perform the contract.
11. Late Bids, Modifications of Bids or Withdrawals of Bids
A. Any bid received after the exact time specified for receipt will not be considered.
Bids must be delivered to the Department of Purchasing, 3 rd Floor, on or before the date and time specified. The bidder is
responsible for ensuring timely delivery to the Department of Purchasing. Proposals sent via United States mail or other
delivery services will be considered only if they are received in the Department of Purchasing before the specified time on the
due date. The Chicago Park District does not guarantee that bids received in the building by mail or other delivery services
will be delivered to the Department of Purchasing before the 1:00 p.m. deadline. The Department of Purchasing’s clock
controls the time, not the bidder’s.
B. Any modification or withdrawal of bid is subject to the same conditions as in (A) above. A bid may also be withdrawn in
person by a bidder or his/her authorized representative, provided his/her identity is made known and he/she signs a receipt
for the bid, but only if the withdrawal is made prior to the exact time set for receipt of bids.
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SECTION D
SCOPE OF SERVICES
1. Contractor agrees to deliver unitized meals *__inclusive__ of milk to locations set out in Exhibit A, attached hereto and made a
part hereof, subject to the terms and conditions of this solicitation.
2. All meals furnished must meet or exceed U.S. Department of Agriculture requirements set out in Exhibit C, attached hereto and
made a part hereof.
3. Contractor shall furnish meals as ordered by the Sponsor during the period of **_June 1, 2012_ to **_August, 31 2012_. Meals
shall be served ***_5_ days a week.
4. The sponsor shall be legally and financially responsible for the conduct of the food service and shall ensure compliance with the rules
and regulations of the Illinois State Board of Education (ISBE) and the United States Department of Agriculture (USDA) regarding Child
Nutrition Programs.
* Sponsor shall insert “inclusive” or “exclusive” as applicable.
** Sponsor shall insert contract commencement date and expiration date.
*** Sponsor shall insert appropriate number of serving days.
UNIT PRICE TABLE AND INSTRUCTIONS
SECTION E
1. Bidders are asked to submit prices on the following meal types meeting the contract specifications set forth in Exhibit C for meals
to be delivered to all of the sites stated in Exhibit A. For example:
A. B. C. D. E.
Meal Type
Estimated Servings
Per Day
Estimated Number
of Serving Days
Unit Price
Total Price
Breakfast 20 180 $1.19 $4,284.00
Supper
(unitized meal)
50 180 $2.49 $22,410.00
A. Sponsor shall indicate for which meal types the contractor will be providing meals during the contract
period.
B. Sponsor shall fill in the estimated number of meals that will be served each day by meal type during the contract period.
C. Sponsor shall fill in the number of anticipated operating days that meals will be served during the contract period.
D. The food service management company shall insert the appropriate unit price for each meal type as indicated by the Sponsor.
E. The food service management company shall calculate total price by multiplying B x C x D.
NOTE: In the event of any inconsistencies or errors, the unit price (D) shall take precedence.
Bidders shall submit their bids on an “all or none” basis. Except as otherwise provided in this solicitation, if a contract is awarded
as a result of this solicitation, it will bind the Sponsor during the term of the contract to secure all its needs from the successful
contractor and such contract shall bind the contractor to perform all such work ordered by the Sponsor at prices specified in the
contract. Award will be made to a single responsive, responsible bidder on the basis of the lowest aggregate cost to the Sponsor.
Evaluation of prices will be on the basis of the estimated requirements set forth herein.
Requirements Contract
a) This is a requirements contract for the Services specified in the Invitation for Bid and for the period set forth therein. The
quantities of such services specified herein are estimates only and are not purchased hereby. Except as may be
otherwise provided herein, in the event the Sponsor’s requirements for services set forth in the Invitation for Bid do not
result in orders in the amounts or quantities described as “estimated” in the Invitation for Bid, such event shall not
constitute the basis for an equitable price adjustment under this contract.
b) The Sponsor shall not be required to purchase from the contractor requirements in excess of the limit on total orders
under this contract, if any.
c) The Sponsor may issue orders which provide for delivery to or performance at multiple destinations.
d) The Sponsor shall not be obligated to place any minimum dollar amount of orders under this contract or any minimum
number of orders. The utilization of the contractor for services specified in the Invitation for Bid will be dependent upon
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the needs and requirements of the Sponsor.
2. Pricing shall be on the menus described in Exhibit B. All bidders must submit bids on the same menu cycle provided by the
Sponsor. Bid price must include price of food, milk (if applicable), packaging, transportation and all other related costs (e.g.,
condiments, utensils, etc.).
3. Evaluation of Bidders
Each bidder will be evaluated on the following factors:
A. Financial capability to perform a contract of the scope required.
B. Adequacy of plant facilities for food preparation, with approved license certification that facilities meet all applicable State
and local health, safety and sanitation standards.
C. Other factors such as transportation capability, sanitation, and packaging.
D. Ability to meet all the specifications in the invitation to bid.
E. Record of past performance and integrity.
See the Bidder Responsibility and Bid Responsiveness Criteria included in the bid packet. Bidders that do not satisfactorily meet
the above criteria may be rejected as nonresponsive and not considered for award.
4. The unit prices of each meal type which the bidder agrees to furnish must be written in ink or typed in the blank space provided
and must include proper packaging as required in the specifications and delivery cost to the designated sites. Unit prices shall
include taxes but any charges or taxes which are required to be paid under future laws must be paid by the bidder at no additional
charge to the Sponsor.
5. Meal Orders
Sponsors will order meals on Friday of the week preceding the week of delivery; orders will be placed for the total number of
days in the succeeding week, and will include breakdown totals for each site and each type of meal.
The Sponsor reserves the right to increase or decrease the number of meals ordered on a forty-eight hour notice or less if
mutually agreed upon between the parties to this contract.
6. Menu-Cycle Change Procedure
The food service management company shall adhere to the eleven day cycle menu(s) and portion sizes specified by the
sponsor on Exhibit B for the first 11 days of meal service. Thereafter, deviation from this menu cycle shall be permitted only upon
authorization of the Sponsor. Menu changes may be made only when agreed upon by both parties. The meals must continue to
meet or exceed the required meal patterns as listed in Exhibit C. When an emergency situation exists which might prevent the
contractor from delivering a specified meal component, he shall notify the Sponsor immediately so substitutions can be agreed
upon. The Sponsor reserves the right to request menu changes within the food service management company’s food cost
periodically throughout the contract period.
7. Noncompliance
The Sponsor reserves the right to inspect and determine the quality of food delivered and reject any meals which do not comply
with the requirements and specifications of the contract. Contractors will be informed within forty-eight hours of disallowed meals.
The contractor shall not be paid for unauthorized menu changes, incomplete meals, meals not delivered within the specified delivery
time period and meals rejected because they do not comply with the specifications or delivered in unsanitary conditions such as
incorrect temperatures. The Sponsor reserves the right to obtain meals from other sources if meals are rejected due to any of the
stated reasons. The contractor shall be responsible for any excess cost, but will receive no adjustment in the event the meals are
procured at a lesser cost. The Sponsor or agency inspecting shall notify the contractor in writing as to the number of meals rejected
and the reasons for rejection.
8. Specifications
A. Packaging
a) Hot meal unit - packaging suitable for maintaining meals in accordance with local health standards. Container and
overlay should have an air-tight closure, be of non-toxic material, and be capable of withstanding temperatures of 400°F
or (204°C) or higher.
b) Cold meal unit or unnecessary to heat - container and overlay to be plastic or paper and non-toxic. If container is made of
plastic, it shall contain recycled content and be recyclable (numbers 1-5 or number 7, excluding number 6).
c) Cartons - each carton shall be labeled to meet state or local requirements. Label to include:
• Processor’s name and address (plant)
• Item identity, meal type
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• Date of production
• Quantity of individual units per carton
d) Meals shall be delivered with the following nonfood items: condiments, straws for milk, napkins, single service ware,
etc. Napkins shall be made of recycled content and be non-bleached i.e. brown. Single service ware shall be made of
recycled content and be recyclable (plastic number 1-5 or 7, excluding plastic number 6).
e) Sandwiches shall be individually wrapped in a plastic, cellophane or waxed paper bag prior to placement in the total
meal package.
f) All containers holding wet or moist products must be designed against seepage, spilling or leaking.
g) Containers that are made from recyclable material shall be labeled “This container is recyclable.”
B. Food Preparation
Meals shall be prepared under properly controlled temperatures and assembled not more than 24 hours prior to delivery. All fresh
fruits and vegetables must be washed thoroughly during handling or before packaging.
C. Food Specifications
Bids are to be submitted based on the menu(s) included in Exhibit B and food specifications in Exhibit D.
D. Food Order Hardware and Software
The contractor shall provide all necessary hardware, software, and training necessary for ordering food through this
contract. Software provided shall have reporting system capabilities such as: meals ordered for the following day; missing
meal orders for the following day; delivery reporting; and claim reporting for every site and meal ordered each day, week
and month.
The contractor shall set-up, and maintain all provided hardware and software.
E. Dedicated Personnel
The contractor shall provide one (1) person to remain on-site at the CPD Administration Building (541 N. Fairbanks,
Chicago, IL 60611) during normal business hours, the period of June 1 – August 31 for each year of the contract. This
dedicated person shall work closely with the CPD to ensure all orders and deliveries are timely and accurate.
A workspace will be provided for this individual at the CPD Administration Building.
GENERAL CONDITIONS
1. Delivery Requirements
SECTION F
A. Delivery shall be made by the contractor to each site in accordance with the order from the Sponsor.
B. Meals shall be delivered daily, unloaded, and placed in the designated area by the contractor’s personnel at each of the
locations and times listed in Exhibit A.
C. The contractor shall be responsible for delivery of all meals and dairy products at the specified time as stated in Exhibit A of this
document or no later than the start of the scheduled meal time at each site. Adequate refrigeration or heating shall be provided
during delivery of all food to insure the wholesomeness of food at delivery in accordance with State or local health codes.
D. The Sponsor reserves the right to add or delete sites. This shall be done by amendment of Exhibit A. Deletion or addition of
sites will be made not less than twenty-four hours prior to the required date of service.
2. Supervision and Inspection
The contractor shall provide management supervision at all times and maintain constant quality control inspections to check for
portion size, appearance and packaging in addition to the quality of products.
3. Recordkeeping
A. Delivery tickets must be prepared by the contractor at a minimum in four copies: two for the contractor, one for the site and one
for the Sponsor. Delivery tickets must be itemized to show the number of meals of each type delivered to each site. Designees
of the Sponsor at each site will check adequacy of delivery and meals before signing the delivery ticket. Invoices shall be
accepted by the Sponsor only if signed by the Sponsor’s designee at the site.
B. The contractor must submit all invoices incurred pertaining to the Sponsor’s food service operation within 30 days of the last day
of each month or the final day of the program.
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C. The contractor shall maintain records supported by delivery tickets, purchase orders, production records for this contract or
other evidence for inspection and reference to support payments and claims.
D. The food service management company shall retain records for a period of three years plus the fiscal current year. If audit
findings have not been resolved, the records shall be retained beyond the three-year period as long as required for the
resolution of the issues raised by the audit. Such records must be available for a period of three years from the date of the final
contract renewal period has expired and/or receipt of final payment under the contract, whichever occurs last, for the purpose of
making audits, examinations, excerpts, and transcriptions by representatives of the Sponsor, the Illinois State Board of
Education, United States Department of Agriculture, and the Comptroller General at any reasonable time and place.
E. The vendor shall maintain the following records for the sponsor:
a) Production records, including quantities and amounts of food used in preparation of each meal and food component of
menus
b) Standardized recipes and yield from recipes
c) Processed product nutritional analysis
d) Dates of preparation of meals
e) Number of meals and locations where meals were delivered
f) Signed delivery slips
g) Nutritional content of individual food items and meals as delivered
h) Food and bid specifications
4. Method of Payment
The contractor shall submit its itemized invoice to the Sponsor biweekly, or monthly as mutually agreed upon. Each invoice shall
give a detailed breakdown of the number of meals delivered at each site during the preceding two weeks or month. Payment will be
made at the unit price specified in the contract. No payment shall be made unless the required delivery receipts have been signed by
the site representative of the Sponsor.
5. Inspection of Facility
A. The Sponsor, the Illinois State Board of Education and the U.S. Department of Agriculture reserve the right to inspect the
contractor’s preparation facilities prior to award and without notice at any time during the contract period, including the right to
be present during preparation and delivery of meals.
B. The contractor’s facilities shall be subject to periodic inspections by USDA, State and local health departments or any other
agency designated to inspect meal quality for the State. This will be accomplished in accordance with U.S. Department of
Agriculture regulations.
C. The contractor shall provide meals which it prepares to be periodically inspected by the local health department or an
independent agency to determine bacteria levels in the meals being served. Such levels shall conform to the standards which
are applied by the local health authority with respect to the level of bacteria which may be present in meals served by other
establishments in the locality. The results of the inspections must be submitted promptly to the sponsor and to the State
agency.
6. Availability of Funds
The Sponsor shall have the option to cancel this contract if the Federal government withdraws funds to support the Summer Food
Service Program by giving the contractor forty-eight hour written notice. It is further understood that, in the event of cancellation of the
contract, the Sponsor shall be responsible for meals that have already been assembled and delivered in accordance with this contract.
7. Number of Meals
The contractor must provide exactly the number of meals ordered. Counts of meals will be made at all sites before meals are
accepted. Damaged or incomplete meals shall not be included when the number of delivered meals is determined.
8. Emergencies
In the event of unforeseen emergency circumstances, the contractor shall immediately notify the Sponsor by telephone of the
following; (1) the impossibility of on-time delivery; (2) the circumstance(s) precluding delivery; and (3) a statement of whether or not
succeeding deliveries will be affected. No payments will be made for deliveries made later than ___15___ minutes after specified meal
time.
Emergency circumstances at the site precluding utilization of meals are the concern of the Sponsor. The Sponsor may cancel orders
provided they give the contractor at least 48 hours notice.
Adjustments for emergency situations affecting the contractor’s ability to deliver meals, or Sponsor’s ability to utilize meals, for periods
longer than 24 hours will be mutually worked out between the contractor and the Sponsor.
9. Terms and Termination
A. This contract is effective for a one-year period commencing _March 1, 2012_ or upon written acceptance of the contract,
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whichever occurs last, through __February 28, 2013__, with options to renew yearly not to exceed four (4) additional years.
B. The Sponsor reserves the right to terminate this contract if the contractor fails to comply with any of the requirements of this
contract. The Sponsor shall notify the contractor of specific instances of noncompliance in writing. In instances where the
contractor has been notified of noncompliance with the terms of the contract and has not taken immediate corrective action, the
Sponsor shall have the right, upon written notice, of immediate termination of the contract and the contractor shall be liable for
any damages incurred by the Sponsor. The Sponsor shall negotiate a repurchase contract on a competitive basis to arrive at a
fair and reasonable price.
C. The Sponsor shall by written notice to the contractor, terminate the right of the contractor to proceed under this contract if it is
found, by the Sponsor that gratuities in the form of entertainment, gifts or otherwise were offered or given by the contractor to
any officer or employees of the Sponsor with a view toward securing a contract or securing favorable treatment with respect to
the awarding or amending of the contract; provided that the existence of the facts upon which the Sponsor makes such findings
shall be an issue and may be reviewed in any competent court.
D. The Sponsor or contractor may cancel this contract for cause or convenience with a 60-day written notification.
E. Neither the contractor nor sponsor shall be responsible for any losses resulting if the fulfillment of the terms of the contract is
delayed or prevented by wars, acts of public enemies, strikes, fires, floods, acts of God, or any other acts which could not have
been prevented by the exercise of due diligence.
F. The only rates that may be renegotiated in subsequent years of this contract are the individual per meal fixed rates contained
herein. Before any fixed rate increases can be implemented as part of a contract renewal agreement, the contractor shall
document to the sponsor, through a written financial analysis, the need for such increase. Renegotiation of all fixed rates in
subsequent years of the contract must not exceed the Consumer Price Index for Urban Consumers—Food Away From Home
annualized rate for December of the previous calendar year, not to exceed _3_%. Percentage increases cannot be applied to
any previous year’s total estimated or actual contract cost.
The Consumer Price Index for Urban Consumers – Food Away From Home percentage increases for 2010 can be found at the
following site: http://www.isbe.net/nutrition/pdf/consumer_price_index.pdf.
G. In the event this contract is terminated as provided in paragraph (B) or (C) hereof, the Sponsor shall be entitled to pursue the
same remedies against the contractor as it could pursue in the event of a breach of the contract by the contractor. In addition, if
this contract is terminated under paragraph (C), the sponsor shall be entitled to as a penalty, in addition to any other damages
in an amount which shall not be less than three or more than ten times the costs incurred by the contractor in providing any
such gratuities to any such officer or employee.
H. The rights and remedies of the Sponsor provided in this clause shall not be exclusive and are in addition to any other rights and
remedies provided by law or under this contract.
10. Subcontracts and Assignments
The contractor shall not subcontract for the total meal, with or without milk or for the assembly of the meal; and shall not assign,
without the advance written consent of the Sponsor, his contract or any interest therein.
In the event of any assignment, the contractor shall remain liable to the Sponsor as principal for the performance of all his
obligations under this contract.
11. Insurance
The contractor will procure and maintain the following insurance:
A. The contractor shall purchase and maintain, during the life of the contract, such insurance as shall protect him on an occurrence basis
or equivalent with limits not less than $1,000,000.00 per occurrence and $2,000,000.00 in the aggregate for bodily injury, property
damage and personal injury. Coverage shall include, but not be limited to: Premises/Operations, Products/Completed Operations
Insurance; Broad Form Property Damage; Contractual Liability; and, if applicable, Explosion/Collapse/Underground Hazard; and XCU
(explosion, collapse, underground) hazards. The Chicago Park District is to be named as an additional insured on a primary, noncontributory
basis.
B. The contractor shall purchase and maintain, for the life of the contract, comprehensive automobile liability insurance covering all owned,
non-owned and hired motor vehicles, including the loading and unloading thereof, with limits not less than $1,000,000.00 combined
single limit per occurrence for bodily injury and property damage. The Chicago Park District is to be named as an additional insured on
a primary, non-contributory basis.
C. Workmen’s Compensation Insurance as prescribed by the laws of the State of Illinois.
D. Comprehensive Bodily Injury, Property Damage, Liability, and Products Liability Insurance, including bodily injury and property
damage caused by automobiles, with limits prescribed by the State of Illinois for injury or death of any one person or for injury
or death of two or more persons in any one accident, for property damage in any one accident, and for products liability in any
9

one accident.
The contractor shall furnish the Sponsor with such evidence of insurance, including insurance covering contractor’s contractual
liability hereunder, as the Sponsor may reasonably require.
E. Contractor shall indemnify Sponsor and the State against any loss or damage (including attorney’s fees and other costs of
litigation) caused by the contractor’s negligent acts or commission of contractor’s agents or employees.
Contractor expressly agrees to defend any suit against the Sponsor alleging personal injury, sickness, or disease arising out of
consumption or use of the merchandise sold, as well as any loss resulting from pilferage by contractor’s employees.
The Sponsor shall promptly notify the contractor and the State Agency in writing of any claims against either contractor or
Sponsor and, in the event of a suit being filed, shall promptly forward to the contractor and the State Agency all papers in
connection therewith. The Sponsor shall not incur any expense or make any settlement without contractor’s consent; providing
however, that if contractor refuses or neglects to defend any such suit, Sponsor may defend, adjust, or settle any such claim,
and the costs of such defense, including reasonable attorney’s fees, may be charged to the contractor’s account.
12. Indemnification
Contractor agrees to and does hereby assume all responsibility for and agrees to indemnify, save and hold harmless, and at the Park
District’s option, defend the Park District, its Commissioners, officers, employees, volunteers, and agents (collectively, the “Indemnitees”)
against any losses, claims, damages, liabilities, actions, suits, proceedings, costs or expenses that the Indemnitees may suffer, incur or
sustain or for which it or they may become liable (including, but not limited to, mechanic’s liens, personal or bodily injury to or death of
persons or loss or damage to property) resulting from, arising out of, or relating to any negligence or intentional misconduct in the
performance of the contractor under this Agreement. The obligation to indemnify the Park District shall survive the termination or
expiration of this Agreement.
13. Prevailing Wage
Each bidder, contractor, and subcontractor shall comply with all applicable prevailing wage requirements.
The contractor shall comply with 820ILCS 130/0.01 et seq., as it may be amended (the “Act”), so long as the Act is in effect, in order to
ensure that such persons covered by the Act are paid the prevailing wage rates as ascertained by the Illinois Department of Labor. All
such contracts shall list the specified rates to be paid to all those employed in the contract. If the Illinois Department of Labor revises
such prevailing wage rates, the revised rates shall apply to all such contracts.
As a condition of making payment to the contractor, the CPD may request that the contractor submit an affidavit or other evidence to the
effect that not less than the prevailing hourly wage rate is being paid to those employed on contracts, in accordance with Illinois law.
14. Non-Liability of Public Officials
Contractor and any assignee or sub-contractor of contractor must not charge any official, employee or agent of the Park District
personally with any liability or expenses of defense or hold any official, employee or agent of the Park District personally liable to them
under any term or provision of the Agreement or because of the Park District’s execution, attempted execution or any breach of the
Agreement.
15. Minority-and Women-Owned Business Enterprise Participation
The contractor shall comply with the Compliance Conditions of this contract, which governs minority- and women-owned business
enterprise programs (“MBE” and/or “WBE”), and requires the contractor compliance with the CPD’s goal of awarding not less than 25%
of the aggregate dollar value of all contracts to qualified MBEs and 5% to qualified WBEs. Chapter XI, Section F of the Code of the
Chicago Park District establishes the Minority- and Women-Owned Business Enterprise program. A copy of this ordinance is available
from the CPD, Department of Purchasing, 541 North Fairbanks Court, 3rd Floor, Chicago, Illinois 60611; (312) 742-5380.
During the term of the contract and any extension thereof, the contractor shall complete and submit quarterly MBE/WBE Utilization
Reports.
10

