Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
Contract No. 1880-15787Amendment No. 1
Vendor Name: GREATARC TECHNOLOGIES. INC.
AMENDMENT NG. 1
Thh Amsndmsnt modigss Contraot Nm 1530-15787, tor PINMAP Maintenance by and between the County ol Cack, gllnoia, herein retensd toas 'County" and Great Arc Technologies, Inc., authorized to do business in ths State of llgnole imrelnafter refermd to as "Consultant":
RECITALS
Whetsas, the Coun'iy and Contractor have entered into a Contract mumuted by the Chief Pmcuremenl Glliosr on March 3, 2017, (hereinafter
refened to as the "Contract), wherein the Consultant is to provide PINMAP Maintenance (hereinafter refsnsd lo as Uw "Services") hom March
1,2017 through February 28, 2018, with two (2), ons (1)year rerwwal opgons, in an amount not lo exceed 8I3880000; and
Whereas, the Contract will expire February 28, 2018, and the agreed upon Services me stg required; and
Whsmas, an increase in gre amount of $138 800 00 is required for the continuation of Servimw; and
whereas, ths county and conlractor desire to renew the contract for hreihw (12) months beginning an March I, 2018 through February 28,2019; and
Whewms, ths County and Contractor desire to indude additional Scope of Services to the Contract; and
Now therefore, in consideragon of mutual covenants coniained hemin, it is agreed by and between the panisc lo amend the Contract as,falfoww
1. Ths Contract Is renewed through Februmy 28, 2019,
2. The Contract is irwrcased by $138,800.00and the Total Contract Amount is revised to $277,200.00.
8. The Contract is hereby amended to incorporate Attachment A and made part cf the Contract.
4, The attached Idsrdlticatlon ct Sub4ankactcrsfsupplktrsfsubCcasu(tents Form, MBEIWBE IAlllzsgcn Plan forms, snd Ecormmlc
Gisdosums Statement under Attachment 8 are Incorporated and made a pwt of tive contract.
5. All alber lerms snd conditions remain ss slated in tile Contract.
In witness whereof, the Comfy snd Contractor have caused this Amendment No. 1 to be executed on ths date and yrmr last written below.
County of Cook, ggnols
„M~.ilLChief Procuremant Oificer
'matsr Are Technologlee Inc.
pcSigned
,„. 15 Gb~q MlS
g(t(-State's Attorney (ii appgcable)
Type or print name (if applicable)
Date:
WiiM+dC W WA7~
. Tilts
g/~yg.or(5I
Contract No.163075767Amendment No. 1
Vendor Name: GREAT ARC TECHNOLOGIES, INC.
ATTACHMENT A
Rev e/I/17
Scope of Services forCook County Government
Office of the Chief Procurement Officer
Task Order Request (TOR) in Reference to Cook County Specification No.1488-14270 K 1488 14183 Category 2 for
Geographic Information Systems (GIS) Department, Bureau of Technology
PINMAP Maintenance —2"'ear Contract Extension
By
Great Arc Technologies, inc.With Subcontractors
Pro-West & Associates, Inc.
Scarfe Consulting, LLC
ESRI, Inc.
6g GreatArc December 15, 2016Updated January 26, 2017
Updated for 2018 Contract Extension December 19, 2017Second Revision for 2018 Contract Extension January 25, 2018
Table of ContentsSection D1: Scope of Services
Section D2: Project Staffing and Updated Rates.
12017 Great Arc Technologies, Inc.401 S. LaSalle Street ~ Suite 1005 ~ Chioago, illinois 60605
p) 312.726.4848~ 1) 312.492.4249solutionsgreatarc.corn e www.greatarc.corn
SECTION D1:SCOPE OF SERVICES
Scope of Services
For this 2018 extension to the Task Order, we propose continuing with the same team. Great Arc will
continue as the Prime contractor, directing all efforts and coordinating the same through a SharePointtracking site. We will also retain responsibility for any updates or enhancements to the web portion ofthe PINMAP application, as well as maintaining the tabular portion of the database. Pro-west will
retain responsibility for any fixes or enhancements to the desktop portion of the application as well asmaintenance of the spatial data. Scarfe Consulting will continue the role of day-to-day projectmanagement (coordinate communications and meetings, update the SharePoint site), perform anyrequired needs assessments, create or update documentation, and perform any required training. In
addition, Scarfe will continue with the user and integration testing that is required after any bug fixesor new functionality has been added to the application. ESRI will continue in a limited support role,assisting Great Arc to transition any database maintenance tasks to us, as well as assist with themigration of the code repository to Cook County for future code management. Once those tasks arecomplete, ESRI will transition to a limited, strictly as-needed support role.
