Summer Food Service Program_IFB - Chicago Park District

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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
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SECTION A SUMMER FOOD SERVICE PROGR
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SECTION C INSTRUCTIONS TO BIDDERS 1
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SECTION D SCOPE OF SERVICES 1. Cont
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• Date of production • Quantity
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whichever occurs last, through __Fe
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SECTION G GENERAL PROVISIONS 1. Thi
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Exhibit A - Program Sites Name and
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Page 37 and 38: Exhibit A - Program Sites Name and
Page 57 and 58: EXHIBIT B - MENUS Sponsor shall att
Page 59 and 60: EXHIBIT C REQUIRED MEAL PATTERNS SU
Page 61 and 62: GROUP E • Cookies 1 , with nuts,
Page 63 and 64: Bidder Responsibility and Bid Respo
Page 65 and 66: Bid-Rigging Certification _________
Page 67 and 68: DISCLOSURE OF LOBBYING ACTIVITIES C
Page 69 and 70: DISCLOSURE OF LOBBYING ACTIVITIES C
Page 71 and 72: P. The term “schedules” means t
Page 73 and 74: their Schedule Bs. The Park Distric
Page 75 and 76: 1. SCHEDULE A [STATEMENT OF PRIME B
Page 77 and 78: 2. Name of MBE/WBE: Address: Contac
Page 79 and 80: II. Summary of MBE/WBE Plan: A. MBE
Page 81 and 82: ALTERNATE SCHEDULE A SIGNATURE PAGE
Page 83 and 84: MBE/WBE UTILIZATION REPORTING REQUI
Page 85 and 86: SUSTAINABILITY STATEMENT Attach add
Page 87: 5. Tax identification number (optio
Page 91 and 92: If the letters "NA," the word "None
Page 93 and 94: If the letters "NA," the word "None
Page 95 and 96: segregated by explicit directive or
Page 97 and 98: EDS CERTIFICATION Under penalty of
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Summer Food Service Program_IFB - Chicago Park District

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