SECTION G
GENERAL PROVISIONS
1. This contract constitutes the entire agreement between the sponsor and contractor and may not be changed, extended orally, or
altered by course of conduct. No other contracts will be signed by the sponsor.
2. It is further agreed between the sponsor and contractor that the exhibits, attachments, and clauses attached and designated are
hereby in all respects made a part of this contract.
3. The contractor shall comply with Title VI of the Civil Rights Act of 1964, as amended; USDA regulations implementing Title IX of the
Education Amendments; Section 504 of the Rehabilitation Act of 1973; Age Discrimination Act of 1975; 7CFR Parts 15, 15a, and 15b;
and FNS Instruction 113-1, Civil Rights Compliance and Enforcement in the School Nutrition Programs; and any additions or
amendments.
4. If this contract is in excess of $100,000, the sponsor and contractor shall comply with all applicable standards, orders, and
regulations, including but not limited to:
A. The Clean Air Act (42 USC 1857[h]), the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Protection
Agency regulations (40 CFR 1.1);
B. Certification Regarding Lobbying pursuant to 31 USC 1352 (Appendix A: 7 CFR Part 3018); and
C. Disclosure of Lobbying Activities pursuant to 31 USC 1352 (Appendix A: 7 CFR Part 3018).
5. The contractor certifies compliance with:
A. Energy Policy and Conservation Act (OMB Circular A-102, Attachments O, paragraph 14.j);
B. The Department of Labor regulations (29 CFR Part 5); and
C. Executive Order 11246, entitled Equal Employment Opportunity, as amended by Executive Order 11375 and Department of
Labor Regulations (41 CFR Chapter 60).
11

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#1 Beginning Date
63 rd Street Beach 06/01/12
6300 S. Lake Shore Drive
Lunch__x ___ # ___35___ ___12:15_pm
PM Snk__x__ # ___35___
Chicago, IL 60649
____3:15_pm
Telephone: (312) 742-5121
Ending Date
8/31/12
#2 Beginning Date
Abbott (Robert) Park 06/01/12
49 E. 95 th Street
Lunch__x____ # __137___ ___12:30_pm
PM Snk__x___ # __136___
Chicago, IL 60628
____3:30_pm
Telephone: (312) 747-6001
Ending Date
8/31/12
#3 Beginning Date
Ada (Sawyer Garrett) Park Valentine Brown 06/01/12
11250 S. Ada St.
Lunch__x____ # ___191__ ___12:30_pm
PM Snk__x___ # ___190__
Chicago, IL 60643
____5:00_pm
Telephone:(312) 747-6002
Ending Date
8/31/12
#4 Beginning Date
Adams (George & Adele) Park Maureen Belling 06/01/12
1919 N. Seminary Ave.
Lunch__x____ # __126___
___12:00_pm
Chicago, IL 60614
Telephone:(312) 747-6136
Ending Date
8/31/12
#5 Beginning Date
Altgeld (John P.) Park Roy Ellis 06/01/12
515 S. Washtenaw Ave.
Lunch__x____ # ___66__ __12:30_pm
PM Snk_x____ # ____65__
Chicago, IL 60612
___3:30_pm__
Telephone:(312) 746-5001
Ending Date
8/31/12
12

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#6 Beginning Date
Alvin Ailey Dance @ Fuller 06/01/12
331 W. 45 th St.
Lunch__x____ # _81_____ ___11:30_am
PM Snk__x___ # _80_____
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6144
Ending Date
8/31/12
#7 Beginning Date
Amundsen (Ronald) Park Greg Mason 06/01/12
6200 W. Bloomingdale Ave.
Lunch__x____ # __101___ ___12:00_pm
PM Snk_x____ # __100___
Chicago, IL 60639
____3:00_pm
Telephone:(312) 746-5003
Ending Date
8/31/12
#8 Beginning Date
Anderson (Louis B.) Park Cheryl Smith 06/01/12
3748 S. Prairie Ave.
Lunch__x____ # __31_____ ___12:30_pm
PM Snk__x___ # __30____
Chicago, IL 60653
____3:00_pm
Telephone:(312) 747-6007
Ending Date
8/31/12
#9 Beginning Date
Archer (William) Park Juan Mendoza 06/01/12
4901 S. Kilbourn Ave.
Lunch__x____ # __181___ ____11:30 am
PM Snk_x____ # __180___
Chicago, IL 60632
____3:00_pm
Telephone:(773) 284-7029
Ending Date
8/31/12
#10 Beginning Date
Armour (Phillip) Square Park Mary Lou Scorza 06/01/12
3309 S. Shields
Lunch__x____ # ___181__
___12:15_pm
Chicago, IL 60616
Telephone:(312) 747-6012
Ending Date
8/31/12
13

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#11 Beginning Date
Athletic Field Park Adrian Loza 06/01/12
33546 W. Addison St.
Lunch__x____ # ____51__ ___11:30_am
PM Snk__x___ # ____26__
Chicago, IL 60618
____3:00_pm
Telephone:(773) 478-2889
Ending Date
8/31/12
#12 Beginning Date
Augusta (Carpenter) Park Leonard Langdon 06/01/12
4433 W. Augusta Blvd.
Lunch_x_____ # ___26___ ___12:30_pm
PM Snk__x__ # ___25___
Chicago, IL 60639
____3:30_pm
Telephone:(312) 742-7544
Ending Date
8/31/12
#13 Beginning Date
Austin Town Hall Park Bobby Starks 06/01/12
5610 W. Lake St.
Lunch_x_____ # ___101__ __12:30_pm
PM Snk_x____ # ___100__
Chicago, IL 60644
___3:30_pm
Telephone:(773) 287-7658
Ending Date
8/31/12
#14 Beginning Date
Avalon Park Pat McMillan 06/01/12
1215 E. 83 rd Street
Lunch___x___ # ___201__ ___12:00_pm
PM Snk___x__ # ___200__
Chicago, IL 60619
____3:00_pm
Telephone:(312) 747-6015
Ending Date
8/31/12
#15 Beginning Date
Avondale Park Tom Broderick 06/01/12
3516 W. School St.
Lunch__x____ # _70_____ ___11:00_am
PM Snk_x____ # _25_____
Chicago, IL 60618
____3:00_pm
Telephone:(773) 478-1410
Ending Date
8/31/12
14

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#16 Beginning Date
Bell (George) Park Kim Gapinski 06/01/12
3020 N. Oak Park Ave.
Lunch__x____ # __76____ ___11:30_am
PM Snk_x____ # __51____
Chicago, IL 60634
____2:30_pm
Telephone:(312) 746-5008
Ending Date
8/31/12
#17 Beginning Date
Berger (Albert E.) Park Deb Maddox 06/01/12
6205 N. Sheridan Rd.
Lunch__x____ # __120___ ___11:45_am
PM Snk__x___ # __121___
Chicago, IL 60660
____2:45_pm
Telephone:(773) 761-0376
Ending Date
8/31/12
#18 Beginning Date
Bessemer Park Lydia Vega 06/01/12
8930 S. Muskegon Ave.
Lunch__x____ # _136____ ___11:30_am
PM Snk__x___ # __125___
Chicago, IL 60617
____3:00_pm
Telephone:(312) 747-6023
Ending Date
8/31/12
#19 Beginning Date
Beverly Park Sue Kukulski 06/01/12
2460 W. 102 nd St.
Lunch__x____ # _41_____ ___12:00_pm
PM Snk__x___ # _30_____
Chicago, IL 60655
____3:00_pm
Telephone:(312) 747-6024
Ending Date
8/31/12
#20 Beginning Date
Blackhawk Park Tom Versen 06/01/12
2318 N. Lavergne Ave.
Lunch__x____ # ___101__ ___12:00_pm
PM Snk_x____ # ____40__
Chicago, IL 60639
____4:30_pm
Telephone:(312) 746-5014
Ending Date
8/31/12
15

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#21 Beginning Date
Bogan Park Nancy Carrig 06/01/12
3939 W. 79 th St.
Lunch__x____ # ___76___
__12:00_pm
Chicago, IL 60652
Telephone:(773) 284-6456
Ending Date
8/31/12
#22 Beginning Date
Bosley Park 06/01/12
3044 S. Bonfield
Lunch__x____ # __16____ ___12:00_pm
PM Snk__x___ # __15____
Chicago, IL 60608
____4:00_pm
Telephone:(312) 747-6026
Ending Date
8/31/12
#23 Beginning Date
Bradley Park Cheryl Ali 06/01/12
9729 S. Yates Ave.
Lunch__x____ # __58____ ___12:00_pm
PM Snk__x___ # __56____
Chicago, IL 60617
____4:00_pm
Telephone:(312) 747-6022
Ending Date
8/31/12
#24 Beginning Date
Brainerd Park Sabrina Steward 06/01/12
1246 W. 92 nd St.
Lunch__x____ # __131___ ___12:00_pm
PM Snk__x___ # __130___
Chicago, IL 60620
____3:00_pm
Telephone:(312) 747-6027
Ending Date
8/31/12
#25 Beginning Date
Brands Park Teresa Woolridge 06/01/12
3259 N. Elston Ave.
Lunch__x____ # ___101__ ___12:00_pm
PM Snk_x____ # _____50_
Chicago, IL 60618
____3:30_pm
Telephone:(773) 478-2414
Ending Date
8/31/12
16

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#26 Beginning Date
Broadway Armory Park Nick Bojko 06/01/12
5917 N. Broadway
Lunch__x____ # __91____ __11:30_am
PM Snk_x____ # __31____
Chicago, IL 60660
___2:30_pm
Telephone:(312) 742-7502
Ending Date
8/31/12
#27 Brkfst___x___ # ___50___ ___8:30_am Beginning Date
Claumet Park Beverly Kress 06/01/12
9801 S. Avenue G
Lunch__x____ # ___166__
___12:00_pm
Chicago, IL 60617
Telephone:(312) 747-6039
Ending Date
8/31/12
#28 Beginning Date
Carver Park 06/01/12
939 E. 132 nd St.
Lunch___x___ # __201___ ___12:00_pm
PM Snk___x__ # ___200__
Chicago, IL 60627
____3:30_pm
Telephone:(312 ) 742-6047
Ending Date
8/31/12
#29 Beginning Date
Chase Camp Katie Fearon-Peon 06/01/12
4701 N. Ashland Ave.
Lunch__x____ # __221___ ___12:00_pm
PM Snk_x____ # __220____
Chicago, IL 60640
____3:30_pm
Telephone:(312) 742-7518
Ending Date
8/31/12
#30 Brkfst__x____ # __50____ ___9:20_pm Beginning Date
Chicago Women Park – South Loop 06/01/12
1801 S. Indiana
PM Snk__x___ # __60____
____2:15_pm
Chicago, IL 60616
Telephone:(312 ) 328-0821
Ending Date
8/31/12
17

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#31 Beginning Date
Chippewa Park Amy Carter 06/01/12
6748 N. Sacramento Ave.
Lunch__x____ # __111___ ___11:45_am
PM Snk_x____ # ___110__
Chicago, IL 60645
____2:45_pm
Telephone:(773) 761-0380
Ending Date
8/31/12
#32 Beginning Date
Chopin (Frederic Francois) Park Mike Mucci 06/01/12
3420 N. Long Ave.
Chicago, IL 60641
Lunch__x____ # __141___ 11:45 am_ Ending Date
Telephone:(773) 685-3247
8/31/12
#33 Beginning Date
Clarendon Community Center Michael Brown 06/01/12
4501 N. Clarendon Ave.
Lunch__x____ # ___101__ ___12:00_pm
PM Snk_x____ # ____80__
Chicago, IL 60640
____3:10_pm
Telephone:(312) 742-7512
Ending Date
8/31/12
#34 Beginning Date
Clark (John S.) Park Gary Taylor 06/01/12
4615 W. Jackson Blvd.
Lunch__x____ # __36____ ___12:00_pm
PM Snk_x____ # __35____
Chicago, IL 60644
____3:15_pm
Telephone:(773) 287-7794
Ending Date
8/31/12
#35 Beginning Date
Cole (Nat King) Park Gene Morgan 06/01/12
361 E. 85 th St.
Lunch___x___ # ___26___ ___12:45_pm
PM Snk___x__ # ___100__
Chicago, IL 60619
____3:45_pm
Telephone:(312) 747-6063
Ending Date
8/31/12
18

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#36 Beginning Date
Columbus (Christopher) Park Jeanette Stovall 06/01/12
500 S. Central Ave.
Lunch_x_____ # __131___ __12:00_pm
PM Snk_x____ # __130___
Chicago, IL 60644
____3:30_pm
Telephone:(773) 287-7641
Ending Date
8/31/12
#37 Beginning Date
Commercial Club Playground Kathy Hamada 06/01/12
1845 W. Rice St.
Lunch__x____ # _81_____ ___12:00_pm
PM Snk_x____ # _80_____
Chicago, IL 60622
____3:00_pm
Telephone:(312) 742-7558
Ending Date
8/31/12
#38 Beginning Date
Cooper Park Marlon Smith 06/01/12
11712 S. Ada St.
Lunch___x___ # ___101__ ___12:15_pm
PM Snk__x___ # ___100__
Chicago, IL 60643
____3:15_pm
Telephone:(312) 747-6096
Ending Date
8/31/12
#39 Beginning Date
Cornell Square Louis Alvarado 06/01/12
1809 W. 50 th St.
Lunch__x____ # _81_____ ___12:00_pm
PM Snk_x____ # _80_____
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6097
Ending Date
8/31/12
#40 Beginning Date
Cragin Park Mark Naumiec 06/01/12
2611 N. Lockwood Ave.
Lunch__x____ # ____46__
___12:15_pm
Chicago, IL 60639
Telephone:(312) 746-5065
Ending Date
8/31/12
19

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#41 Beginning Date
Curie (Marie) Park Bobby Starks 06/01/12
4949 S. Archer Ave.
Lunch_x_____ # __121___ ___12:00_pm
PM Snk_x____ # __100___
Chicago, IL 60639
____3:00_pm
Telephone:(773) 284-7124
Ending Date
8/31/12
#42 Beginning Date
Dawes Park Sam Harris 06/01/12
8040 S. Damen Ave.
Lunch__x____ # __61____ ___12:30_pm
PM Snk__x___ # __60____
Chicago, IL 60620
____3:30_pm
Telephone:(312) 747-6108
Ending Date
8/31/12
#43 Beginning Date
Donovan Park Michelle Drez 06/01/12
3620 S. Lituanica
Lunch___x___ # __41____ ___10:45_am
PM Snk__x___ # __40____
Chicago, IL 60609
____2:15_pm
Telephone:(312) 747-6111
Ending Date
8/31/12
#44 Beginning Date
Dooley Park Max Kobrinetz 06/01/12
3402 W. 77 th St.
Lunch___x___ # __41____ ___12:00_pm
PM Snk__x___ # __40____
Chicago, IL 60652
____3:30_pm
Telephone:(312) 745-1412
Ending Date
8/31/12
#45 Beginning Date
Douglas (Stephen A.) Park Angela Salis 06/01/12
1401 S. Sacramento Ave.
Lunch_x_____ # __101___ __12:30_pm
PM Snk_x____ # __100___
Chicago, IL 60623
____3:00_pm
Telephone:(773) 762-2842
Ending Date
8/31/12
20

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#46 Beginning Date
Dunham (Robert J.) Dan White 06/01/12
4638 N. Melvina Ave.
Lunch___x___ # ___181__ _12:00 pm_
PM Snk__x___ # ___120__
Chicago, IL 60630
_3:00 pm_
Telephone:(773) 685-3257
21
Ending Date
8/31/12
#47 Beginning Date
Durkin Park Paul Veloitis 06/01/12
8445 S. Kolin Ave.
Lunch__x____ # __101___ ___12:00_pm
PM Snk__x___ # ___100__
Chicago, IL 60652
____3:00_pm
Telephone:(773) 284-731
Ending Date
8/31/12
#48 Beginning Date
Dvorak (Anton) Park Tony Segara 06/01/12
1119 W. Cullerton St.
Lunch__x____ # __141___ ___12:30_pm
PM Snk__x___ # ___140__
Chicago, IL 60608
____3:30_pm
Telephone:(312) 746-5083
Ending Date
8/31/12
#49 Beginning Date
Eckhart (Bernard A.) Park John Borek 06/01/12
1330 W. Chicago Ave.
Lunch__x____ # ___151__ ___12:00_pm
PM Snk_x____ # ___150__
Chicago, IL 60622
____3:30_pm
Telephone:(312) 746-5490
Ending Date
8/31/12
#50 Beginning Date
Archer (William) Park
4901 S. Kilbourn Ave.
Chicago, IL 60632
Juan Mendoza
Telephone: (773) 284-7029
06/01/12
Ending Date
PM Snk x__ # ___60__ ____5:00_pm 8/31/12

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#51 Beginning Date
Emmerson (Louis L.) Park Moseth Sample 06/01/12
1820 W. Granville Ave.
Lunch__x____ # __31____ ___12:00_pm
PM Snk_x____ # _30_____
Chicago, IL 60660
____3:00_pm
Telephone:(773) 761-0433
Ending Date
8/31/12
#52 Beginning Date
Euclid Park Clarissa Ford 06/01/12
9800 S. Parnell Ave.
Lunch__x____ # ___56____ ___12:30_pm
PM Snk__x___ # ___55___
Chicago, IL 60628
____3:30_pm
Telephone:(312) 747-6124
Ending Date
8/31/12
#53 Beginning Date
Eugene Field Park Tracy Brumley 06/01/12
5100 N. Ridgeway Ave.
Lunch__x____ # __86____ ___11:15_am
PM Snk_x___ # __85____
Chicago, IL 60625
____2:45_pm
Telephone:(773) 478-9744
Ending Date
8/31/12
#54 Beginning Date
Fernwood Park Corinthia Davis-John 06/01/12
10436 S. Wallace St.
Lunch__x____ # __226___ ___12:00_pm
PM Snk__x___ # __225___
Chicago, IL 60628
____3:00_pm
Telephone:(312) 747-6132
Ending Date
8/31/12
#55 Beginning Date
Fosco (Peter) Park Jackie Guthrie 06/01/12
1313 S. Throop St.
Lunch__x____ # __201___ ___12:00_pm
PM Snk_x____ # __200____
Chicago, IL 60608
____3:00_pm
Telephone:(312) 746-5086
Ending Date
8/31/12
22

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#56 Beginning Date
Foster Park Anita Gueringer 06/01/12
1440 W. 84 th St.
Lunch__x____ # __251___ ___12:00_pm
PM Snk__x___ # __250___
Chicago, IL 60620
____3:00_pm
Telephone:(312) 747-6135
Ending Date
8/31/12
#57 Beginning Date
Franklin (Benjamin) Park Robert Bisbee 06/01/12
4320 W. 15 St.
Lunch__x____ # __101___ ___12:30_pm
PM Snk_x____ # __100___
Chicago, IL 60623
____3:30_pm
Telephone:(312) 747-7676
Ending Date
8/31/12
#58 Beginning Date
Fuller (Melville) Park Michael Brown 06/01/12
331 W. 45 th St.
Lunch__x____ # __81____ ___12:00_pm
PM Snk__x___ # __80____
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6144
Ending Date
8/31/12
#59 Beginning Date
Gage Park Alex Zamora 06/01/12
2411 W. 55 th St.
Lunch___x___ # ___122__ ___12:30_pm
PM Snk__x___ # _150___
Chicago, IL 60629
____3:00_pm
Telephone:(312) 747-6147
Ending Date
8/31/12
#60 Beginning Date
Galewood Park Monique Young-Johnson 06/01/12
5729 W. Bloomingdale Ave.
Lunch__x____ # __71____ ___11:00_am
PM Snk_x____ # __70____
Chicago, IL 60639
____2:00_pm
Telephone:(312) 746-5089
Ending Date
8/31/12
23

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#61 Beginning Date
Garfield (James A.) Park Jim Hobson 06/01/12
100 N. Central Park Ave.
Lunch__x____ # ___156__ __11:00_am
PM Snk__x___ # ___155__
Chicago, IL 60624
____3:00_pm
Telephone:(312) 746-5092
Ending Date
8/31/12
#62 Beginning Date
Gately Park Anita Whiteside 06/01/12
810 E. 103 rd St.
Lunch__x____ # __101___ ___11:00_am
PM Snk__x___ # ___100__
Chicago, IL 60628
____3:00_pm
Telephone:(312) 747-6155
Ending Date
8/31/12
#63 Beginning Date
Gill (Joseph L.) Park Bob Geraghty 06/01/12
825 W. Sheridan Rd.
Lunch__x____ # __101___ ___12:00_pm
PM Snk_x____ # ___40___
Chicago, IL 60613
____3:30_pm
Telephone:(312) 742-7802
Ending Date
8/31/12
#64 Beginning Date
Girls in the Game (Union Park) Tony Fitzgerald 06/01/12
1501 W. Randolph St.
Lunch__x____ # __121___
____12:00_pm
Chicago, IL 60607
Telephone:(312) 746-5494
Ending Date
8/31/12
#65 Beginning Date
Harrison (Carter) Park ____9:00_am 06/01/12
1824 S. Wood St.
Tony Gonzales Bkfst__x____ # __20___
Chicago, IL 60608
Telephone: (312) 746-5491
Ending Date
8/31/12
24