We anticipate the following general actions for this Task Order Extension:
1. Great Arc and Pro-West will resume bug-fixes based on the priority list.2. If the task has not already been completed by the start of this 2018 extension, Great Arc will
work with ESRI to transition database maintenance tasks to Great Arc and work with CookCounty to determine how best to transition the code repository from ESRI to Cook.
3. All bug-fixes, updates or enhancements to the system will be fully tested Once the fixes havepassed testing in Development, SharePoint will be updated to reflect progress. Based on anagreed upon schedule, updated code will be pushed to the Test environment for Cook testing.Cook will test all fixes in Test. If the tests fail, SharePoint will be updated and Great Arc will
look further into the issues. Otherwise, the updated code will be pushed to Cook Production onan agreed upon schedule.
4. Any documentation that requires updating based on application fixes or enhancements will beupdated.
5. Any bug fixes or enhancements to the system that are beyond currently scoped functionalitymay require a small needs assessment to determine the exact scope of functional changes oradditions. In this case, that assessment will be made and presented to Cook to determinewhether or not to proceed with that work.
6. Assuming the County hosts or licenses the code repository, code will be pushed fromDevelopment according to agreed-upon rules
7. Regarding Status Reporting, that is driven by updates to the SharePoint project tracking andissue list. If separate spreadsheet-based status reports are required outside of SharePoint,those reports can be generated from SharePoint and disseminated on a schedule asdetermined by the County.
2017 Great Arc Technologies, Inc.
3IPage
SECTION D2:PRQJEGT STAFFING AND UPDATED RATES
Project Staffing and Updated Rates
Project Staffing
The following is a listing of all staff available from each of the Prime and Subcontractors that areavailable for this project. The data grid that follows lists additional information.
Great Arc Techno/Dales. Inc.Michael Scanlon —Program Manager (overall Task Order management)David Skyles —Technical LeadBrett Ward —Database Administration, DevelopmentBryan Luman - DeveloperChristopher Jennings —DeveloperDerek Brovold —GIS SpecialistTareen Scanlon - Analyst
Scarte Consultina LLCDanielle Scarfe —Project Management/Needs Assessment/DocumentatioPro-West tt Associates. Inc.Josh Marsh - CTOLucas Scharenbroich - Technology ManagerAdam Skoog - Application DeveloperRoyal Paddock - Application DeveloperLisa Schaefer, GISP —Geospatial Data SpecialistESRI. Inc.
Mark Williams —PM
Margaret Gregory —Parcel Fabric Subject Matter ExpertMahesh Ramiah —Technical LeadRobed Blischke —Software Build Management
n/Testing
Name
Michael Scanlon
Danielle Scarfe
David Skyles
Brett Ward
Experience20+ years20+ years
20+ years20+ years
Title
Program Manager / Senior Developer
PM/Needs Assmt/Testing (WBECertified)Technical Lead/Senior Developer
Database Administrator
Availability
Full
Full
Full
Full
2017 Great Arc Technologies, Inc.
4lpage
SECTION D2:PROJECT STAFFING AND UPDATED RATES
Bryan Luman
Christopher Jennings
De re k Brovold
Tareen Scanlon
Josh Marsh
Lucas Scharenbroich
Adam SkoogRoyal Paddock
Lisa SchaeferMark Williams
Margaret Gregory
Ma hesh Ramia h
Robert Blischke
15+years15+years15+yea rs
2+ years10+years14+ years
8+ years8+ years17+years10+years10+years10+ years10+years
GIS Developer
GIS DeveloperGIS Specialist
Analyst
CTO
Technology Manager
Application DeveloperApplication Developer
GISP —Geospatial Data Specialist
PM
Parcel Fabric Subject Matter Expert
Technical Lead
Software Build Management
Full
Full
Pa rt
Part
Full
Full
Full
Full
Full
Full
Full
Full
Full
2017 Great Arc Technologies, Inc.
SlPage
SECTION D2:PROJECT STAFFING AND UPDATED RATES
Updated Rates
Hourly Rate Matrix
Company/ResourceGreat Arc Technoioaies.Inc.
Michael Scanlon
David Skyles
Brett Ward
Bryan Luman
Christopher Jennings
Derek Brovold
Tareen Scanlon
Scarfe Consuitina. LLC
Danie lie Scarfepro-West a Associates.Inc
Josh Marsh
Lucas Scharenbroich
Adam Skoog
Royal Paddock
Lisa Schaefer
ESRI. Inc.