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#66 Beginning Date
Gompers (Samuel) Park Denise Raymond 06/01/12
4222 W. Foster Ave.
Lunch__x____ # __241___ ___12:00_pm
PM Snk_x____ # __240___
Chicago, IL 60630
____3:00_pm
Telephone:(773) 631-7859
Ending Date
8/31/12
#67 Beginning Date
Grand Crossing Park Marques Buford 06/01/12
7655 S. Ingleside Ave.
Lunch__x____ # __101___ ___12:00_pm
PM Snk_x____ # ___100__
Chicago, IL 60619
____3:00_pm
Telephone:(312) 747-6158
Ending Date
8/31/12
#68 Beginning Date
Graver Park Laura Casey 06/01/12
1518 W. 102 nd Pl.
Lunch__x____ # __121___ ___12:00_pm
PM Snk__x___ # __120___
Chicago, IL 60643
____3:00_pm
Telephone:(312) 747-6163
Ending Date
8/31/12
#69 Beginning Date
Green Briar Park Tim Gibson 06/01/12
2650 W. Peterson
Lunch__x____ # _66_____ __11:50_am
PM Snk_x ___ # _65_____
Chicago, IL 60659
___3:30_pm
Telephone:(773) 761-0582
Ending Date
8/31/12
#70 Beginning Date
Haines School Park Precious Morgan 8/31/12
247 W. 23 rd St.
Lunch__x____ # ___81___ ____11:00_am
PM Snk__x___ # ___100___
Chicago, IL 60616
____3:30_pm
Telephone:(312) 742-0291
Ending Date
8/31/12
25

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#71 Beginning Date
Hale Park Rose Minelli 06/01/12
6258 W. 62 nd St.
Lunch__x____ # __301___ ___12:30_pm
PM Snk_x____ # ___300__
Chicago, IL 60638
____3:30_pm
Telephone:(773) 229-1032
Ending Date
8/31/12
#72 Beginning Date
Hamilton Park Sandra Thomas 06/01/12
513 W. 72 nd St.
Lunch__x____ # __122___ ___12:15_pm
PM Snk__x__ # __120___
Chicago, IL 60621
____3:30_pm
Telephone:(312) 747-6174
Ending Date
8/31/12
#73 Beginning Date
Hamilin (Hannibal) Park Kara Donaldson 06/01/12
3035 N. Hoyne Ave.
Lunch__x____ # _161____
___12:30_pm
Chicago, IL 60618
Telephone:(312) 742-7785
Ending Date
8/31/12
#74 Beginning Date
Harris (Harriet M.) Recreation Center Gerald Washington 06/01/12
6200 S. Drexel Ave.
Lunch__x____ # _111____ __12:30_pm
PM Snk__x___ # _110____
Chicago, IL 60637
___3:30_pm
Telephone:(312) 747-2706
Ending Date
8/31/12
#75 Beginning Date
Harrison (Carter H.) Park Tony Gonzalez 06/01/12
1824 S. Wood St.
Lunch__x____ # __201___ ___12:00_pm
PM Snk__x___ # ___60___
Chicago, IL 60608
____4:00_pm
Telephone:(312) 746-5491
Ending Date
8/31/12
26

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#76 Beginning Date
Hayes Park Ryan Morris 06/01/12
2936 W. 85 th St.
Lunch__x____ # __251___ ___12:00_pm
PM Snk__x___ # __250___
Chicago, IL 60652
____3:00_pm
Telephone:(312) 747-6177
Ending Date
8/31/12
#77 Beginning Date
Hermitage Park Romero Norwood 06/01/12
5839 S. Wood St.
Lunch__x____ # __26____ ___12:00_pm
PM Snk__x___ # ____25__
Chicago, IL 60636
____3:00_pm
Telephone:(312) 747-6179
Ending Date
8/31/12
#78 Beginning Date
Hermosa Park Melody Mitchell 06/01/12
2240 N. Kilbourn Ave.
Lunch__x____ # __76____ ___12:30_pm
PM Snk_x____ # __50____
Chicago, IL 60634
____3:30_pm
Telephone:(312) 742-7540
Ending Date
8/31/12
#79 Beginning Date
Hiawatha Park Larry Krawetz 06/01/12
8029 W. Forest Preserve Dr.
Lunch__x____ # __241___ ___11:30_am
PM Snk_x____ # __180___
Chicago, IL 60659
____2:30_pm
Telephone:(312) 746-5559
Ending Date
8/31/12
#80 Beginning Date
Hollywood Park 06/01/12
3312 W. Thorndale Ave.
Lunch__x____ # __61____ ___11:30_am
PM Snk_x____ # __60____
Chicago, IL 60647
____2:30_pm
Telephone:(773) 478-3482
Ending Date
8/31/12
27

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#81 Beginning Date
Holstein Park Shannon English 06/01/12
2200 N. Oakley Ave.
Lunch_x_____ # __201___ __11:45_am
PM Snk__x___ # __180___
Chicago, IL 60624
___2:45_pm
Telephone:(312) 742-7554
Ending Date
8/31/12
#82 Beginning Date
Homan Square Park 06/01/12
3559 W. Arthington St.
Park, Cultural Camp,
Lunch__x____ # __201___ ___11:15_am
PM Snk_x____ # __200___
Chicago, IL 60612
TR Camp
____4:00_pm
Telephone:(312) 746-6650
Ending Date
8/31/12
#83 Beginning Date
Mirrimac Park 06/01/12
6363 W. Irving Park Rd.
Donna Segreti Lunch__x____ # __141___
___12:00_pm
Chicago, IL 60634
Telephone: (773) 685-3382
Ending Date
8/31/12
#84 Beginning Date
Horner (Henry) Park Tom McManamon 06/01/12
2741 W. Montrose Ave.
Lunch__x____ # __181___ ___11:30_am
PM Snk_x____ # __200___
Chicago, IL 60608
____2:30_pm
Telephone:(773) 478-3449
Ending Date
8/31/12
#85 Beginning Date
Humboldt (Baron Von) Park Nereida Aviles 06/01/12
1440 N. Sacramento Ave.
Lunch_x_____ # ___181__ ___12:00_pm
PM Snk__x___ # ___180__
Chicago, IL 60618
____3:30_pm
Telephone:(312) 742-7549
Ending Date
8/31/12
28

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#86 Beginning Date
Independence Park Eileen Sweeney 06/01/12
3945 N. Springfield Ave.
Lunch__x_____ # __201___ ___11:30_am
PM Snk__x___ # ___40___
Chicago, IL 60645
___3:30_pm
Telephone:(773) 478-3538
Ending Date
8/31/12
#87 Beginning Date
Indian Boundary Park Phil Martini 06/01/12
2500 W. Lunt Ave.
Lunch__x____ # __116___ ___11:30_am
PM Snk_x___ # ___115__
Chicago, IL 60646
____2:30_pm
Telephone:(773) 764-0338
Ending Date
8/31/12
#88 Beginning Date
Indian Road Park Mary Faith Flahive 06/01/12
6010 W. Matson Ave.
Lunch__x____ # __120___
___12:00_pm
Chicago, IL 60643
Telephone:(773) 631-3761
Ending Date
8/31/12
#89 Beginning Date
Jackie Robinson Park Surain Stephens 06/01/12
10540 S. Morgan St.
Lunch_______ # ___51___ ___12:00_pm
PM Snk_x____ # __50___
Chicago, IL 60620
__3:00 pm_
Telephone:(312) 745-4041
Ending Date
8/31/12
#90 Beginning Date
Jackson Park William Tillis 06/01/12
6401 S. Stony Island Ave.
Lunch__x____ # ___276__ ___12:00_pm
PM Snk__x___ # ___275__
Chicago, IL 60630
____3:00_pm
Telephone:(773) 256-0903
Ending Date
8/31/12
29

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#91 Beginning Date
Jefferson (Thomas) Memorial Park Andrea Woppel 06/01/12
4822 N. Long Ave.
Lunch__x____ # _251____ __11_:30_am
PM Snk_x____ # _250____
Chicago, IL 60651
___2_:30_pm
Telephone:(773) 685-3316
Ending Date
8/31/12
#92 Beginning Date
Kedvale Park 06/01/12
4134 W. Hirsch
Lunch__x____ # _21_____ ___12:00_pm
PM Snk__x___ # _20_____
Chicago, IL 60632
____3:00_pm
Telephone:(312) 742-7543
Ending Date
8/31/12
#93 Beginning Date
Kelly (Edward J.) Park Craig Bandyk 06/01/12
2725 W. 41 st St.
Lunch__x____ # __61____ ___12:00_pm
PM Snk_x____ # __60____
Chicago, IL 60639
____3:15_pm
Telephone:(312) 747-6197
Ending Date
8/31/12
#94 Beginning Date
Kelvyn (William) Park Gonzalo Reyes 06/01/12
4438 W. Wrightwood Ave.
Lunch__x____ # _126____ __11:30_am
PM Snk_x____ # _100____
Chicago, IL 60655
____2:30_pm
Telephone:(312) 742-7547
Ending Date
8/31/12
#95 Beginning Date
Kennicott (Jonathan A.) Park Renee Shepherd 06/01/12
4434 S. Lake Park Ave.
Lunch_x_____ # __176___ ___12:00_pm
PM Snk_x____ # __170___
Chicago, IL 60653
____3:00_pm
Telephone:(312) 747-7138
Ending Date
8/31/12
30

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#96 Beginning Date
Revere (Paul) Park 06/01/12
2509 W. Irving Park Rd.
Greg Czajkowski PM Snk__x____ # __26____
___11:00_am
Chicago, IL 60618
Telephone: (773) 478-1220
Ending Date
8/31/12
#97 Beginning Date
Ken-Well Park Delonese Robinson 06/01/12
2945 N. Kenosha Ave.
Lunch__x____ # __41____ ___12:00_pm
PM Snk_x____ # __20____
Chicago, IL 60641
____3:00_pm
Telephone:(773) 685-3348
Ending Date
8/31/12
#98 Beginning Date
Kenwood Community Park Tony McCoy 06/01/12
1330 E. 50 th St.
Lunch__x____ # __61____ ___12:00_pm
PM Snk_x____ # __60____
Chicago, IL 60615
____3:30_pm
Telephone:(312) 747-6286
Ending Date
8/31/12
#99 Beginning Date
Kilbourn Park Julie Thompson 06/01/12
3501 N. Kilbourn Ave.
Lunch_x_____ # ____176_ ___11:30_am
PM Snk_x____ # _____20
Chicago, IL 60641
____3:15_pm
Telephone:(773) 685-3351
Ending Date
8/31/12
#100 Beginning Date
Kosciuszko (Thadeuz) Park Rebecca Tirado 06/01/12
2732 N. Avers Ave.
Lunch__x____ # __191___ __12:00_pm
PM Snk_x____ # __190___
Chicago, IL 60647
___3:45_pm
Telephone:(312) 742-7546
Ending Date
8/31/12
31

Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Beginning Date
Dates of
Program
(mm/dd/yy)
#101
LaFollette (Robert M.) Park Steve Collins 06/01/12
1333 N. Laramie Ave.
Lunch__x____ # ___111__ ___12:00_pm
PM Snk__x___ # ___110__
Chicago, IL 60651
____3:00_pm
Telephone:(773) 287-0541
Ending Date
8/31/12
#102 Beginning Date
Lake Meadows Park Sherri Overton 06/01/12
3117 S. Rhodes Ave.
Lunch___x___ # __111___ ____12:00_pm
PM Snk_x____ # __110___
Chicago, IL 60616
____3:00_pm
Telephone:(312) 747-6287
Ending Date
8/31/12
#103 Brkfst___x___ # __90___ ___9:00_am Beginning Date
Lake Shore Park Leticia Tremaine 06/01/12
808 N. Lake Shore Dr.
Lunch__x____ # ___101__ ___12:00_pm
PM Snk_x____ # ____100_
Chicago, IL 60611
____3:00_pm
Telephone:(312) 742-7891
Ending Date
8/31/12
#104 Beginning Date
Lawler Park Nancy Kohn 06/01/12
5210 W. 64 th St.
Lunch__x____ # ___41___ ___12:00_pm
PM Snk__x___ # ___40___
Chicago, IL 60638
____3:30_pm
Telephone:(773) 284-7328
Ending Date
8/31/12
#105 Beginning Date
Le Claire Hearst (Antoine, Phoebe) Joe Laws 06/01/12
Community Center
Lunch__x____ # _61_____
5120 W. 44 th PM Snk__x___ # _60_____ __12:00_pm
Street
____3:30_pm
Chicago, IL 60638
8/31/12
Telephone:(312) 747-6438
Ending Date
32

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#106 Beginning Date
Lincoln Park Cultrual Center Cindi Jahraus 06/01/12
2045 N. Lincoln Park West
Lunch__x____ # _161____ ___12:00_pm
PM Snk_x____ # __160___
Chicago, IL 60614
____3:00_pm
Telephone:(312) 742-7226
Ending Date
8/31/12
#107 Beginning Date
Lindblom Park Tim White 06/01/12
6054 S. Damen Ave.
Lunch__x__ # __151___ ___11:00_am
PM Snk_x__ # __150___
Chicago, IL 60636
____4:00_pm
Telephone:(312) 747-6443
Ending Date
8/31/12
#108 Beginning Date
Lowe Park 06/01/12
5203 S. Lowe Ave.
Lunch__x____ # __51____ ___12:00_pm
PM Snk__x__ # __50____
Chicago, IL 60609
____3:30_pm
Telephone:(312) 747-6445
Ending Date
8/31/12
#109 Beginning Date
Loyola Park Mary Faith Hopkins 06/01/12
1230 W. Greenleaf Ave.
Lunch__x____ # __306___ __11:30_am
PM Snk__x___ # __275___
Chicago, IL 60626
____2:45_pm
Telephone:(773) 262-8605
Ending Date
8/31/12
#110 Beginning Date
Madden Ellis 06/01/12
535 W. 35 th St.
Lunch__x____ # ___61___ ___12:00_pm
PM Snk__x___ # ___60___
Chicago, IL 60653
____3:00_pm
Telephone:(312) 747-6446
Ending Date
8/31/12
33

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#111 Beginning Date
Mahalia Jackson 06/01/12
8407 S. Kerfoot
Lunch__x____ # __61____ ___12:00_pm
PM Snk__x___ # __60____
Chicago, IL 60620
____3:00_pm
Telephone:(312 ) 747-6154
Ending Date
8/31/12
#112 Beginning Date
Mann Park Pat McGuire 06/01/12
13000 S. Carondolet Ave.
Lunch__x____ # __151___ ___12:15_pm
PM Snk__x___ # __150___
Chicago, IL 60633
____3:15_pm
Telephone:(773) 646-0210
Ending Date
8/31/12
#113 Beginning Date
Margate Fieldhouse Jennifer Bice 06/01/12
4921 N. Marine Dr.
Lunch__x____ # ___161__ ___12:00_pm
PM Snk_x____ # ___130__
Chicago, IL 60640
____3:30_pm
Telephone:(312) 742-7522
Ending Date
8/31/12
#114 Beginning Date
Marquette Park Doug Borders 06/01/12
6734 S. Kedzie Ave.
Lunch___x___ # __206___
___12:00_pm
Chicago, IL 60629
Telephone:(312) 747-6469
Ending Date
8/31/12
#115 Beginning Date
Mayfair Park Maria McDorman 06/01/12
4550 W. Sunnyside Ave.
Lunch___x___ # ____91__ ___12:00_pm
PM Snk__x___ # _____90_
Chicago, IL 60630
____3:00_pm
Telephone:(773) 685-3361
Ending Date
8/31/12
34

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#116 Beginning Date
McFetridge Dave Schneider 06/01/12
3843 N. California Ave.
Lunch__x____ # __31____ ___1:00_pm
PM Snk__x___ # __30____
Chicago, IL 60618
____4:00_pm
Telephone:(773) 478-2609
Ending Date
8/31/12
#117 Beginning Date
McGuane (John F.) Park Kal Moy 06/01/12
2901 S. Poplar Ave.
Lunch__x____ # __201___ ____12:00_pm
PM Snk__x___ # ___45___
Chicago, IL 60608
____4:15_pm
Telephone:(312) 747-6497
Ending Date
8/31/12
#118 Beginning Date
McKiernan Sara Bush 06/01/12
10714 S. Sawyer
PM Snk_x____ # _85_____
____2:30_pm
Chicago, IL 60655
Telephone:(312) 747-2883
Ending Date
8/31/12
#119 Brkfst__x____ # __30____ ____9:00_am Beginning Date
McKinley (William) Park Vito Mastrandrea 06/01/12
2210 W. Pershing Rd.
Lunch__x____ # ___251__
___12:40_pm
Chicago, IL 60609
Telephone:(312) 747-6527
Ending Date
8/31/12
#120 Beginning Date
Merrimac Park Donna Segreti 06/01/12
6343 W. Irving Park Rd.
Day Camp, Play Camp Lunch__x____ # __61___ __12:00_pm
PM Snk_x____ # __140___
Chicago, IL 60634
____3:00_pm
Telephone:(773) 685-3382
Ending Date
8/31/12
35

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#121 Beginning Date
Meyering Park Solomon Smith 06/01/12
7140 S. King Dr.
Lunch__x____ # _62_____ ____11:00_am
PM Snk__x___ # _60_____
Chicago, IL 60619
____3:00_pm
Ending Date
8/31/12
#122 Beginning Date
Minuteman Park Jenny Garcia 06/01/12
5940 S. Central Ave.
Lunch__x____ # __81____ ___12:00_pm
PM Snk__x__ # __80____
Chicago, IL 60638
____3:30_pm
Telephone:(773) 284-0214
Ending Date
8/31/12
#123 Beginning Date
Moore (Maurice T.) Park Cheryl Bullock 06/01/12
5085 W. Adams St.
Lunch__x____ # ___31___ ___12:00_pm
PM Snk__x___ # ___30___
Chicago, IL 60644
____3:00_pm
Telephone:(773) 287-0561
Ending Date
8/31/12
#124 Beginning Date
Moran Park 06/01/12
5727 S. Racine Ave.
Lunch__x____ # __26____ ___12:00_pm
PM Snk__x___ # __26____
Chicago, IL 60636
____3:45_pm
Telephone:(312) 747-6560
Ending Date
8/31/12
#125 Beginning Date
Mozart (Amadeus) Park Jesus Perez 06/01/12
2036 N. Avers St.
Lunch__x____ # __101___ ___12:00_pm
PM Snk_x____ # __100___
Chicago, IL 60647
____3:00_pm
Telephone:(312) 747-6560
Ending Date
8/31/12
36

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#126 Beginning Date
Mt. Greenwood Park John Foran 06/01/12
3721 W. 111 th St.
PM Snk_x____ # __220___
___2:30_pm
Chicago, IL 60655
Telephone:(312) 747-6564
Ending Date
8/31/12
#127 Beginning Date
Murray Park Tim Greer 06/01/12
1743 W. 73 rd St.
Lunch__x____ # ___32___ ___12:00_pm
PM Snk__x___ # ___30___
Chicago, IL 60636
____3:00_pm
Telephone:(312) 747-6562
Ending Date
8/31/12
#128 Beginning Date
Nash (Don) Community Center Rochelle Portee-White 06/01/12
1833 E. 53 rd St.
Lunch___x___ # __111___ ___11:00_am
PM Snk__x___ # __110___
Chicago, IL 60649
____3:30_pm
Telephone:(773) 256-0904
Ending Date
8/31/12
#129 Beginning Date
NTA Farah Tunks 06/01/12
55 W. Cermak Rd.
Lunch__x____ # __81____ ___12:00_pm
PM Snk_x____ # __80____
Chicago, IL 60616
____3:00_pm
Telephone:(312) 747-1615
Ending Date
8/31/12
#130 Beginning Date
Nichols Park Heather Kelly 06/01/12
1655 E. 53 rd St.
Lunch__x____ # __141___ ___12:00_pm
PM Snk__x___ # __140___
Chicago, IL 60615
____3:30_pm
Telephone:(312) 747-2703
Ending Date
8/31/12
37

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#131 Beginning Date
Normandy Park Kathy Murray 06/01/12
6660 W. 52 nd St.
Lunch___x___ # ___201__ ___12:00_pm
PM Snk__x___ # ___125__
Chicago, IL 60638
____3:00_pm
Telephone:(773) 229-1421
Ending Date
8/31/12
#132 Beginning Date
Norwood Park Jennifer Fitzgerald 06/01/12
5801 N. Natoma Ave.
Chicago, IL 60631
Telephone:(773) 631-4893
Ending Date
Lunch__x____ # __31____ ___11:00_am 8/31/12
#133 Beginning Date
O’Hallaren Park Terry Jones 06/01/12
8335 S. Honore St.
Lunch__x____ # __43____ ___12:00_pm
PM Snk__x___ # __42____
Chicago, IL 60620
____3:00_pm
Telephone:(312) 747-6573
Ending Date
8/31/12
#134 Brkfst__x____ # ___50___ ___9:00_am Beginning Date
Oakdale Park Quedell Paramore 06/01/12
965 W. 95 th St.
Lunch__x____ # ___91___
_12:00_pm
Chicago, IL 60643
Telephone:(312) 747-6569
Ending Date
8/31/12
#135 Beginning Date
Ogden Park Ron Wright 06/01/12
6500 S. Racine Ave.
Lunch__x____ # ___201__ ____12:00_pm
PM Snk_x___ # ___200__
Chicago, IL 60636
____3:00_pm
Telephone:(312) 747-6572
Ending Date
8/31/12
38

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#136 Beginning Date
Olympia Park Debbie Groh 06/01/12
6566 N. Avondale Ave.
PM Snk_x____ # ___160__
__3:30_pm
Chicago, IL 60631
Telephone:(773) 631-6861
Ending Date
8/31/12
#137 Beginning Date
Oriole Park Frank Clark 06/01/12
5430 N. Olcott Ave.
Lunch__x____ # _161____ ___11:30 am_
PM Snk__x___ # ___30___
Chicago, IL 60656
____2:30 pm_
Telephone:(773) 631-6197
Ending Date
8/31/12
#138 Beginning Date
Owens (Jesse) Park Jetaune Guyton 06/01/12
2032 E. 88 th St.
Lunch__x____ # ___151__ ___11:30_am
PM Snk__x___ # ____150_
Chicago, IL 60617
____2:30_pm
Telephone:(312) 747-6709
Ending Date
8/31/12
#139 Beginning Date
Wicker (Charles) Park John Davidson 06/01/12
1425 N. Damen Ave.
PM Snk__x___ # ____120_
____3:00_pm
Chicago, IL 60622
Telephone: (312) 742-7553
Ending Date
8/31/12
#140 Beginning Date
Palmer Park Dina Rutledge 06/01/12
201 E. 111 th St.
Lunch__x____ # ____251_ ____1:00_pm
PM Snk__x___ # ____250_
Chicago, IL 60628
____4:00_pm
Telephone:(312) 747-6576
Ending Date
8/31/12
39

Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#141 Beginning Date
Paschen (Christian P.) Park Tanya Dillard 06/01/12
1932 W. Lunt Ave.
Lunch__x____ # __35____ ___11:45_am
PM Snk_x___ # ___36___
Chicago, IL 60626
____2:45_pm
Telephone:(773) 262-5871
Ending Date
8/31/12
#142 Beginning Date
Pasteur Park 06/01/12
5825 S. Kostner Ave.
Lunch__x____ # ___91___ ___12:00_pm
PM Snk__x___ # ___25___
Chicago, IL 60629
____4:00_pm
Telephone:(773) 284-0530
Ending Date
8/31/12
#143 Beginning Date
Peterson (Pehr Samuel) Park Kiala Moore 06/01/12
5801 N. Pulaski Rd.
Lunch__x____ # __121___ ___12:00_pm
PM Snk__x___ # ___120__
Chicago, IL 60646
____3:00_pm
Telephone:(312) 742-7584
Ending Date
8/31/12
#144 Beginning Date
Kenwood Community Park 06/01/12
1330 E. 50 th St.
Bkfst__x____ # __10___
___8:30_am
Chicago, IL 60615
Telephone: (312) 747-6286
Ending Date
8/31/12
#145 Beginning Date
Portage Park Mike Nimietz 06/01/12
4100 N. Long Ave.
Lunch___x___ # ___221__
___11:00 am_
Chicago, IL 60641
Telephone:(773) 685-7235
Ending Date
8/31/12
40

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#146 Beginning Date
Pottawwattomie Park Barbara Dever 06/01/12
7340 N. Rogers Ave.
Lunch__x____ # ____51__ __11:30_am
PM Snk__x___ # ____50__
Chicago, IL 60626
____2:30_pm
Telephone:(773) 262-5835
Ending Date
8/31/12
#147 Beginning Date
Pulaski (Casimer) Park Jim Boldt 06/01/12
1419 W. Blackhawk St.
Lunch__x____ # ___101__ ___1:00_pm
PM Snk_x____ # ____60__
Chicago, IL 60622
____4:15_pm
Telephone:(312) 742-7559
Ending Date
8/31/12
#148 Beginning Date
Rainbow Beach Park Janine Moore 06/01/12
3111 E. 77 th St.
Lunch__x____ # ___251__ ___12:00_pm
PM Snk__x___ # ___250__
Chicago, IL 60649
____3:00_pm
Telephone:(312) 745-1479
Ending Date
8/31/12
#149 Beginning Date
Rainey Park Paul Serritella 06/01/12
4350 W. 79 th St.
Lunch__x____ # __101___ ___12:00_pm
PM Snk_x____ # ___40___
Chicago, IL 60652
____4:00_pm
Telephone:(773) 284-0696
Ending Date
8/31/12
#150 Beginning Date
Revere (Paul) Park Greg Czajkowski 06/01/12
2509 W. Irving Park Rd.
Revere I, Revere II
Lunch___x___ # ___180__ ___11:30_am
PM Snk__x___ # ____55__
Chicago, IL 60618
___11:30_am
Telephone:(773) 478-1220
Ending Date
8/31/12
41

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#151 Beginning Date
Riis (Jacob A.) Park Keith Hammerberg 06/01/12
6100 W. Fullerton Ave.
Lunch__x____ # __181___ ___12:00_pm
PM Snk_x ___ # ___40___
Chicago, IL 60639
____3:00 pm
Telephone:(312) 746-5363
Ending Date
8/31/12
#152 Beginning Date
River Park Vera Ornate 06/01/12
5100 N. Francisco Ave.
Lunch___x___ # __261___ ___12:00_pm_
PM Snk__x___ # ___100__
Chicago, IL 60625
____3:15_pm
Telephone:(312) 742-7516
Ending Date
8/31/12
#153 Beginning Date
Robichaux Park Sherri Hudson 06/01/12
9247 S. Eggleston Ave.
Lunch__x____ # __81____ ___12:30_pm
PM Snk__x___ # __80____
Chicago, IL 60620
___3:30_pm
Telephone:(312) 747-6648
Ending Date
8/31/12
#154 Beginning Date
Rosedale Park Stacey Anti 06/01/12
6312 W. Rosedale Ave.
Lunch__x____ # __141___ ___11:30 am_
PM Snk__x___ # __140___
Chicago, IL 60646
____2:30 pm_
Telephone:(773) 631-7156
Ending Date
8/31/12
#155 Beginning Date
Rowan Park Martha Ramirez 06/01/12
11546 S. Avenue L
Lunch__x____ # _131____ ___12:00_pm
PM Snk__x___ # _130____
Chicago, IL 60617
____3:00_pm
Telephone:(773) 646-3180
Ending Date
8/31/12
42

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#156 Beginning Date
Russell Square Park Richard Blake 06/01/12
3045 E. 83 rd St.
Lunch__x____ # __121____ ___12:00_pm
PM Snk__x___ # __120___
Chicago, IL 60617
____3:00_pm
Telephone:(312) 747-6651
Ending Date
8/31/12
#157 Beginning Date
Rutherford Sayre (Thomas, William) George Mavrou 06/01/12
6871 W. Belden Ave.
Lunch__x____ # ___66___ ___11:30_am
PM Snk_x____ # ___65___
Chicago, IL 60635
____2:30_pm
Telephone:(312) 746-5368
Ending Date
8/31/12
#158 Beginning Date
Sauganash Park Michelle Baldwin 06/01/12
5861 N. Kostner Ave.
Lunch___x___ # __36____ ___12:00_pm
PM Snk__x___ # __120___
Chicago, IL 60646
____3:15_pm
Telephone:(773) 685-6122
Ending Date
8/31/12
#159 Beginning Date
Schreiber Park Venus De La Cruz 06/01/12
1552 W. Schreiber Ave.
Lunch___x___ # __26____
___11:45_am
Chicago, IL 60626
Telephone:(773) 262-6741
Ending Date
8/31/12
#160 Beginning Date
Scottsdale Park Michelle Heinen 06/01/12
4637 W. 83 rd St.
Lunch__x____ # __146___ ___12:00_pm
PM Snk__x___ # ___115__
Chicago, IL 60652
____3:30_pm
Telephone:(773) 284-1826
Ending Date
8/31/12
43

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#161 Beginning Date
Senka Park Tim Bus 06/01/12
5656 S. St. Louis Ave.
Lunch__x____ # __76____ ___12:00_pm
PM Snk__x___ # __75____
Chicago, IL 60629
____3:00_pm
Telephone:(312) 747-7632
Ending Date
8/31/12
#162 Beginning Date
Seward Joyce Herron 06/01/12
375 W. Elm
Lunch__x____ # ___151__ ___11:45_am
PM Snk_x____ # ___150__
Chicago, IL 60610
____3:00 _pm
Telephone:(312) 742-7895
Ending Date
8/31/12
#163 Beginning Date
Shabbona Park Larua LeVitus 06/01/12
6935 Addison St.
Lunch___x___ # __251___ ___11:30_am
PM Snk__x___ # ___76___
Chicago, IL 60634
___2:30_pm
Telephone:(773) 685-6205
Ending Date
8/31/12
#164 Beginning Date
Shedd (John G.) Park Wanda Norris 06/01/12
3660 W. 23 rd St.
Lunch__x____ # __51____ ____12:00_pm
PM Snk_x____ # __50____
Chicago, IL 60623
___3:30_pm
Telephone:(773) 762-3168
Ending Date
8/31/12
#165 Beginning Date
Sheil (Bernard) Community Center Erin McGuire 06/01/12
3505 N. Southport Ave.
Lunch__x____ # ___25___
___12:00_pm
Chicago, IL 60657
Telephone:(312) 742-7826
Ending Date
8/31/12
44

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#166 Beginning Date
Sherman Park Marvin Tolbert 06/01/12
1301 W. 52 nd St.
Lunch___x___ # __151___ ___12:15_pm
PM Snk__x___ # ___150__
Chicago, IL 60609
____3:30_pm
Telephone:(312) 746-5369
Ending Date
8/31/12
#167 Beginning Date
Sherwood Park Priscilla Alexander 06/01/12
5701 S. Shields Ave.
Lunch__x____ # __81____ ___12:15_pm
PM Snk__x___ # __80____
Chicago, IL 60621
____4:00_pm
Telephone:(773) 256-0926
Ending Date
8/31/12
#168 Beginning Date
Simons (Almira) Park Maria Delgado 06/01/12
1640 N. Drake Ave.
Lunch___x___ # __21____ ___12:00_pm
PM Snk__x___ # __20____
Chicago, IL 60647
____3:00_pm
Telephone:(312) 742-7548
Ending Date
8/31/12
#169 Beginning Date
Skinner (Mark) Park Tabrena Howard 06/01/12
1331 W. Adams St.
Lunch_x_____ # __151___ ___11:00_pm
PM Snk__x___ # ___150__
Chicago, IL 60606
____3:00_pm
Telephone:(312) 746-5560
Ending Date
8/31/12
#170 Beginning Date
Smith (Joseph Higgins) Park Sherita Taylor 06/01/12
2526 W. Grand Ave.
Lunch__x____ # ___121__ ___11:00_am
PM Snk__x___ # ___120__
Chicago, IL 60612
____3:00_pm
Telephone:(312) 742-7534
Ending Date
8/31/12
45

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#171 Beginning Date
Smith (Wendell) Park 06/01/12
9912 S. Prinston Ave.
Lunch__x____ # __46____ ___12:30_pm
PM Snk__x___ # __45____
Chicago, IL 60628
____3:30_pm
Telephone:(312) 747-6689
Ending Date
8/31/12
#172 Beginning Date
South Shore Cultural Center Andrea Adams 06/01/12
7059 S. South Shore Dr.
Lunch__x____ # ___141__ ___12:00_pm
PM Snk_x____ # ___140__
Chicago, IL 60649
____3:30_pm
Telephone:(773) 256-0149
Ending Date
8/31/12
#173 Beginning Date
Sumner Park Glenn Christmas 06/01/12
4320 W. 5 th Ave.
Lunch__x____ # __61____ ___12:00_pm
PM Snk_x____ # ___60___
Chicago, IL 60624
____3:15_pm
Telephone:(312) 746-5394
Ending Date
8/31/12
#174 Beginning Date
Tarkington Park Ray Richard 06/01/12
3344 W. 71 st St.
Lunch__x____ # __76____ ___12:00_pm
PM Snk__x___ # __75____
Chicago, IL 60629
____3:00_pm
Telephone:(312) 747-6136
Ending Date
8/31/12
#175 Beginning Date
Taylor (Robert Rochon) Park Derrick Faulkner 06/01/12
39 W. 47 th St.
Lunch___x___ # __116___ ___12:00_pm
PM Snk___x__ # __115___
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6728
Ending Date
8/31/12
46

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#176 Beginning Date
Taylor-Lauridsen (John, Emil) Park Al Mikuzis 06/01/12
647 W. Root St.
Lunch__x____ # __91____ ___12:00_pm
PM Snk__x___ # __90____
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6729
Ending Date
8/31/12
#177 Beginning Date
Tilton (George W.) Park Randy Williams 06/01/12
305 N. Kostner Ave.
Lunch___x___ # ___26___ ___12:00_pm
PM Snk_x____ # ___25___
Chicago, IL 60624
____3:30_pm
Telephone:(773) 287-0806
Ending Date
8/31/12
#178 Beginning Date
Touhy (Patrick L.) Park John Yost 06/01/12
7348 N. Paulina St.
Lunch__x____ # __61____ __11:00_am
PM Snk_x____ # __40____
Chicago, IL 60626
____2:00_pm
Telephone:(773) 262-6737
Ending Date
8/31/12
#179 Beginning Date
Humboldt (Baron Von) Park Neveida Aviles Bkfst_x____ # __54____ __9:00_am 06/01/12
144 N. Sacramento Ave.
Chicago, IL 60618
Telephone: (312) 742-7549
Ending Date
8/31/12
#180 Beginning Date
Trumbull Park Joe Lewis 06/01/12
2400 E. 105 th St.
Lunch__x____ # __101___ ___12:00_pm
PM Snk__x___ # __100___
Chicago, IL 60617
____3:30_pm
Telephone:(312) 747-6759
Ending Date
8/31/12
47

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#181 Beginning Date
Tuley Donna Jones 06/01/12
501 E. 90 th Pl.
Lunch__x____ # ___224__ ___12:00_pm
PM Snk_x____ # ___226__
Chicago, IL 60619
____3:20_pm
Telephone:(312) 747-6763
Ending Date
8/31/12
#182 Beginning Date
Union Park Tony Fitzgerald 06/01/12
1501 W. Randolpth St.
Lunch__x____ # __119___ ___12:30_pm
PM Snk_x____ # ___118__
Chicago, IL 60607
____3:30_pm
Telephone:(312) 746-5494
Ending Date
8/31/12
#183 Beginning Date
Valley Forge Park Dawn Ostrowski 06/01/12
7001 W. 59 th St.
Lunch__x____ # __81____ ___12:00_pm
PM Snk__x___ # ___80___
Chicago, IL 60638
____3:00_pm
Telephone:(773) 229-0812
Ending Date
8/31/12
#184 Beginning Date
Veteran’s Memorial Park Anthony Navarro 06/01/12
2820 E. 98 th St.
Lunch___x___ # ___41___ ___11:30_am
PM Snk___x__ # ___40___
Chicago, IL 60624
____2:30_pm
Telephone:(312) 747-6812
Ending Date
8/31/12
#185 Beginning Date
Vittum (Harriet Elizabeth) Park Roland Konow 06/01/12
5010 W. 50 th St.
Lunch___x___ # ___151__
___12:00_pm
Chicago, IL 60638
Telephone:(773) 284-6022
Ending Date
8/31/12
48

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#186 Beginning Date
Warren (Laurence C.) Park Diana Lynn Schilz 06/01/12
6601 N. Western Ave.
Lunch__x____ # ___141__ ___11:30_am
PM Snk_x____ # ___100__
Chicago, IL 60645
____2:30_pm
Telephone:(773) 262-6314
Ending Date
8/31/12
#187 Beginning Date
Washington Park Janie Collins 06/01/12
5531 S. Martin Luther King
Lunch__x____ # __181___ ___1:00_pm
PM Snk__x___ # __150___
Chicago, IL 60637
____4:30_pm
Telephone:(773) 256-1248
Ending Date
8/31/12
#188 Beginning Date
Washtenaw Park Wanda Norris 06/01/12
2521 S. Washtenaw Ave.
Lunch__x____ # __31____ ___12:00_pm
PM Snk_x____ # __30____
Chicago, IL 60608
____3:00_pm
Telephone:(312) 747-6992
Ending Date
8/31/12
#189 Beginning Date
Welles (Gideon) Park Becky Kilber 06/01/12
2333 W. Sunnyside Ave.
Lunch_x_____ # __411___
___11:45_am
Chicago, IL 60625
Telephone:(312) 742-7511
Ending Date
8/31/12
#190 Beginning Date
Wentworth Gardens Park Larry Baldwin 06/01/12
3770 S. Wentworth
Lunch_x_____ # _50____ _12:00_pm
PM Snk_x____ # __50____
Chicago, IL 60609
____3:00_pm
Telephone:(312) 747-6996
Ending Date
8/31/12
49

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#191 Beginning Date
Wentworth Park Dan Ryan 06/01/12
5625 S. Mobile Ave.
Lunch__x____ # _191____ ___12:00_pm
PM Snk__x___ # __150___
Chicago, IL 60638
____3:15_pm
Telephone:(312) 747-6993/7098
Ending Date
8/31/12
#192 Beginning Date
West Chatham Park Valarie Tines 06/01/12
8223 S. Princeton Ave.
Lunch__x____ # __91____ ___12:00_pm
PM Snk__x___ # __90____
Chicago, IL 60620
____3:00_pm
Telephone:(312) 747-6998
Ending Date
8/31/12
#193 Beginning Date
West Lawn Park Paul Pope 06/01/12
4233 W. 65 th St.
Lunch_x_____ # __251___ ___11:45_am
PM Snk_x____ # __200___
Chicago, IL 60629
____3:15_pm
Telephone:(773) 284-2803
Ending Date
8/31/12
#194 Beginning Date
West Pullman Park Debra McKenzie 06/01/12
401 W. 123 rd St.
Lunch__x____ # ___211__ ___11:30_am
PM Snk__x___ # ___210__
Chicago, IL 60628
____4:30_pm
Telephone:(312) 747-7090
Ending Date
8/31/12
#195 Beginning Date
White (Edward H.) Park 06/01/12
1120 W. 122 nd St.
Lunch__x____ # __61____ ___12:15_pm
PM Snk__x___ # __60____
Chicago, IL 60643
____3:15_pm
Telephone:(312 ) 747-7106
Ending Date
8/31/12
50

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#196 Beginning Date
Wicker (Charles, Joel) Park John Davidson 06/01/12
1425 N. Damen Ave.
Lunch__x____ # __121___ ___12:00_pm
PM Snk__x___ # __81____
Chicago, IL 60622
____2:30 pm
Telephone:(312) 742-7553
Ending Date
8/31/12
#197 Beginning Date
Wildwood Park Jim Ziaja 06/01/12
6950 N. Hiawatha Ave.
PM Snk__x___ # ___50___
___2:30_pm
Chicago, IL 60646
Telephone:(773) 631-7455
Ending Date
8/31/12
#198 Beginning Date
Williams (Daniel Hale) Park Earl Norris 06/01/12
2710 S. Dearborn St.
Lunch__x____ # __20____ ___12:00_pm
PM Snk__x___ # __20____
Chicago, IL 60616
____3:00_pm
Telephone:(312) 747-7107
Ending Date
8/31/12
#199 Beginning Date
Willye White Sharon O’Connell 06/01/12
1610 W. Howard
Lunch___x___ # ___51___ ___11:00_am
PM Snk__x___ # ___50___
Chicago, IL 60626
____2:00_pm
Telephone:(773) 262-5051
Ending Date
8/31/12
#200 Beginning Date
Wilson (Frank J.) Park Sherida Hudak 06/01/12
4630 N. Milwaukee Ave.
Lunch__x____ # __81____ ___11:00_am
PM Snk_x____ # __80____
Chicago, IL 60630
____2:00 pm_
Telephone:(773) 685-6454
Ending Date
8/31/12
51

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#201 Beginning Date
Wilson (John P.) Community Center Judee Gurgone 06/01/12
3225 S. Racine Ave.
Lunch_x_____ # __41____ ____12:00_pm
PM Snk__x___ # __40____
Chicago, IL 60608
____3:00_pm
Telephone:(312) 747-7001
Ending Date
8/31/12
#202 Beginning Date
Wilson (John P.) Park Gina Arredia 06/01/12
1122 W. 34 th Pl.
Lunch__x____ # __81____ ____11:00_am
PM Snk_x____ # __50____
Chicago, IL 60608
____3:00_pm
Telephone:(312) 747-7002
Ending Date
8/31/12
#203 Beginning Date
Winnemac Park Lisa Ragucci 06/01/12
5100 N. Leavitt St.
Lunch___x___ # __71____
11:30_am
Chicago, IL 60625
Telephone:(312) 742-5101
Ending Date
8/31/12
#204 Beginning Date
Woodhull Park Angela Jackson 06/01/12
7340 S. East End Ave.
Lunch___x___ # __61____ ___12:30_pm
PM Snk___x__ # __60____
Chicago, IL 60649
____3:30_pm
Telephone:(773) 256-1903
Ending Date
8/31/12
#205 Beginning Date
Wrightwood Park Jennifer Prinzlau 06/01/12
2534 N. Greenview Ave.
Lunch__x____ # __111___ ___11:30_am
PM Snk_x____ # __111___
Chicago, IL 60614
____2:30_pm
Telephone:(773) 256-1903
Ending Date
8/31/12
52

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#206 Beginning Date
Wolfe Park 06/01/12
3325 E. 108 th St.
Lunch_x_____ # __51____ ____12:00_pm
PM Snk__x___ # __30____
Chicago, IL 60617
____3:30_pm
Telephone:(312) 747-7005
Ending Date
8/31/12
#207 Brkfst___x___ # ___70___ ___10:45_am Beginning Date
Kennedy Park 06/01/12
11320 S. Western
Chicago, IL 60655
Telephone:(312) 747-6198
Ending Date
8/31/12
#208 Beginning Date
Kennedy Park 06/01/12
11320 S. Western
Lunch__x____ # __70____ ___12:30_pm
PM Snk_x____ # __70____
Chicago, IL 60655
____2:45_pm
Telephone: (312) 747-6198
Ending Date
8/31/12
#209 Beginning Date
Archer Park 06/01/12
11320 S. Western
PM Snk_x____ # __60____
___5:00_pm
Chicago, IL 60655
Telephone: (773) 284-7029
Ending Date
8/31/12
#210 Beginning Date
Dvorak (Anton) Park 06/01/12
1119 W. Cullerton St.
Tony Segara Bkfst_x____ # __40____
___8:30_pm
Chicago, IL 60608
Telephone: (312) 746-5083
Ending Date
8/31/12
53

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#211 Beginning Date
Norwood Park 06/01/12
5801 N. Natoma Ave.
Jennifer Fitzgerald Lunch_x_____ # __276____
____1:00_pm
Chicago, IL 60631
Telephone: (773) 631-4893
Ending Date
8/31/12
#212 Beginning Date
Norwood Park 06/01/12
5801 N. Natoma Ave.
Jennifer Fitzgerald Lunch_x_____ # __41____
____1:00_pm
Chicago, IL 60631
Telephone: (773) 631-4893
Ending Date
8/31/12
#213 Beginning Date
Homan Square ____11:00_am 06/01/12
3559 W. Arlington St.
Lunch_x_____
Chicago, IL 60612
PM Snk_x_____
Telephone: (312) 746-6650
# __31____
# __30____ ____4:00_pm Ending Date
8/31/12
#214 Beginning Date
Homan Square ____11:15_am 06/01/12
3559 W. Arlington St.
Lunch_x_____
Chicago, IL 60612
PM Snk_x_____
Telephone: (312) 746-6650
# __21____
# __20____ ____4:00_pm Ending Date
8/31/12
#215 Beginning Date
Fuller (Melville) Park ____9:00_am 06/01/12
331 W. 45 th St.
Michael Brown Bkfst_x_____ # __30____
Chicago, IL 60609
Telephone: (312) 746-6144
Ending Date
8/31/12
54

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#216 Beginning Date
Independence Park 06/01/12
3945 N. Springfield Ave.
Eileen Sweeney Lunch_x_____ # __51____
____11:30_am
Chicago, IL 60645
Telephone: (773) 748-3538
Ending Date
8/31/12
#217 Beginning Date
Lake Meadows Park 06/01/12
3117 S. Rhodes Ave.
Sherri Overton Bkfst_x_____ # __20____
____9:00_am
Chicago, IL 60616
Telephone: (312) 747-6287
Ending Date
8/31/12
#218 Beginning Date
Loyola Park 06/01/12
1230 W. Greenleaf Ave.
Mary Faith Hopkins Bkfst_x_____ # __46____
____8:15_am
Chicago, IL 60626
Telephone: (773) 262-8605
Ending Date
8/31/12
#219 Beginning Date
Margate Field House 06/01/12
4921 N. Marine Dr.
Jennifer Bice Bkfst_x_____ # __30____
____8:30_am
Chicago, IL 60640
Telephone: (312) 742-7522
Ending Date
8/31/12
#220 Beginning Date
NTA 06/01/12
55 W. Cermak Rd.
Farah Tunks Bkfst_x_____ # __60____
____9:00_am
Chicago, IL 60616
Telephone: (312) 747-1615
Ending Date
8/31/12
55

Exhibit A - Program Sites
Name and address of site(s) where program will
operate
Contact Person
Type of Meal
Quantity of
Meals - (HDP)
Highest Daily
Participation
Delivery Time
for Each Meal
Dates of
Program
(mm/dd/yy)
#221 Beginning Date
Robichaux Park 06/01/12
9247 S. Eggleston Ave.
Sherri Hudson Lunch_x_____ # __21____
____11:00_am
Chicago, IL 60620
Telephone: (312) 747-6648
Ending Date
8/31/12
#222 Beginning Date
Taylor (Robert) Park 06/01/12
39 W. 47 th St.
David Faulkner Bkfst_x_____ # __45____
____8:30_am
Chicago, IL 60609
Telephone: (312) 747-6728
Ending Date
8/31/12
#223 Beginning Date
Amundsen (Ronald) Park 06/01/12
6200 W. Bloomingdale Ave.
Greg Mason Bkfst_x_____ # __41____
____9:00_am
Chicago, IL 60639
Telephone: (312) 746-5003
Ending Date
8/31/12
#224 Beginning Date
Fosco (Peter) Park 06/01/12
1313 S. Throop St.
Jackie Guthrie Bkfst_x_____ # __50____
____9:00_am
Chicago, IL 60608
Telephone: (312) 746-5086
Ending Date
8/31/12
#225 Beginning Date
Madden Ellis 06/01/12
535 W. 35 th Street
Bkfst_x_____ # __20____
____8:30_am
Chicago, IL 60653
Telephone: (312) 747-6446
Ending Date
8/31/12
56

EXHIBIT B - MENUS
Sponsor shall attach the menu cycle and specifications for the program. The menu cycle must be at a minimum, an eleven day cycle.
You may specify as long a menu cycle as you want served. The bid menu cycle must be served throughout the contract period.
Breakfast menu
See attached PDF document (labeled “Exhibit B – Breakfast Menu”) for the Breakfast Menu Cycle.
Please note: Fresh Fruit should include the following: bananas, oranges, kiwi, apples, peaches, and pears.
Lunch/Supper menu
See attached PDF document (labeled “Exhibit B – Lunch Menu”) for the Lunch/Supper Menu Cycle.
Additional Options for Days 12-15 are as follows:
Day 12 Day 13
Smoked Turkey 2.1 oz Garden Salad Blend 3 oz
Monterey Jack Cheese 0.75 oz Reduced-Fat Shredded
Lettuce ¼ c Cheddar Cheese 0.5 oz
Potato Roll 1.37 oz Chicken 1 oz
Seasonal Fresh Fruit ½ c Black Beans 1/4 c
Fresh Carrots ¼ c Tomato 0.5 oz
Ancho Chipotle Sauce 0.4 oz Fresh Carrots ¼ c
1% Chocolate Milk 1 c Dinner Roll 2.09 oz
Taco Sauce
0.4 oz
Light Ranch Dressing
1 oz
1% Chocolate Milk 1 c
Day 14 Day 15
Salami (All Beef) ½ oz Garden Salad Blend 3 oz
Bologna 1 oz American Cheese 1 oz
American Cheese ½ oz Turkey 1 oz
Wheat Sub Roll 2.4 oz Tomato .5 oz
Peaches ½ c Seasonal Fresh Fruit ½ c
Fresh Seasonal Fruit ½ c Whole Wheat Dinner Roll 1.8 oz
Mustard 0.4 oz Light Ranch Dressing 1 oz
1% White Milk 1 c 1% White Milk 1 c
57

EXHIBIT B - MENUS
Sponsor shall attach the menu cycle and specifications for the program. The menu cycle must be at a minimum, an eleven day cycle. You
may specify as long a menu cycle as you want served. The bid menu cycle must be served throughout the contract period.
Supplement menu
See attached PDF document (labeled “Exhibit B – Supplemental Menu”) for the Supplement Menu.
Additional Options for Days 12-15 are as follows:
Day 12
Lowfat Granola Bars
2.2 oz
100% Fresh Fruit Juice 6 oz
Day 13
Vanilla Whole Grain
Crackers
1 oz
100% Fresh Fruit Juice 6 oz
Day 14
Non-Fat Fruit Yogurt
4 oz
100% Fresh Fruit Juice 6 oz
Day 15
Strawberry Whole Grain
Crackers
1 oz
100% Fresh Fruit Juice 6 oz
Field Trip Menu
The CPD may request the contractor to provide meals for field trips. If so, the following menu is requested
for such meals:
Peanut Butter & Jelly
Graham Bar (1)
Seasonal Fresh Fruit
100% Fruit Juice
(Shelf Stable)
Honey Roasted
Sunflower Seeds
Milk (1% white or chocolate)
1 oz (*Bar must be equivalent to 1oz M/MA and 1 serving of grain
or bread; see Exhibit C for required meal pattern)
½ c
4 oz
1 oz
1 c
Hot Dog Menu
The CPD may request the contractor to provide hot dog meals. If so, the following menu is requested for
such meals:
Turkey Hot Dog
2 oz
Whole Wheat Hot Dog Bun .9 oz
Seasonal Fresh Fruit
½ c
100% Fruit Juice 4 oz
Ketchup / Mustard
0.4 oz / 0.4 oz
Milk (1% white or chocolate) 1 c
58

EXHIBIT C
REQUIRED MEAL PATTERNS
SUMMER FOOD SERVICE PROGRAM ILLINOIS STATE BOARD
OF EDUCATION
Each meal must contain, at a minimum, foods from each of the
components indicated.
MEAL
Breakfast
Lunch/Supper
FOOD COMPONENTS
Fluid Milk 1
Juice or Fruit or Vegetable
Grain/Bread 2
Fluid Milk 1
Meat/Meat Alternate 3
Juice or Fruit or Vegetable 4
(2 servings)
Grain/Bread 2
1 cup
½ cup
1 serving
1 cup
2 ounces
¾ cup total
1 serving
Snack
(any two
items)
Fluid Milk 1
Juice or Fruit or Vegetable5
Meat/Meat Alternate 3
Grain/Bread 2
1 cup
¾ cup
1 ounce
1 serving
1
Milk must be served as a beverage, on cereal, or in part for each purpose.
2
Refer to Grains/Breads Requirements on following pages.
3
Refer to Meat/Meat Alternate Requirements on following pages.
4
Serve two or more kinds of vegetables and/or fruits or a combination of both. Full-strength fruit or
vegetable juice may be counted to meet no more than half of this requirement.
5
Juice may not be served when milk is served as the only other component.
59

GRAINS/BREADS REQUIREMENTS
The item must be whole-grain, enriched, made from whole-grain or enriched meal or flour, or bran or germ. If it is a cereal, the product
must be whole-grain, enriched, or fortified. In lieu of using the minimum serving sizes listed, the contribution of a recipe may be
calculated to determine the number of grains/breads servings the recipe provides. The crediting of a food item as a grains/breads
serving is determined by the total amount of enriched or whole-grain meal and/or flour in the recipe divided by the number of servings
the recipe yields. The amount of flour or meal contained in each serving is then divided by 14.75 grams. Bran, germ, and corn meal are
calculated in the same manner. For recipes with ingredients listed in Groups H and I, follow the weights and volumes listed for the
specific servings in these groups.
MINIMUM SERVING SIZES
The following Grains/Breads Chart has been divided into nine groups. The required weight for each group is based on the key nutrients
in one slice of bread (25 grams or 0.9 ounces) or an equal amount (14.75 grams) of whole-grain, enriched flour, bran, or germ. Within
each group all bread items have approximately the same nutrient and grain content in each serving. Items with fillings, toppings, etc.,
require larger serving sizes to meet the minimum grain content. Some of the following foods, or their accompaniments, may contain
more sugar, salt, and/or fat than others. This should be considered when deciding how often to serve them.
GROUP A
•Breading Type Coating
• Bread Sticks, hard
•Chow Mein Noodles
• Crackers, saltines, snack
• Croutons
• Pretzels, hard
• Stuffing, dry
GROUP B
• Bagels, Biscuits
• Batter Type Coating
• Breads, white, wheat, whole wheat, French, Italian
• Buns, hamburger, hot dog
• Crackers, graham (all shapes), animal
• Egg Roll Skins
• English Muffins
• Pita Bread, white, wheat, whole wheat
• Pizza Crust
• Pretzels, soft
• Rolls, white, wheat, whole wheat, potato
• Tortillas, wheat, corn
• Tortilla Chips, wheat, corn
• Taco Shells
GROUP C
• Cookies 1 , plain
•Cornbread, Corn Muffins
•Croissants, Pancakes, Waffles
• Pie Crust, dessert, meat/meat alternate
• Turnover Crust 2
GROUP D
• Doughnuts 2 , cake, yeast, raised, unfrosted
• Granola Bars 2 , plain
• Muffins, all but corn
• Sweet Roll
• Toaster Pastry 2 , unfrosted
MINIMUM SERVING SIZE FOR GROUP A
1 serving = 20 g or 0.7 oz
MINIMUM SERVING SIZE FOR GROUP B
1 serving = 25 g or 0.9 oz
MINIMUM SERVING SIZE FOR GROUP C
1 serving = 31 g or 1.1 oz
MINIMUM SERVING SIZE FOR GROUP D
1 serving = 50 g or 1.8 oz
60

GROUP E
• Cookies 1 , with nuts, raisins, chocolate pieces, fruit purees
• Doughnuts 2 , cake, yeast, raised, frosted, glazed
• French Toast
• Grain Fruit Bars 2
• Granola Bars 2 with nuts, raisins, chocolate pieces, fruit
• Sweet Rolls, Toaster Pastry 2 , frosted
GROUP F
• Cake 1 , plain, unfrosted
• Coffee Cake 2
GROUP G
• Brownies 1 , plain (Allowed only for snack)
• Cake 1 , frosted, all varieties (Allowed for breakfast or snack)
GROUP H
• Barley, Bulgar
• Breakfast Cereals, cooked
• Corn Grits
• Macaroni, all shapes
• Noodles, egg — all varieties
• Pasta, all shapes
• Ravioli, noodle only
• Rice, enriched white or brown
MINIMUM SERVING SIZE FOR GROUP E
1 serving = 63 g or 2.2 oz
MINIMUM SERVING SIZE FOR GROUP F
1 serving = 75 g or 2.7 oz
MINIMUM SERVING SIZE FOR GROUP G
1 serving = 115 g or 4 oz
MINIMUM SERVING SIZE FOR GROUP H
1 serving = ² c cooked or 25 g or 0.9 oz dry
GROUP I
• Breakfast Cereal, dry
• Rice Cakes
MINIMUM SERVING SIZE FOR GROUP I
1 serving = lesser of ½ c or 1 oz
1
Allowed only for desserts or snacks.
2
Allowed for breakfast and/or snack.
MEAT/MEAT ALTERNATE
Meat/meat alternates must be served at lunch and supper and may be served as part of the snack. A serving of cooked lean meat,
poultry, or fish (without the weight of bone or breading), cheese, yogurt, cooked dry beans/peas, eggs, peanut butter or other nut
butters, and nuts or seeds, or any combination of these may be used to meet this requirement. You may serve these foods as the
entrée or as part of the entrée and in one other menu item. Examples: ground meat and cheese combined in a casserole meet
the requirement of a main entrée; a peanut butter sandwich and half of a deviled egg meet the requirement as part of the entrée
and an additional menu item.
Nuts and seeds may not fulfill more than 50 percent of the meat/meat alternate requirement for lunch or supper, but may fulfill the
entire requirement for a snack. For the purpose of determining combinations, one ounce of nuts or seeds is equal to one ounce of
cooked lean meat, poultry, or fish. The nuts and seeds that may be used as a meat alternate include peanuts, soynuts, tree nuts
(almonds, walnuts, and pecans), and seeds (sunflower, sesame, and pumpkin).
MEAT/MEAT ALTERNATE
• Lean Meat, Poultry, Fish
• Cheese
• Eggs
• Yogurt
• Cooked Dry Beans/Peas
• Nut Butters
• Nuts
SERVING SIZE – LUNCH/SUPPER
2 oz
2 oz
1 egg
8 oz
½ c
2 T = 50%
1 oz = 50%
61

Specifications shall be as follows:
EXHIBIT D – Product Specifications
1. Milk and milk products are defined as “. . . fluid types of pasteurized flavored or unflavored whole milk or low-fat milk, or skim milk or
cultured buttermilk which meet State and local standards for such milk . . . “ Milk delivered hereunder shall conform to these
specifications.
2. Breads, bread alternates, and grains must be made from whole-grain or enriched meal or flour. All breads and grains must be fresh
(or frozen, if applicable) and must meet the minimum weight per serving as listed on Schedule C. If applicable, product should be in
moisture-proof wrapping and pack code date provided.
3. All meat and poultry must have been inspected by the United State Department of Agriculture (USDA) and must be free from off color
or odor.
• Beef must be at least 70:30 lean to fat, preferable 80:20 lean to fat
• Poultry should be U.S. Grade A when applicable and should meet the recommendations outline in Specifications for Poultry
Products, A guide for Food Service Operators from USDA.
• For breaded and battered items, all flours must be enriched for breads/grains credit and breading/batter must not exceed 30% of
the weight of the finished product.
• For sausage patties, the maximum fat allowed is 50% by weight; industry standard of 38% to 42% fat preferred.
4. All cured processed meats (bologna, frankfurters, luncheon meat, salami, others) shall be made from beef and/or poultry. No variety
meats, fillers, extenders, non-fat milk solids, or cereal will be allowed. Meats must not show evidence of greening, streaking, or other
discoloration.
5. Any serving of chicken nuggets, fish sticks, corn dogs or any other type of breaded item must contain enough meat to yield at least 2
ounces of meat in order to meet the USDA minimum requirement for lunch/supper or at least one ounce of meat in order to meet the
USDA minimum requirement for snack.
6. All cheese should be firm, compact and free from gas holes; free of mold; free of undesirable flavor and odors; pasteurized when
applicable; and preferably reduced or lowfat. All cheese should have a bright, uniform, and attractive appearance; have a pleasing flavor;
demonstrate satisfactory meltability; and contain proper moisture and salt content.
7. All fish must have been inspected by the United States Department of Commerce (USCD) and meet minimum flesh and
batter/breading required for USDA Grade A product or product packed under federal inspection (PUFI) by the USDC.
8. All fresh fruits must be ripe and in good condition when delivered and must be ready for consumption per the USDA Food Buying
Guide. Fruits must at a minimum meet the food distributors’ second quality level. Fruits should have characteristic color and good flavor
and be well-shaped and free from scars and bruises. Size must produce a yield equal to or greater than the attached 11-day cycle menu
requirements.
9. All fresh vegetables must be ripe and in good condition when delivered and must be ready for consumption per the USDA Food
Buying Guide. Vegetables must at a minimum meet the food distributors’ second quality level. Vegetables should have characteristic
color and good flavor and be well-shaped and free from discoloration, blemishes, and decay. Size must produce a yield equal to or
greater than the attached 11-day cycle menu requirements.
10. All canned vegetables must meet the food distributors’ first quality level (extra fancy and fancy) and canned fruits (standard) must
meet the second quality level. Vegetables should have characteristic color and good fresh flavor and be free of discoloration, blemishes,
and decay.
11. Eggs must be inspected and passed by the state or federal Department of Agriculture and used within 30 days of date on carton.
Eggs should be grade A, uniform in size, clean, sound-shelled, and free of foreign odors or flavors.
12. Sauces, such as gravy, spaghetti sauce, pizza sauce, etc., must be smooth and uniform in color with no foreign substance, flavor,
odor, or off color.
13. If applicable, the food production facility, manufacturing plan, and products must meet all sanitary and other requirements of the
Food, Drug, and Cosmetic Act and other regulations that support the wholesomeness of products.
14. Meals and food items must be stored and prepared under properly controlled temperatures and in accordance with all applicable
health and sanitation regulations.
62

Bidder
Responsibility
and Bid
Responsiveness
Criteria
Financial Stability of
Bidder
Bidder Responsibility and Bid Responsiveness Criteria
2012 Summer Food Service Program
Minimum Standard(s)
To Demonstrate
Compliance
♦ Three years of profitable financial
performance
♦ No petitions for bankruptcy by contractor or
principals of contractor
Bonding ♦ Bid bond for 5% of total bid and ability to
provide a 10% performance bond
Insurance ♦ Enforce insurance as required in bid
document
Experience ♦ A minimum of five (5) years in food service
management business
References ♦ FSMC will provide at least three (3)
customer references. Sponsor will randomly
contact references from list.
Transportation Ability ♦ FSMC shall have at least 2 refrigerated
trucks in working order to make meal
deliveries
♦ FSMC shall implement an anti-idling policy
for all vehicles.
Evidence/Document(s)
Required
To Demonstrate Compliance
♦
♦
♦
♦
♦
♦
♦
Provide copies of company
financial statements for past three
years
Bid bond for 5% included with bid
and ability to provide a 10%
performance bond within 10 days
of the contract award
Sample certificate of insurance
demonstrating required coverage
Documentation of experience by
bidding company
FSMC will provide a history of all
organizations they have had
contracts with in the past 5 years
with contact information
Sponsor will inspect refrigerated
trucks before award
FSMC shall provide a copy of the
policy after award and provide
documentation that drivers have
received the policy.
Copy of Health Inspection Reports
for the last 2 years
Taste-test of lunch items
(3 judges)
Health Department
Inspections
♦ Not more than 2 critical citations within the
past 2 years
♦
Provide Taste Tests ♦ At least 95% of foods tested must be
♦
of Lunch Items
acceptable in presentation, appearance,
taste and proper temperature
Site-Visits ♦ FSMC will provide a list of facilities utilized ♦ Sponsor will inspect the facilities
for the food preparation for this contract
before award
Meal Delivery ♦ Plan for delivery of meals ♦ Description of plan that
accommodates sponsor’s needs
Timely Delivery ♦ Not late more than 2 times per month ♦ References—list of clients over the
past 3 years
Staffing Plans for
Delivery Trucks
Hardware and
Software for Food
Orders
♦
Criminal background and sex offender
checks have been conducted on all delivery
truck drivers
Hardware, software, and training
necessary for ordering food
through this contract. Software
provided shall have reporting
system capabilities as listed in the
specification section on page 7.
♦
♦
Vendor certifies that all criminal
background checks have been
conducted for all delivery truck
drivers, including the sex offender
database.
Vendor shall provide the hardware
and software specifications and a
sample of various reports
generated, including those
referenced on page 7,
63

ILLINOIS STATE BOARD OF EDUCATION
Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Orders 12549 and 12689, Debarment and Suspension,
7 CFR 3017 Subpart C Responsibilities of Participants Regarding Transactions. The regulations were published as Part
IV of the January 30, 1989 Federal Register (pages 4722-4733) and Part II of the November 26, 2003 Federal Register
(pages 66533-66646). Copies of the regulations may be obtained by contacting the Illinois State Board of Education.
BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS BELOW.
CERTIFICATION
The prospective lower tier participant certifies, by submission of this Certification, that:
1. Neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
2. It will provide immediate written notice to whom this Certification is submitted if at any time the prospective lower tier
participant learns its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances;
3. It shall not knowingly enter any lower tier covered transaction with a person who is debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or
agency with which this transaction originated;
4. It will include the clause titled Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion—
Lower Tier Covered Transactions, without modification, in all lower tier covered transactions and in all solicitations for
lower tier covered transactions;
5. The certifications herein are a material representation of fact upon which reliance was placed when this transaction
was entered into; and
6. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this Certification.
______________________________________________________________________________________________
Organization Name
PR/Award Number or Project Name
_____________________________________________________________________________________________________________
Name and Title of Authorized Representative
________________________________________________________________________________________________________________
Signature
Date
Instructions for Certification
1. By signing and submitting this Certification, the prospective lower tier participant is providing the certifications set out herein.
2. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other
remedies available to the Federal government, the department or agency with which this transaction originated may pursue all available
remedies, including suspension and/or debarment.
3. Except for transactions authorized under paragraph 3 above, if a participant in a covered transaction knowingly enters into a lower tier
covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal government, the department or agency with which this transaction originated may pursue
all available remedies, including suspension and/or debarment.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used herein, have the meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549 and Executive Order 12689. You may contact the person to which this
Certification is submitted for assistance in obtaining a copy of those regulations.
5. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is
not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows the certification is erroneous. A
participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not
required to, check the “GSA Excluded Parties List System” at http://epls.arnet.gov/.
6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the
certification required herein. The knowledge and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
64

Bid-Rigging Certification
________________________________________________________________, a duly
(Agent)
authorized agent of _____________________________________________________,
(Contractor)
do hereby certify that neither ______________________________________________,
(Contractor)
nor any individual presently affiliated with ____________________________________
(Contractor)
_______________________, has been barred from bidding on a public contract as a
result of a violation of either Section 33E-3 (bid-rigging) or Section 33E-4 (bid rotating)
of the Illinois Criminal Code, contained in Chapter 38 of the Illinois Revised Statutes.
_____________________________________
Authorized Agent
_____________________________________
Contractor
65

Certification Regarding Lobbying
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form LLL - ‘‘Disclosure on Lobbying Activities,” in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
___________________________________________________________________
Organization Name
____________________________________________________________________
PR/Award (or Application) Number or Project Name
____________________________________________________________________
Name and Title of Authorized Representative
____________________________________________
Signature
______________________
Date
66

DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
(See reverse for public burden disclosure)
1. Type of Federal Action:
2. Status of Federal Action:
3. Report Type:
a. contract
b. grant
c. cooperative agreement
d. loan
e. loan guarantee
f. loan insurance
4. Name and Address of Reporting Entity:
Prime
Subawardee
Tier _______,if known:
a. bid/offer/application
b. initial award
c. post-award
a. initial filing
b. material change
For Material Change Only:
year _________ quarter _____
date of last report __________
5. If Reporting Entity in No. 4 is Subawardee, Enter Name and
Address of Prime:
Congressional District, if known:
Congressional District, if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, if applicable: _____________
8. Federal Action Number, if known: 9. Award Amount, if known:
10. a. Name and Address of Lobbying Entity
(if individual, last name, first name, MI):
$
b. Performing Services (including address if different from
No. 10a) (last name, first name, MI):
(attach Continuation Sheet (s)
SF-LLL-A, if necessary
11. Amount of Payment (check all that apply):
$ ________________________ actual planned
12. Form of Payment (check all that apply):
a. cash
13. Type of Payment (check all that apply):
a. retainer
b. one-time fee
c. commission
d. contingent fee
e. deferred
f. other; specify: _________________________
b. in-kind; specify: nature ____________
value _____________
14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member (s) contacted for
Payment Indicated in Item 11:
(attach Continuation Sheet(s) SF-LLL-A if necessary)
15. Continuation Sheet(s) SF-LLL-A attached: Yes No
16. Information requested through this form is authirezd by title 31 U.S.C. section
1352. This disclosure of lobbying activities is a material representation of fact
upon which reliance was place by the tier above when this transaction was made or
entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This
information will be reported to the Congress semi-annually and will be available
for public inspection. Any person who fails to file the required disclosure shall be
subjedt to a civil penalty of not less than $10,000 and not more than $10,000 for
each such failure.
Federal Use Only:
Signature: ______________________________________________
Printed Name: __________________________________________
Title: __________________________________________________
Telephone No.: ___________________ Date: ________________
Authorized for Local Reproduction Standard Form - LLL
67

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether sub-awardee or prime Federal recipient, at the
initiation or receipt of a covered Federal action, or a material change to a previous filing pursuant to title 31 U.S.C. section
1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing
or attempting to influence an officer or employee or any agency, a Member of Congress, and officer or employee of
Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A
Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both
the initial filing and material change report. Refer to the implementing guidance published by the Office of Management
and Budget for additional Information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the
outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the
information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if
known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be a prime
or subaward recipient. Identify the tier of the subawardee e.g. the first subawardee of the prime is the 1 st .tier.
Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks “Subawardee”, then enter the full name, address, city, state and
zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency, making the award or loan commitment. Include at least one organizational
level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full
Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan
commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.d.
Request for Proposal (RFP) number; invitation for Bid (IFB) number, grant announcement number; the contract,
grant, or loan award number, the application proposal control number assigned by the Federal agency). Include
prefixes e.g., “RFP-DE-90-001.”
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the
Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity
identified in item 4 to influence the covered Federal action.
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item4) to the
lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check
all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned
to be made.
12. Check the appropriate box (es). Check all boxes that apply. If payment is made through an in-kind contribution,
specify the nature and value of the in-kind payment.
13. Check the appropriate box (es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to
perform, and the date (s_ of any services rendered. Include all preparatory and related activity, not just time spent
in actual contract with Federal officials. Identify the Federal official (s) or employee (s) contacted or the officer (s),
employee (s), or Member (s) of Congress that were contacted.
15. Check whether or not a SF-LLL-A Continuation Sheet (s) is attached.
16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Office of Management and Budget,
Paperwork Reduction Project (0348-0046), Washington, D.C. 20503
68

DISCLOSURE OF LOBBYING ACTIVITIES
CONTINUATION SHEET
Reporting Entity: _______________________________________ Page _______ of ________
69

COMPLIANCE CONDITIONS
Regarding Participation by Minority – and Women-Owned Business Enterprises
1. Definitions
A. The term “broker” means a person or entity that fills orders by purchasing or receiving supplies from a third party supplier rather
than out of its own existing inventory, and provides no commercially useful function other than acting as a conduit between the
supplier and the customer. Brokerage will not be counted towards MBE/WBE goals.
B. The term “certification” or “certified” means official recognition of the MBE or WBE status of a business by a public or private entity
such as the City of Chicago, the Chicago Minority Business Development Council (CMBDC), the Women’s Business Development
Center (WBDC), or the Small Business Administration (SBA).
C. The term “commercially useful function” means that a firm is responsible for the execution of a distinct element of the work of the
contract and carries out its responsibilities by actually performing, managing, and supervising the work involved, or by fulfilling its
responsibilities as joint venturer. To determine whether a firm is performing a commercially useful function, the Chicago Park
District will evaluate the amount of work subcontracted, industry practices, and other relevant factors.
D. The term “contract” means any contract, purchase order, or agreement awarded by any officer or agency of the Chicago Park
District, or whose cost is to be paid from funds belonging to or administered by the Park District, regardless of the source.
E. The term “direct participation” means the participation in the contract by an MBE or WBE (1) as the prime contractor, (2) as a
partner in a joint venture, (3) as the subcontractor of a portion of the work of the contract, or (4) as the vendor of goods and/or
services used in or related to the purpose of the contract.
F. The term “established business” means a business entity which, by virtue of its size and capacity for competing in the markets in
which it operates, does not need to be a participant in the MBE/WBE program in order to effectuate the purposes of the program
as determined by the Park District. In general, a business entity shall be presumed to be an established business if it meets local
and other nationally recognized standards for such status.
G. The term “indirect participation” means the participation by an MBE or WBE as the supplier of goods and/or services that are not
used directly for the purposes of the contract, but that are used in other aspects of the bidder’s business.
H. The term “joint venture” means an association of two or more businesses formed to carry out a single business enterprise for
profit, and for which purposes they combine their expertise, property, capital, efforts, skills and knowledge.
I. The term “local business” means a business entity located within the counties of Cook, DuPage, Kane, Lake, McHenry or Will in the
State of Illinois (the “Six-County Region”) which has the majority of its regular, full-time work force located within the six-county
region.
J. The term “lowest responsible bidder” means that bidder which submits the lowest price and meets all other bid specifications,
including the MBE goal and the WBE goal and these Compliance Conditions, unless a reduction or waiver is granted.
K. The term “minority group” means any of the following racial or ethnic groups:
• African-Americans or Blacks (persons having origins in any of the Black racial groups in Africa)
• Hispanics (persons of Spanish culture with origins in Mexico, South or Central America or the Caribbean Islands,
regardless of race)
• Asian-Americans (persons having origins in any of the original peoples of East Asia, Southeast Asia, the Indian subcontinent,
or the Pacific Islands)
• Other groups, or other individuals, found by the General Superintendent to be socially and economically disadvantaged and to
have suffered actual racial or ethnic discrimination and decreased opportunities to compete in Chicago area markets and to
do business with the Chicago Park District.
• For purposes of contracts funded by state or federal government sources, groups found to be eligible for the designation of
DBE by such governmental sources.
L. The term “minority-owned business” or “MBE” means a local business that is certifiably at least 51% owned by one or more
members of one or more minority groups, or, in the case of a publicly-held corporation, a corporation in which at least 51% of the
stock is owned by one or more members of one or more minority groups, and whose management and daily business operations
are controlled by one or more members of one or more minority groups, and which is not an established business.
M. The term “minority-owned business enterprise goal” or “MBE goal” means the goal adopted for participation by MBEs by the
Chicago Park District Code, Chapter XI, Section F.
N. The term “owned” means having all of the customary incidents of ownership, including the right of disposition and the sharing of all
risks and profits, commensurate with the degree of ownership interest.
O. The term “program” means the Minority and Women-owned Business Enterprise Program enacted by Chapter XI, Section F of the
Code of the Chicago Park District, and all rules, regulations, forms, and schedules promulgated thereunder.
70

P. The term “schedules” means the Schedule A and Schedule B provided by the Park District.
Q. The term “women-owned business” or “WBE” means a local business that is certifiably at least 51% owned by one or more
women, or, in the case of a publicly held corporation, a corporation in which 51% of the stock is owned by one or more women,
and whose management and daily business operations are controlled by one or more women, and which is not an established
business.
R. The term “women-owned business enterprise goal” or “WBE goal” means the goal adopted for participation by WBEs by the
Chicago Park District Code, Chapter XI, Section F.
2. Policy
It is the policy of the Chicago Park District that members of minority groups and women participate to the maximum feasible extent in
the performance of Park District contracts. During the performance of this contract, the bidder agrees that it shall not discriminate on
the basis of race, color, religion, sex, national origin, ancestry, age, marital status, physical or mental disability, unfavorable discharge
from military service, parental status, or sexual orientation in the solicitation for or purchase of goods or services, or the
subcontracting of work in the performance of this contract.
3. Commitment to MBE/WBE Participation
A. In order to be considered responsive, the bidder shall commit to expending at least 25% of the total contract price with MBEs
(“MBE goal”) and at least 5% with WBEs (“WBE goal”), unless, prior to the submission of the bid, the Park District granted a
percentage reduction or a waiver. The Director of Purchasing, subject to the approval of the General Superintendent, may extend
the period for the granting of reductions or waivers in order to increase the opportunities for the participation of MBEs and/or
WBEs in the performance of the contract.
B. If the bidder is a certified MBE firm, the WBE requirement MUST STILL BE MET.
If the bidder is a certified WBE firm, the MBE requirement MUST STILL BE MET.
A business enterprise owned by a woman who is a member of a minority group may be counted as an MBE or a WBE, BUT
NOT BOTH.
C. The total dollar value of the bidder’s MBE or WBE direct participation and indirect participation shall be counted toward the MBE
and/or WBE goals.
D. If the contract value is increased through a change order or contract modification, the MBE and WBE expenditures must increase
proportionally.
E. The MBE goal and the WBE goal may be achieved by:
a) The bidder’s status as an MBE or a WBE (plus the addition of an MBE or WBE, whichever is not fulfilled by the
bidder’s own certification); and/or
b) The bidder’s status as a joint venturer with one or more MBEs and/or WBEs. The percentage of the
ownership and control of the MBE joint venturer or WBE joint venturer shall be the percentage of
participation counted toward the MBE goal and/or the WBE goal. A joint venture is eligible for participation
MBE and/or WBE, if, and only if, all of the following requirements are satisfied:
as an
• The MBE or WBE venturer(s) participates in the ownership, control, management responsibilities, risks and profits of
the joint venture in proportion with the MBE and/or WBE ownership percentage.
• The MBE and/or WBE venturer(s) is responsible for a clearly defined portion of the work of the contract in proportion
with the MBE’s and/or WBE’s ownership percentage; and
• The MBE and/or WBE venturer(s) actually performs with its own forces and using its own equipment, work equal to at
least 75% of the value of its ownership of the joint venture.
The Director of Purchasing, in consultation with appropriate Park District staff, will evaluate the proposed joint venture
agreement and all other relevant documents to determine whether these requirements have been satisfied; and/or
c) Subcontracting a portion of the work of the contract to one or more MBEs and/or WBEs:
• A bidder may count toward its MBE or WBE goal only expenditures to firms that perform a commercially useful
function in the work of the contact.
• Brokering will not be counted toward the Program's goals. Consistent with normal industry practices, an MBE or
WBE may enter into subcontracts; however, if an MBE or WBE subcontracts a significantly greater portion of the work
of the contract than would be expected on the basis of normal industry practices, the MBE or WBE shall be presumed
not to be performing a commercially useful function. The bidder may present evidence to rebut this presumption.
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Where an MBE or WBE, consistent with industry practices, intends to enter into further subcontracts totaling more
than 25% of the value of the MBE’s or WBE’s subcontract, the MBE or WBE must submit all documents required by
Section 2.04 of these Conditions regarding all further subcontracts, except that reductions or waivers of the MBE goal
or WBE goal need not be obtained. However, the dollar value of any work that is further subcontracted to other than
MBEs and/or WBEs shall not be counted toward the attainment of the bidder’s MBE and/or WBE goals. This
provision does not apply to MBEs or WBEs who represent manufacturers. Agreements between a bidder and an
MBE or WBE in which the MBE or WBE promises not to provide subcontracting quotations to other bidders are
prohibited.
• The purchase of materials or services used in or related to the performance of the contract from one or more MBEs
and/or WBEs; or
• The purchase or subcontracting of materials or services not specifically related to the performance of this contract
from one or more MBEs and/or WBEs (indirect participation); or
• Any combination of the foregoing.
4. Reduction or Waiver of the MBE goal and/or WBE goal
The Director of Purchasing, in consultation with appropriate Park District staff, shall consider any request for a reduction or a waiver of
the MBE goal and/or the WBE goal when necessary. A reduction or waiver may be granted if, among other things, the reasonable
and necessary requirements of the contract render sufficient subcontracting, joint venturing or other participation of MBEs and/or
WBEs unfeasible or excessively costly; or, sufficient MBEs and/or WBEs capable of providing the goods and services required by the
contract are not readily available despite affirmative efforts to locate such businesses.
A. If a bidder determines that it is unable to meet the required MBE goal and/or the WBE goal through direct subcontracts, the
bidder should attempt to meet the goal through indirect subcontracts.
B. In the rare instance in which indirect subcontracting also is not possible, the bidder must request a reduction or a waiver of the
goal(s) prior to submission of its bid. In order to obtain a reduction or waiver, the bidder must document its unsuccessful
solicitation (as either direct or indirect subcontractors or joint venturers) of a reasonable number of the appropriately certified
MBEs and WBEs. Documentation must include, but is not necessarily limited to:
a) A detailed statement of efforts to identify and select portions of work identified in the bid solicitation for subcontracting to or joint
venturing with MBEs and WBEs; and
b) A listing of all MBEs and WBEs contacted and not utilized, including:
• Names, addresses and telephone numbers of MBEs and WBEs solicited;
• Date, time and method of contact;
• A statement from each contacted MBE or WBE explaining why it was not available to do the work, or a statement that
the MBE or WBE did not respond; and
• Where relevant, documentation of all prices quoted by all subcontractors.
5. Procedure to Determine Compliance
A. MBE/WBE Participation (“Schedules”)
a) Schedule A: Statement of Prime Bidder Regarding MBE/WBE Utilization. In order to achieve both the MBE and WBE goals,
the prospective awardee must submit a completed Schedule A, committing the bidder to the utilization of each listed MBE and
WBE, including MBE and WBE joint venturers. The prospective awardee must commit to the expenditure of a specific dollar or
percentage amount of participation by each MBE and WBE firm. The total dollar or percentage commitment to proposed MBE
firms must at least be equal to the MBE goal. The total dollar or percentage commitment to proposed WBE firms must at least
be equal to the WBE goal. The bidder is responsible for calculating the dollar equivalent of the MBE and WBE goals. All
commitments made in Schedule A must conform to the submitted Schedule Bs. The bidder will not be permitted to substitute
another firm for the MBE and/or WBE listed in Schedule A, except as described in Section 2.04.03. of these Conditions.
b) Schedule B: Letter of Intent from MBE or WBE to Perform as Subcontractor, Supplier and/or Consultant as Included in the
Bidder’s Schedule A. Each Schedule B must accurately detail the work to be performed by the MBE or WBE and the agreed
rates and prices.
B. Letters of Certification
A copy of each proposed MBE’s and WBE’s current letters of certification (or other certification documents) must be submitted with
72

their Schedule Bs. The Park District accepts certification by public or private entities such as the City of Chicago, the Chicago
Minority Supplier Development Council (CMSDC), the Woman’s Business Development Center (WBDC), or the Small Business
Administration (SBA). The Park District reserves the right to determine that even if an entity is certified, its inclusion in the
Program does not further the Program’s purposes. The Park District – not the bidder – shall determine the adequacy of the letters
of certification or other certification documents.
a) A receipt for the submittal of an application for certification is NOT AN ACCEPTABLE alternative to a current certification letter.
b) The only ACCEPTABLE alternative to a current certification letter is a “courtesy extension letter” from the same certifying
agency.
C. Evaluation of the Schedule
If the potential awardee fails to meet the MBE goal and/or the WBE goal and no reduction or waiver was granted before the
proposal was submitted; or is found to be unresponsive or uncooperative; or if false statements were made in the Schedules; or if
the bidder fails to cooperate promptly with the Park District, the bidder may be deemed unresponsive and eliminated from award
consideration.
6. Contract Performance
A. MBE and WBE Utilization Reports
The awardee shall maintain records of all relevant data with respect to the utilization of MBEs and WBEs, retaining these records
for a period of at least three years after expiration of the contract. The awardee shall file quarterly MBE and WBE Utilization
Reports. Each MBE and WBE Utilization Report will reflect the current status of current and projected payments to MBEs and
WBEs. Such reports shall include the following: the name, business address, telephone number and contact person of each MBE
and WBE actually involved in the performance of the contract; a description of the work performed and/or product or service
supplied by each MBE or WBE; the date and amount of each payment; and such other information as may assist the Director of
Purchasing in determining the awardee’s compliance with the provisions of the Program.
B. Access to Records
During the term of the contract and for a period of three years after the expiration date of the contract, the Director of Purchasing
shall have access to the awardee’s books and records, including without limitation payroll records, tax returns and records, and
books of account, on five business days notice, to allow the Director of Purchasing to determine the awardee’s compliance with its
commitment to MBE and WBE participation and the status of any MBE or WBE performing any portion of the contract. This
provision shall be in addition to, and not a substitute for, any other provision allowing inspection of the awardee’s records by any
officer or official of the Chicago Park District for any purpose.
C. Substitution of MBEs and WBEs Listed in the Schedules
When the awardee believes it has become necessary to substitute a new MBE or WBE in order to actually fulfill the MBE goal or
WBE goal, or to complete the work of the contract, the awardee must submit a written request for permission to substitute a
different MBE or WBE. Any substitution must receive prior approval from the Director of Purchasing. If the participation of MBEs
and/or WBEs in the contract would be reduced by the substitution, the awardee must utilize MBEs and/or WBEs in other areas of
the contract to meet the MBE goal and/or WBE goal, unless a reduction or waiver is granted. Such a request must include specific
reasons for the proposed substitution, stating why the MBE or WBE is unable to complete the work. Acceptable reasons include,
but are not limited to, the following:
a) The MBE or WBE was found not to be able to perform the work as described in the Schedules, or was not able to perform on
time.
b) The MBE or WBE was found not to be able to produce acceptable work.
c) The MBE or WBE was discovered to be improperly certified.
d) The MBE or WBE later demanded an unreasonable escalation of price.
The awardee’s substitution request should include the names, addresses, and officials of any proposed substitute MBE or
WBE and the dollar value and scope of work of the proposed subcontract. Such notification shall also include documents that
are required of bidders to determine bid compliance, including the Schedules and current letters of certification. The Park
District will not approve extra payment for escalated costs incurred by the awardee when a substitution becomes necessary for
the awardee in order to comply with the MBE goal and/or the WBE goal.
7. Non-Compliance
The following constitute material breaches of the contract and shall entitle the Park District to declare a default, terminate the contract
and exercise those remedies provided for in the contract and at law or in equity: (1) failure to satisfy the MBE goal and/or the WBE
73

goal required by the contract; or (2) the disqualification of the MBE or WBE when such status was a factor in the contract award and
was misrepresented by the bidder.
A. In the event of an awardee’s non-compliance with the commitment to MBE and/or WBE participation, the awardee agrees to pay
damages to the MBEs and WBEs that were underutilized due to no fault of the MBE or WBE. The unexcused reduction of MBE
and/or WBE participation in connection with a contract, including any modification thereof, shall entitle the affected MBEs and
WBEs to damages. The awardee agrees to submit any dispute concerning such damages to binding arbitration by an
independent arbitrator, other than any department or agency of the Chicago Park District, with reasonable expenses, including
attorneys’ fees and costs being recoverable by a prevailing MBE or WBE.
B. In the event that an awardee is determined by the Director of Purchasing not to have been involved in any misrepresentation of the
status of a disqualified MBE or WBE included in the Schedules, the Director of Purchasing may allow the awardee to discharge the
MBE or WBE and, if possible, identify and engage a qualified MBE or WBE as a replacement. A MBE must be replaced by
another MBE and a WBE must be replaced by another WBE, unless a reduction or waiver is granted.
C. If, after notice and a hearing before the Director of Purchasing, the General Superintendent determines that an awardee or a MBE
or WBE has made fraudulent misrepresentations to the Director of Purchasing regarding the utilization of MBEs or WBEs, or has
colluded with another making such fraudulent misrepresentations, the awardee or MBE or WBE shall be disqualified from
contracting or subcontracting on additional contracts with the Park District for a period of three years.
D. The consequences provided herein shall be in addition to any other criminal or civil liability to which such entities may be subject.
The General Superintendent, through the General Counsel of the Park District, shall inform the appropriate law enforcement
officers of instances of fraudulent misrepresentation and collusion.
End of Compliance Conditions
74

1. SCHEDULE A [STATEMENT OF PRIME BIDDER]
A. Completion of Schedule A
INSTRUCTIONS FOR COMPLETING SCHEDULES A AND B
a) Schedule A must be completed and signed by the bidder.
b) The bidder must commit to the expenditure of a specific dollar amount of participation by each MBE/WBE listed on the
Schedule A.
B. Joint Venture Attachment to Schedule A (Joint Venture only)
a) If the bidder’s MBE/WBE plan includes the participation of an MBE/WBE as a joint venture partner, the bidder must
submit, with the Schedule A, a copy of the parties’ Joint Venture Agreement.
b) The Alternate Signature Page of the Schedule A must be signed by the joint venture partners.
C. Non-compliant Bid
Failure to submit a properly completed and signed Schedule A (and joint venture documentation, if applicable) will render the
bid non-compliant, which will remove the bidder from further award consideration.
2. SCHEDULE B [STATEMENT OF MBE/WBE FIRM(S)]
A. Completion of Schedule B
a) A Schedule B form must be completed and signed by each MBE/WBE firm listed on the Schedule A as participating in the
contract as a subcontractor. Only that subcontractor shall sign the Schedule B.
b) That MBE/WBE firm also must submit, with their Schedule B, all of their current Letters of Certification obtained from public or
private entities such as the City of Chicago, the Chicago Minority Business Development Council (CMBDC), the Women’s
Business Development Center (WBDC), or the Small Business Administration.
B. Non-compliant Bid
Failure of the prime bidder to submit a completed and signed Schedule B and current certification letter(s) for each subcontractor
listed on the Schedule A may render the bid non-compliant, which will remove the prime submitter from further award
consideration.
75

SCHEDULE A
Statement of Prime Submitter Regarding Its MBE/WBE Utilization Plan
TO BE COMPLETED BY SUBMITTER ONLY
Submitter: ______________________________________
Project:
Is the submitter a certified MBE/WBE? MBE: Yes No WBE: Yes No
If yes, attach all current Letters of Certification.
NOTE:
CERTIFICATION OF THE SUBMITTER AS AN MBE SATISFIES ONLY THE MBE GOAL; THE WBE GOAL MUST STILL BE MET. CERTIFICATION OF THE
SUBMITTER AS A WBE SATISFIES ONLY THE WBE GOAL; THE MBE GOAL MUST STILL BE MET. CERTIFICATION OF THE SUBMITTER AS BOTH MBE AND
WBE MAY SATISFY ONE GOAL ONLY.
The submitter intends to perform work in connection with this project as a:
GENDER: RACE/ETHNICITY: TYPE OF FIRM:
Male Black/African American Partnership
Female Hispanic American Sole Proprietorship
Asian American
Corporation
White American
Joint Venturer
Other
Other
All MBE/WBE firms included in the following plan must be certified as such by a public or private organization such as the City of
Chicago, Chicago Minority Supplier Development Council (CMSDC), Women Business Development Center (WBDC), and the Small
Business Administration.
I. Participation of MBE/WBE Firms
In determining the manner of MBE/WBE participation in the performance of this contract, the submitter shall consider involvement
with MBE/WBE firms as joint venture partners, subcontractors, and suppliers of goods and services, either directly or indirectly.
A. If submitter is a joint venturer and one or more joint venture partners are certified MBEs or WBEs, attach copies of Letters of
Certification and a copy of the Joint Venture Agreement clearly describing the role of the MBE/WBE firm(s) and its ownership
interest in the joint venture.
B. Proposing MBE/WBE subcontractors/suppliers/consultants to perform work or supply goods or services not directly related to the
performance of this contract is considered to be indirect participation.
MBE/WBE Subcontractors/Suppliers/Consultants:
1. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
76

2. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
3. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
4. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
5. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
77

6. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used as direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
7. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: _______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
8. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: ______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
9. Name of MBE/WBE:
Address:
Contact Person:
E-mail: ______________________________________________
Phone:
Fax: ______________________
MBE/WBE Participation: Dollars $ Percent: %
Will this subcontractor be used for direct or indirect participation? (circle one)
Schedule B and all current certification letters attached? Yes No
Attach additional sheets as needed.
78

II.
Summary of MBE/WBE Plan:
A. MBE Participation:
Dollar Amount of Percent Amount of
MBE Firm Name Participation Participation
$ %
$ %
$ %
$ %
$ %
$ %
$ %
$ %
Total MBE Participation: $ %
B. WBE Participation:
Dollar Amount of Percent Amount of
WBE Firm Name Participation Participation
$ %
$ %
$ %
$ %
$ %
$ %
$ %
$ %
Total WBE Participation: $ %
The submitter designates the following person as its MBE/WBE Liaison Officer:
(Name and Title)
( )
(Phone Number)
(E-mail address)
CONTINUE TO NEXT PAGE
79

To the best of my knowledge, information and belief, the facts and representations contained in this Schedule are true, and no material
facts have been omitted.
Any material misrepresentation will be grounds for terminating any contract that may be awarded and for initiating action under federal or
state laws concerning false statements.
Bidder:
Signature:
Name/Title:
(Print or Type Name of Business)
(Written Signature of Authorized Officer/Representative)
(Print or Type Name and Title of Person Signing Statement)
Date:
NOTE
If submitter is an MBE/WBE joint venture with a non-MBE/WBE firm,
use the following signature page instead:
End of Schedule A
80

ALTERNATE SCHEDULE A SIGNATURE PAGE
FOR MBE/WBE JOINT VENTURE WITH A NON-MBE/WBE FIRM
Complete this signature page only if you are an MBE/WBE operating as a joint venture with a non-MBE/WBE Firm
To the best of my knowledge, information and belief, the facts and representations contained in this Schedule are true, and no material
facts have been omitted.
Any material misrepresentation will be grounds for terminating any contract that may be awarded and for initiating action under federal or
state laws concerning false statements.
NOTE:
After filing this statement and before the completion of the joint venture’s work on this project, if there is any change in the information
submitted, the joint venturer must inform the Chicago Park District.
(Name of MBE/WBE Partner Firm)
(Name of Non-MBE/WBE Partner Firm)
(Written Signature of Authorized Officer/Representative)
(Written Signature of Authorized Officer/Representative)
(Print or Type Name and Title)
(Print or Type Name and Title)
(Date)
(Date)
81

SCHEDULE B
Statement of Intent from MBE/WBE to Perform as Subcontractor, Supplier and/or Consultant
DO NOT FILL OUT OR SIGN THIS FORM IF YOU ARE THE PRIME SUBMITTER
Project:
From:
To:
(Name of MBE/WBE Firm)
(Name of Prime Contractor-Submitter)
MBE: Yes No
WBE: Yes No
and the Chicago Park District:
The undersigned intends to perform work in connection with the above projects as a:
GENDER: RACE/ETHNICITY:
TYPE OF FIRM:
Male Black/African American
Partnership
Female Hispanic American Sole Proprietorship
Asian American
Corporation
White American
Joint Venturer
Other
Other
The MBE/WBE status of the undersigned is confirmed by the attached current Letters of Certification from public or private entities such
as the City of Chicago, the Chicago Minority Supplier Development Council (CMSDC), the Women’s Business Development Center
(WBDC), and the Small Business Administration.
Attach all current certification letters behind Schedule B.
The undersigned is prepared to provide the following services or supply the following goods in connection with the above project/contract:
The above described performance is offered for the following price and described terms of payment:
If more space is needed to fully describe the MBE/WBE firm’s proposed scope of work and/or payment schedule, attach additional
sheets.
The undersigned will enter into a written agreement for the above work with you as prime contractor, conditioned upon your execution of
a contract with the Chicago Park District, and will do so within (3) three working days of receipt of a signed contract from the Chicago
Park District.
Signature:
Name/Title:
(Signature of Owner or Authorized Agent of MBE/WBE)
(Print or Type Name and Title)
Date:
Address: _______________________________________________________________________________
Telephone: ______________________________________
Fax: _______________________________
End of Schedule B
82

MBE/WBE UTILIZATION REPORTING REQUIREMENTS
CHICAGO PARK DISTRICT
TERM AGREEMENT CONTRACTS
For term agreement contracts for materials, supplies, equipment, services, etc., utilization reports are to be submitted monthly. The
MBE/WBE Utilization Report form will be provided to the awardee with the awardee’s executed contract, and the awardee’s first
MBE/WBE Utilization Report will be due no later than ninety (90) days after the date of that contract’s execution.
All utilization reports must be accompanied by the following supporting documentation:
1. Copies of cancelled checks (both sides), wire transfers, and other forms of payments to MBE(s) and WBE(s). These payments
must be for services provided ON THIS CONTRACT ONLY
2. Copies of invoices from MBE(s) & WBE(s) for services provided ON THIS CONTRACT ONLY
3. Signed and notarized waivers of lien, when applicable
Submission Address: MBE/WBE Utilization Reports are to be submitted directly to:
Compliance Officer
Department of Purchasing
Chicago Park District
541 N. Fairbanks Court
3 rd Floor
Chicago, IL. 60611
Submission Fax: 312-742-5326
For more information, contact Luetha Aytch, Compliance Officer, at 312-742-4436,
or via e-mail at luetha.aytch@chicagoparkdistrict.com
End of MBE/WBE Reporting Requirements
83

SUSTAINABILITY STATEMENT INSTRUCTIONS
The Chicago Park District is committed to green and sustainable practices and good environmental stewardship. Consequently, we are
asking bidders to provide a Statement of Sustainability to ensure our bidders are also incorporating sustainability into their firms’
practices.
INSTRUCTIONS
On the following Sustainability Statement form, provide a clear description of your firm’s sustainable practices, policies, or procedures.
These practices may include, but may not be limited to, the following categories and examples:
Waste Minimization within your office or facilities, such as a recycling programs, double-sided copying, electronic internal
communications (i.e. memos), use of recycled-content materials and reusable cups, limiting printing, electronic document management,
instituting green purchasing policies, using green cleaning supplies and practices, or reducing packaging in materials you procure or
supply.
Energy Efficiency within your office, facilities, or firm, such as lighting retrofits, photo-sensor switches for lighting, effective use of daytime
lighting, using Energy Star rated appliances or equipment, using an alternative fuel or having efficient fleet policies, an anti-idling policy,
or indoor temperature management (i.e. turning the thermostat up in the summer and down in the winter).
Water Efficiency within the office, facilities, or firm, such as faucet or fixture retrofits, switching from individual bottled water to office water
coolers or drinking fountains, and installing drought-tolerant landscaping.
Staff encouraged to adopt sustainable practices and supported by your firm through public transit benefits, bicycle accommodations,
telecommuting options, support for green seminar attendance, becoming US Green Building Council LEED accredited, or creating an
internal “green team.”
Education of your staff about green practices, education of your business peers about your green accomplishments, education of your
community by your sustainability, or notice of any environmental awards your firm has achieved.
CONTINUE TO NEXT PAGE
84

SUSTAINABILITY STATEMENT
Attach additional sheets if necessary.
Waste Minimization
Energy Efficiency
Water Efficiency
Staff
Education
End of Sustainability Statement
85

ECONOMIC DISCLOSURE STATEMENT
WHO MUST SUBMIT AN EDS
APPLICANTS: Any entity or individual (the" Applicant') making an application to the Park District for action requiring approval
of the Park District’s Board of Commissioners (“Board of Commissioners”).
ENTITIES HOLDING AN INTEREST IN THE APPLICANT: Generally, whenever an ownership interest in the Applicant (for
example, shares of stock of the Applicant or a limited partnership interest in the Applicant) is held or owned by a legal entity
(for example, a corporation or partnership, rather than an individual) each such legal entity must also file an EDS on its own
behalf, and any parent of that legal entity must do so until individual owners are disclosed. However, if an entity filing an EDS
is a corporation (or a direct or indirect, wholly-owned subsidiary of such corporation) whose shares are registered on a national
securities exchange pursuant to the Securities Exchange Act of1934 as amended, only those shareholders that own ten percent
(10%) or more of that filing entity's stock must file EDSs on their own behalf.
REQUIREMENT: The Chicago Park District (the "Park District") requires disclosure of the information requested in this Economic
Disclosure Statement and Affidavit ("EDS") before any Park District action may be taken regarding the matter that is the subject of this
EDS. Please fully complete each statement, with all information current as of the date this EDS is signed. If a question is not applicable,
answer with "N.A." An incomplete EDS will be returned and any Park District action will be interrupted.
EXECUTION: Please print or type all responses clearly and legibly. Add additional pages if needed, being careful to identify the
portion of the EDS to which each additional page refers.
ACKNOWLEDGMENT OF POSSIBLE CREDIT AND OTHER CHECKS: By completing and filing this EDS, the Undersigned
acknowledges and agrees, on behalf of itself and the entities or individuals named in this EDS, that the Park District may
investigate the creditworthiness of some or all of the entities or individuals named in this EDS.
CERTIFYING THIS EDS: Execute the certification on the date of the initial submission of this EDS. You may be asked to recertify
this EDS on the last page as of the date of submission of any related ordinance to the Board of Commissioners, or as of
the date of the closing of your transaction.
PUBLIC DISCLOSURE: It is the Park District's policy to make this document available to the public on its internet site and/or
upon request.
SECTION 0: GENERAL INFORMATION
Date this EDS is completed:
1. Who is submitting this EDS? That entity or individual will be the "Undersigned" throughout this EDS.
NAME OF ENTITY OR INDIVIDUAL
NOTE: The Undersigned is the entity or individual submitting this EDS, whether the Undersigned is an Applicant or is
an entity holding an interest in the Applicant. This EDS requires certain disclosures and certifications from Applicants
that are not required from entities holding an interest in the Applicant. When completing this EDS, please observe
whether the section you are completing applies only to Applicants.
[ ] Check here if the Undersigned is filing this EDS as an Applicant
[ ] Check here if the Undersigned is filing as an entity holding an interest in an Applicant.
Identify the Applicant in which this entity holds an interest:
2. Business address of the Undersigned:
3. Telephone: Fax: E-mail:
4. Name of contact person:
86

5. Tax identification number (optional):
6. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS
pertains (Include specification number and location if applicable):
SECTION I: DISCLOSURE OF OWNERSHIP INTERESTS
A. NATURE OF ENTITY
1. Indicate whether the Undersigned is an individual or legal entity:
[ ] Individual
[ ] Business corporation
[ ] Sole proprietorship
[ ] Limited Liability Company
[ ] Joint venture
[ ] General partnership
[ ] Limited partnership
[ ] Not-for-profit corporation
Is the not-for-profit corporation also a 501(c)(3)?
[ ] Yes [ ] No
[ ] Other entity (please specify) ________________________________________
2. State of incorporation or organization, if applicable:
3. For legal entities not organized in the State of Illinois: Is the organization authorized to do business in the
State of Illinois as a foreign entity?
[ ]Yes [ ] No [ ] N/A
B. ORGANIZATION INFORMATION
1. IF THE UNDERSIGNED IS A CORPORATION:
a. Date of incorporation:
b. List below the names and titles of all executive officers and all directors of the corporation. For notfor-profit
corporations, also list below any executive director of the corporation, and indicate all
members, if any, who are legal entities. If there are no such members, write "no members."
NAME
TITLE
c. If the Undersigned is a corporation (or a direct or indirect wholly owned subsidiary of such
corporation) whose shares are registered on a national securities exchange pursuant to the Securities
Exchange Act of 1934, please provide the following information concerning shareholders who own
shares equal to or in excess of 7.5% of the corporation's outstanding shares.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
87

d. For corporations that are not registered on a national securities exchange pursuant to the Securities
Exchange Act of 1934, list below the name, business address and percentage of ownership interest of
each shareholder.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
2. IF THE UNDERSIGNED IS A PARTNERSHIP OR JOINT VENTURE:
For general or limited partnerships or joint ventures: list below the name, business address and percentage of
ownership interest of each partner. For limited partnerships, indicate whether each partner is a general partner
or a limited partner.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
3. IF THE UNDERSIGNED IS A LIMITED LIABILITY COMPANY:
a. List below the name, business address and percentage of ownership interest of each (1) member and
(2) manager. If there are no managers, write "no managers," and indicate how the company is
managed.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
b. List below the names and titles of all officers, if any. If there are no officers, write "no officers."
NAME
TITLE
4. IF THE UNDERSIGNED IS A LAND TRUST, BUSINESS TRUST, ESTATE OR OTHER SIMILAR ENTITY
a. List below the name and business address of each individual or legal entity holding legal title to the
property that is the subject of the trust.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
b. List below the name, business address and percentage of beneficial interest of
each beneficiary on whose behalf title is held.
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
88

5. IF THE UNDERSIGNED IS ANY OTHER LEGAL ENTITY
First describe the entity, then provide the name, business address, and the percentage of interest of all
individuals or legal entities having an ownership or other beneficial interest in the entity.
Describe the entity:
NAME BUSINESS ADDRESS PERCENTAGE INTEREST
SECTION II: BUSINESS RELATIONSHIPS WITH PARK DISTRICT OFFICIALS
A. DEFINITIONS AND DISCLOSURE REQUIREMENT
1. The Undersigned must indicate whether it had a "business relationship" with a Park
District Commissioner in the twelve (12) months before the date this EDS is signed.
2. For the purposes of this EDS, a "business relationship" means any contractual or other private business
dealing of a Commissioner , or his or her spouse, or of any entity in which the Commissioner or his or her
spouse has a financial interest with a person or entity which entitles the Commissioner to compensation or
payment in the amount of $2,500 or more during the prior twelve months; but a "financial interest" does not
include: (a) any interest of the spouse or of an employee or Commissioner which interest is related to the
spouse’s independent occupation, profession, or employment; (b) any ownership through purchase at fair
market value or inheritance of less than 1 % of the shares of a corporation, or any corporate subsidiary, parent
or affiliate thereof, regardless of the value of or dividends on such shares, if such shares are registered on a
securities exchange pursuant to the Securities Exchange Act of 1934, as amended, (c) the authorized
compensation paid to an Employee or a Commissioner for his office or employment; (d) any economic interest
not distinguishable from the economic interests of the public generally ; (e) a time or demand deposit in a
financial institution; (f) a money market mutual fund account; or (g) an endowment or insurance policy or
annuity contract purchased from an insurance company. A “contractual or other private business dealing"
does not include any employment relationship of a Commissioner’s spouse with an entity when such spouse
has no discretion concerning or input relating to the relationship between that entity and the Park District.
B. CERTIFICATION
1. Has the Undersigned had a "business relationship" with a Park District Commissioner in the twelve
(12) months before the date this EDS is signed?
[ ]Yes [ ]No
If yes, please identify below the name(s) of the Park District Commissioner(s) and describe the relationship(s):
SECTION III: DISCLOSURE OF RETAINED PARTIES
89

A. DEFINITIONS AND DISCLOSURE REQUIREMENTS
"Lobbyist" means any person (a) who, for compensation or on behalf of any person other than himself, undertakes to
influence any legislative or administrative action, or (b) any part of whose duty as an employee of another includes
undertaking to influence any legislative or administrative action.
1. The Undersigned must disclose certain information about attorneys, lobbyists, accountants, consultants,
subcontractors, and any other person whom the Undersigned has retained or expects to retain in connection
with the Matter. In particular, the Undersigned must disclose the name of each such person, his/her business
address, the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The
Undersigned is not required to disclose employees who are paid solely through the Undersigned's regular
payroll.
2. If the Undersigned is uncertain whether a disclosure is required under this Section, the Undersigned must
either (a) ask the Park District’s Director of Purchasing whether disclosure is required, or (b) make the
disclosure.
B. CERTIFICATION
Each and every attorney, lobbyist, accountant, consultant, subcontractor, or other person retained or anticipated to be
retained directly by the Undersigned with respect to or in connection with the Matter is listed below [begin list here,
add sheets as necessary]:
NAME
(indicate whether
retained or anticipated to
be retained)
BUSINESS ADDRESS
RELATIONSHIP TO UNDERSIGNED
(attorney, lobbyist, etc.)
FEES
(indicate whether
paid or estimated)
[ ] Check here if no such individuals have been retained by the undersigned or are anticipated to be retained by the
undersigned.
SECTION IV: CERTIFICATIONS
A. CERTIFICATION OF COMPLIANCE
For purposes of the certifications in this Section IV, the term "affiliate" means any individual or entity that, directly or
indirectly controls the Undersigned, is controlled by the Undersigned, or is, with the Undersigned, under common
control of another individual or entity. Indicia of control include, without limitation: interlocking management or
ownership; identity of interests among family members; shared facilities and equipment; common use of employees;
or organization of a business entity following the ineligibility of a business entity to do business with the federal
government or a state or local government, including the Park District and the City of Chicago, using substantially the
same management, ownership, or principals as the ineligible entity.
1. The Undersigned is not delinquent in the payment of any tax administered by the Illinois Department of
Revenue, nor are the Undersigned or its affiliates delinquent in paying any fine, fee, tax or other charge owed
to the City of Chicago or the Park District. This includes all water charges, sewer charges, license fees, parking
tickets, property taxes or sales taxes. If there are any such delinquencies, note them below:
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively
presumed that the Undersigned certified to the above statements.
2. The Undersigned and its affiliates have not, in the past five (5) years, been found in violation of any Park
District, City, state or federal environmental law or regulation. If there have been any such violations, note
them below:
90

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively
presumed that the Undersigned certified to the above statements.
3. If the Undersigned is the Applicant, the Undersigned and its affiliates will not use, nor permit their
subcontractors to use, any facility on the U.S. EPA's List of Violating Facilities in connection with the Matter
for the duration of time that such facility remains on the list.
4. If the Undersigned is the Applicant, the Undersigned will obtain from any contractors / subcontractors hired, or
to be hired in connection with the Matter, certifications equal in form and substance to those in this Section IV,
and will not, without the prior written consent of the Park District, use any such contractor/subcontractor that
does not provide such certifications or that the Undersigned has reason to believe has not provided or cannot
provide truthful certifications.
5. If the Undersigned is unable to make the certifications required in this Section IV, A, provide an explanation:
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively
presumed that the Undersigned certified to the above statements.
B: CHILD SUPPORT OBLIGATIONS: CERTIFICATION REGARDING COURT-ORDERED CHILD SUPPORT COMPLIANCE
For purposes of this part, "Substantial Owner" means any individual who, directly or indirectly, owns or holds a 10% or
more interest in the Undersigned. Note: This may include individuals disclosed in Section I (Disclosure of Ownership
Interests), and individuals disclosed in an EDS filed by an entity holding an interest in the Applicant.
If the Undersigned's response below is #1 or #2, then all of the Undersigned's Substantial Owners must remain in
compliance with any such child support obligations until the Matter is completed. Failure of the Undersigned's
Substantial Owners to remain in compliance with their child support obligations in the manner set forth in either #1 or
#2 constitutes an event of default.
Check one:
____1. No Substantial Owner has been declared in arrearage on any child support obligations
by the Circuit Court of Cook County, Illinois, or by another Illinois court of competent
jurisdiction.
____2. The Circuit Court of Cook County, Illinois or another Illinois court of competent
jurisdiction has issued an order declaring one or more Substantial Owners in arrearage
on child
support obligations. All such Substantial Owners, however, have entered into
court-approved
agreements for the payment of all such child support owed, and all such
Substantial Owners are in
compliance with such agreements.
____3. The Circuit Court of Cook County, Illinois or another Illinois court of competent
jurisdiction has issued an order declaring one or more Substantial Owners in arrearage
on child
support obligations and (a) at least one such Substantial Owner has not
entered into a courtapproved
agreement for the payment of all such child support
owed; or (b) at least one such Substantial
Owner is not in compliance with a court
approved agreement for the payment of all such child support owed;
or both (a) and (b).
____4. There are no Substantial Owners.
C. FURTHER CERTIFICATIONS
For purposes of this part, "Affiliated Entity" means an individual or entity that, directly or indirectly: controls the
Undersigned, is controlled by the Undersigned, or is, with the Undersigned, under common control of another
individual or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of
interests among family members; shared facilities and equipment; common use of employees; or organization of a
business entity following the ineligibility of a business entity to do business with federal or state or local government
91

or unit thereof, including the Park District and the City of Chicago, using substantially the same management,
ownership, or principals as the ineligible entity.
With respect to Applicable Parties, the term Affiliated Entity means an individual or entity that directly or indirectly
controls the Applicable Party, is controlled by it, or, with the Applicable Party, is under common control of another
individual or entity; any responsible official of the Undersigned; any Applicable Party or any Affiliated Entity or any
other official, agent or employee of the Undersigned; any Applicable Party or any Affiliated Entity acting pursuant to
the direction or authorization of a responsible official of the Undersigned; any Applicable Party, or any Affiliated Entity
(collectively "Agents").
1. The Undersigned, and, if the Undersigned is a legal entity, its principals (officers, directors, partners,
members, managers, executive director):
a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from any transactions by any federal, state or local unit of government;
b. have not, within a five-year period preceding the date of this EDS, been convicted of a criminal
offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining,
attempting to obtain, or performing a public (federal, state or local) transaction or contract under a
public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft;
forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen
property;
c. are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(federal, state or local) with commission of any of the offenses enumerated in C, 1, b of this section;
d. have not, within a five- (5) year period preceding the date of this EDS, had one or more public
transactions (federal, state or local) terminated for cause or default; and
e. have not, within a five- (5) year period preceding the date of this EDS, been convicted, adjudged guilty,
or found liable in a civil proceeding, in any criminal or civil action instituted by the Park District, City
of Chicago or by the federal government, any state, or any other unit of local government.
2. Neither the Undersigned, nor any Applicable Party, nor any Affiliated Entity of either the Undersigned or any
Applicable Party nor any Agents have, during the five (5) years before the date this EDS is signed, or, with
respect to an Applicable Party, an Affiliated Entity, or an Affiliated Entity of an Applicable Party during the five
(5) years before the date of such Applicable Party's or Affiliated Entity's contract or engagement in connection
with the Matter:
a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a
public officer or employee of the Park District, the City of Chicago, the State of Illinois, or any agency
of the federal government or of any state or local government in the United States of America, in that
officer's or employee's official capacity;
b. agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement,
or been convicted or adjudged guilty of agreement or collusion among bidders or prospective
bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
c. made an admission of such conduct described in a or b above that is a matter of record, but have not
been prosecuted for such conduct.
3. The Undersigned understands and shall comply with (a) all applicable requirements of Governmental Ethics
under Park District Code, and (b) all the applicable provisions of the Park District Purchasing and Contracting
Code.
4. Neither the Undersigned, Affiliated Entity or Applicable Party, or any of their employees, officials, agents or
partners, is barred from contracting with any unit of state or local government as a result of engaging in or
being convicted of (a) bid-rigging in violation of 720 ILCS 5/33E-3; (b) bid-rotating in violation of 720 ILCS 5/33E-
4; or (c) any similar offense of any state or of the United States of America that contains the same elements as
the offense of bid-rigging or bid-rotating.
5. If the Undersigned is unable to certify to any of the above statements in this Part C, the Undersigned must
explain below:
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If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively
presumed that the Undersigned certified to the above statements.
D. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
For purposes of this Part D, the term "financial institution" means a bank, savings and loan association, thrift, credit
union, mortgage banker, mortgage broker, trust company, savings bank, investment bank, securities broker, municipal
securities broker, securities dealer, municipal securities dealer, securities underwriter, municipal securities
underwriter, investment trust, venture capital company, bank holding company, financial services holding company, or
any licensee under the Consumer Installment Loan Act, the Sales Finance Agency Act, or the Residential Mortgage
Licensing Act. However, "financial institution" specifically shall not include any entity whose predominant business is
the providing of tax deferred, defined contribution, or pension plans to public employees in accordance with Sections
403(b) and 457 of the Internal Revenue Code.
1. CERTIFICATION
The Undersigned certifies that the Undersigned [check one]
______ is
______ is not
a "financial institution" as defined above.
2. IF THE UNDERSIGNED IS A FINANCIAL INSTITUTION, THEN THE UNDERSIGNED PLEDGES:
“We are not and will not become a predatory lender as defined in Chapter 2 -32 of the Municipal Code of the
City of Chicago. We further pledge that none of our affiliates is, and none of them will become, a predatory
lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or
becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the
Park District."
If the Undersigned is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-
455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code of
the City of Chicago, explain here (attach additional pages if necessary):
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively
presumed that the Undersigned certified to the above statements.
E. CERTIFICATION REGARDING INTEREST IN PARK DISTRICT BUSINESS
Any words or terms defined in the Park District Code have the same meanings when used in this Section IV.
1. Does any Commissioner or Employee of the Park District have a financial interest in his or her own name or in
the name of any other person in the Matter?
[ ]Yes [ ]No
NOTE: If you answered "No" to Item IV, E, 1, you are not required to answer Items IV, E, 2 or IV, E, 3 below. Instead,
review the certification in Item IV, E, 4 and then proceed to Section V. If you answered "Yes" to Item IV, E, 1, you must
first respond to Item IV, E, 2 and provide the information requested in Item IV, E, 3. After responding to those items,
review the certification in Item IV, E, 4 and proceed to Section V.
2. Unless sold pursuant to a process of competitive bidding, no Park District Commissioner or Employee shall
have a financial interest in his or her own name or in the name of any other person in the purchase of any
property that (a) belongs to the Park District, or (b) is sold for taxes or assessments, or (c) is sold by virtue of
legal process at the suit of the Park District (collectively, "Park District Property Sale"). Compensation for
property taken pursuant to the exercise of any power of eminent domain does not constitute a financial
interest within the meaning of this Section IV.
Does the Matter involve a Park District Property Sale?
[ ] Yes [ ] No
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3. If you answered "yes" to Item IV, E, 1, provide the names and business addresses of the Park District
Commissioners or Employees having such interest and identify the nature of such interest:
NAME BUSINESS ADDRESS NATURE OF INTEREST
4. The Undersigned further certifies that no prohibited financial interest in the Matter will be acquired by any Park
District Commissioner or employee.
SECTION V: CERTIFICATIONS FOR FEDERALLY - FUNDED MATTERS
A. CERTIFICATION REGARDING LOBBYING
1. List below the names of all individuals registered under the federal Lobbying Disclosure Act of 1995 who have
made lobbying contacts on behalf of the Undersigned with respect to the Matter: [Begin list here, add sheets
as necessary]:
If no explanation appears or begins on the lines above, or if the letters "NA" or if the word “None" appear, it will be
conclusively presumed that the Undersigned means that NO individuals registered under the Lobbying Disclosure Act
of 1995 have made lobbying contacts on behalf of the Undersigned with respect to the Matter.
2. The Undersigned has not spent and will not expend any federally appropriated funds to pay any individual
listed in Section V, A, 1, above, for his or her lobbying activities or to pay any individual to influence or attempt
to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of
any federally funded contract, making any federally funded grant or loan, entering into any cooperative
agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or
cooperative agreement.
3. The Undersigned will submit an updated certification at the end of each calendar quarter in which there occurs
any event that materially affects the accuracy of the statements and information set forth in parts 1 and 2
above.
If the Matter is federally funded and any funds other than federally appropriated funds have been or will be paid to any
individual for influencing or attempting to influence an officer or employee of any agency (as defined by applicable
federal law), a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the Matter, the Undersigned must complete and submit Standard Form-LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions. The form may be obtained online from the federal Office of
Management and Budget (OMB) web site at:
http://www.whitehouse.qov/omb/qrants/sfillin.pdf, linked on the page
http://www.whitehouse.qov/omb/qrants/qrantsforms.html.
4. The Undersigned certifies that either (a) it is not an organization described in section 501(c)(4) of the Internal
Revenue Code of 1986, as amended; or (b) it is an organization described in section 501 (c)(4) of the Internal
Revenue Code of 1986, as amended but has not engaged and will not engage in "Lobbying Activities".
5. If the Undersigned is the Applicant, the Undersigned must obtain certifications equal in form and substance to
those in Section V, A, 1-4 above from all subcontractors before it awards any subcontract and the Undersigned
must maintain all such subcontractors' certifications for the duration of the Matter and must make such
certifications promptly available to the Park District upon request.
B. CERTIFICATION REGARDING NON-SEGREGATED FACILITIES
"Segregated facilities," as used in this provision, means any waiting rooms,' work areas, restrooms, washrooms,
restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots,
drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees, that are
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segregated by explicit directive or are in fact segregated on the basis of race, color, religion, sex, or national origin
because of habit, local or employee custom, or otherwise.
1. If the Undersigned is the Applicant, the Undersigned does not and will not maintain or provide for its
employees any segregated facilities at any of its establishments, and it does not and will not permit its
employees to perform their services at any location under its control where segregated facilities are
maintained.
However, separated or single-user restrooms and necessary dressing or sleeping areas must be provided to
assure privacy between the sexes.
2. If the Undersigned is the Applicant and the Matter is federally funded, the Undersigned will, before the award of
subcontracts (if any), obtain identical certifications from proposed subcontractors under which the
subcontractor will be subject to the Equal Opportunity Clause. Contracts and subcontracts exceeding $10,000,
or having an aggregate value exceeding $10,000 in any twelve- (12) month period, are generally subject to the
Equal Opportunity Clause. See 41 CFR Part 60 for further information regarding the Equal Opportunity Clause.
The Undersigned must retain the certifications required by this paragraph for the duration of the contract (if
any) and must make such certifications promptly available to the Park District upon request.
3. If the Undersigned is the Applicant and the Matter is federally funded, the Applicant will forward the notice set
forth below to proposed subcontractors:
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENTS FOR CERTIFICATIONS OF NON-SEGREGATED
FACILITIES
Subcontractors must submit to the Contractor a Certification of Non-segregated Facilities before the award of any
subcontract under which the subcontractor will be subject to the federal Equal Opportunity Clause. The subcontractor
may submit such certifications either for each subcontract or for all subcontracts during a period (e.g., quarterly,
semiannually, or annually).
C. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
Federal regulations require prospective contractors for federally funded Matters (e.g., the Applicant) and proposed
subcontractors to submit the following information with their bids or in writing at the outset of negotiations. (NOTE:
This Part C is to be completed only if the Undersigned is the Applicant.)
1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal
regulations? (See 41 CFR Part 60-2.)
[ ]Yes [ ] No [ ] N/A
2. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ]Yes [ ] No [ ] N/A
3. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance
Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing
requirements?
[ ]Yes [ ] No [ ] N/A
SECTION VI: NOTICE AND ACKNOWLEDGMENT REGARDING PARK DISTRICT ETHICS AND CAMPAIGN FINANCE ORDINANCES
The Park District’s Governmental Ethics Code, Chapter III of the Park District Code, imposes certain duties and obligations on
individuals or entities seeking Park District contracts, work, business, or transactions. The Undersigned must comply fully with
the applicable codes.
[ ] By checking this box the undersigned acknowledges and understands that the Park District’s Governmental Ethics Code,
among other things:
1. Provides that any contract negotiated, entered into or performed in violation of the Park District’s
Governmental Ethics Code can be voided by the Park District.
2. Limits the gifts and favors any individual or entity can give, or offer to give, to any Park District Commissioner,
employee, contractor or the spouse or minor child of any of them, including:
a. any cash gift or any anonymous gift; and
b. any gift based on a mutual understanding that the Commissioner’s or employee's or Park District
contractor's actions or decisions will be influenced in any way by the gift.
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3. Prohibits any Park District Commissioner or employee from having a financial interest, directly or indirectly, in
any contract, work, transaction or business of the Park District, if that interest has a cost or present value of
$5,000 or more, or if that interest entitles the owner to receive more than $2,500 per year.
4. Prohibits any appointed Park District Commissioner from engaging in any contract, work, transaction or
business of the Park District, unless the matter is wholly unrelated to the appointed official's duties or
responsibilities.
5. Provides that Park District Commissioners and employees or their spouses or minor children, cannot receive
compensation or anything of value in return for advice or assistance on matters concerning the operation or
business of the Park District, unless their services are wholly unrelated to their Park District duties and
responsibilities.
6. Provides that former Park District Commissioners and employees cannot, for a period of one year after their
Park District employment ceases, assist or represent another on any matter involving the Park District, if, while
with the Park District, they were personally and substantially involved in the same matter.
7. Provides that former Park District employees and Commissioners cannot ever assist or represent another on
a Park District contract if, while with the Park District, they were personally involved in or directly supervised
the formulation, negotiation or execution of that contract.
SECTION VII: CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
THE UNDERSIGNED UNDERSTANDS AND AGREES THAT:
A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other
agreement between the Applicant and the Park District in connection with the Matter, whether procurement, Park
District assistance, or other Park District action, and are material inducements to the Park District's execution of any
contract or taking other action with respect to the Matter. The Undersigned understands that it must comply with all
statutes, ordinances, and regulations on which this EDS is based.
B. If the Park District determines that any information provided in this EDS is false, incomplete or inaccurate, any contract
or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the Park
District may pursue any remedies under the contract or agreement (if not rescinded, void or voidable), at law, or in
equity, including terminating the Undersigned's participation in he Matter and/or declining to allow the Undersigned to
participate in other transactions with the Park District.
C. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the
public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing
this EDS, the Undersigned waives and releases any possible rights or claims which it may have against the Park
District in connection with the public release of information contained in this EDS and also authorizes the Park District
to verify the accuracy of any information submitted in this EDS.
D. The Undersigned has not withheld or reserved any disclosures as to economic interests in the Undersigned, or as to
the Matter, or any information, data or plan as to the intended use or purpose for which the Applicant seeks Park
District action.
E. The information provided in this EDS must be kept current. In the event of changes, the Undersigned must supplement
this EDS up to the time the Park District takes action on the Matter.
SIGNATURE PAGE FOLLOWS
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EDS CERTIFICATION
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS on behalf of the
Undersigned, and (2) warrants that all certifications and statements contained in this EDS are true, accurate and complete as of
the date furnished to the Park District.
(Print or type name of legal entity or individual submitting this EDS)
Date:
By:
(Sign here)
Print or type name of signatory:
Title of signatory:
Subscribed to before me on [date] ____________________, at __________________County,
_________________________ [state].
Commission expires:
Notary Public
SEAL
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LEGAL ACTIONS
Provide the information below.
QUESTION YES NO
Has your firm been issued a notice of default on any contract awarded in the last
three (3) years?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Does your firm have any judgments, claims (liquidated damages, etc.), arbitration
proceedings, or suits pending against it?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
INCLUDE THE DOLLAR AMOUNT OF CLAIMS OR JUDGMENTS AND THE VALUE OF THE CONTRACT ON
WHICH THE CLAIM WAS FILED.
Within the past three (3) years, has your firm been party to any lawsuits or
arbitration proceedings with regard to any contracts?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Within the past three (3) years, has any officer or principal of your firm been an
officer or principal of another organization that failed to complete any contract as
a result of termination, litigation, arbitration, or similar matter?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Has any key person with your firm (or its predecessor, if applicable) ever been
convicted of or charged with any state or federal crime such as embezzlement,
theft, forgery, bribery, falsification or destruction of records, receipt of stolen
property, criminal anti-trust violations, bid rigging, bid rotating, or the like?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Has your firm ever been temporarily or permanently debarred from a contract
awarded by any local, state, or federal agency?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Within the past three (3) years, has your firm been assessed penalties for any
statutory or administrative violations, including MBE, WBE, or Equal Employment
Opportunity violations?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
Has your firm ever failed to complete any work awarded to it?
IF THE ANSWER IS YES, PROVIDE A BRIEF EXPLANATION OR DESCRIPTION ON A SEPARATE SHEET.
End of Legal Actions Form
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