Mark Williams
Margaret Gregory
Mahesh Ramiah
Robert Blischke
Title
Program Manager/SeniorDeveloper
Technical Lead/Senior Developer
Database Administrator
GIS Developer
GIS Developer
GIS Specialist
Analyst
Project Manager/NeedsAssmt/Testing
CTO
Technology Manager
Application Developer
Application Developer
GISP —Geospatial Data Specialist
Project Manager
Parcel Fabric Subject MatterExpert
Technical Lead
Software Build Management
Role
Project/Program Manager
Developer/Technical Lead
DBA
Application Developer
Application Developer
GIS Specialist
Analyst
Project Manager/NeedsAssmt/Testing
CTO
Technology Manager
Apphcat<on Developer
Application Developer
GISP —Geospatial Data Specialist
Senior GIS Consultant/ProjectManager
G IS System/Softwa re DeveloperGIS System/Software Developer
GIS Technical Specialist/Engineer
Hourly
Rate
$165
$165
$155
$140
5140
$125
$85
$168
$121.30
$ 121.30
$111.72
$111.72
$102.14
$347
$294
5294
$227
Total Estimated Budget $138,600
2017 Great Arc Technologies, Inc.
6lPage
Contract No. 1630-15767Amendment No. 1
Vendor Name: GREAT ARC TECHNOLOGIES, INC.
ATTACHMENT B
Rev 6/1/17
Contract ¹: TOR No. 1630-15767 (Ext)
ocpo oNLY:Cook County Disoualiacsaon
Office of the Chief Procurement Offfcer 48'"'dentificationof Subcontractor/Supplier/Subconsultant Form /
The Bidder/Proposer/Respondent ("the Contractor" ) will fully complete and execute and submit an Identification ofSubcontractor/Supplier/Subconsultant Form ("ISF")with each Bid, Request for Proposal, and Request forQualification. The Contractor must complete the ISF for each Subcontractor, Supplier or Subconsultant whichshall be used on the Contract. In the event that there are any changes in the utilization of Subcontractors,Suppliers or Subconsultants, the Contractor must file an updated I SF.
Bix¹RFp/RFQ No, TOR No. 1630-15767 (EA)
Total Bid or Proposal Amount:
Contractor: Great Arc Technologies, inc.
Authorized Contactfor Contractor Michael Scanlon
Email Address(Contractor) [email protected]
Com an Add as401 S. LaSalle Street
(Contractor):
Zip (Contractor), Chicago, illinois 60605City, State and
Telephone andFair (Corilractor). 312-726-4848
Estimated Start andComPletion Dates 3/1/2018 - 2/28/2019(Contractor):
Date: 1/5/2018
Contract Title: PINMAP Maintenance (Year 2 Extension)
Subcontractor/Supplier/Subconsultant to be ESRI Incadded or substitute:Authorized Contact forSubcontractor/Supplier/ Mark WilliamsSubconsultantEmail Address(Subcontractor) [email protected]
Comps y Add as 380 New York Street
(Subcontractor):(Subcontractor).
Redlands, CA 92373City, State and Zip
Telephone and Fax 360-754-4727 ext 1-8915(Subcontractor):Estimated Start andCompletion Dates 3/1/2018 - 2/28/2019(Subcontractor):
Note: Upon request, a copy of all written subcontractor agreements must be provided to the OCPO.
Descrlotion of Services or SuoouesTotal Price of
Subcontract forServices or Suooliss
Assist with database related tasks, migration of code repository, and related services T 8 M to $6,930 max
The subcontract documents will incorporate all requirements of the Contract awarded to the Contractor as applicable.The subcontract will in no way hinder the Subcontractor/Supplier/Subconsultant from maintaining its progress on anyother contract on which it is either a Subcontractor/Supplier/Subconsultant or principal contractor. This disclosure ismade with the understanding that ths Contractor is not under sny circumstances relieved of its abilities andobligations, and is responsible for the organization, performance, and quality of work. This form does not approveany proposed changes, revisions or modifications to the contract approved MBE/WBE Utilization Plan. Anychanges to the contract's approved MBE/WBE/Ufifzation Plan must be submitted to the Office of theContract Compliance.
Great Arc Technologies, Inc.
Contractor
Michael Scanlon
Name
President ~Title
1/5/2018
Prime Contractor Signature Date
Version 1.0
Contract ¹: TOR No. 1630-15767 (Ext)
ocpo oNLY:Cook County
Office of the Chief Procurement Ofgcer Check Comoiete
identification of Subcontractor/Supplier/Subconsultant Form /
The Bidder/Proposer/Respondent ("the Contracted) will fully complete and execute and submit an Identification ofSubcontractor/Supplier/Subconsultant Form ("ISF")with each Bid, Request for Proposal, and Request forQualification. The Contractor must complete the ISF for each Subcontractor, Supplier or Subconsultant whichshall be used on the Contract. In the event that there are any changes in the utilization of Subcontractors,Suppliers or Subconsultants, the Contractor must file an updated ISF.
Bid/RFP/RFQ No
'otal
Bid or Proposal Amount: 3
Contractor: Great Arc Technologies, Inc.
Authorized Contactfor Contractor: Michael Scanlon
Email Address(ConIracIor)
m scan Ion @g re a Ia rc.com
C m an Addrsss401 S. LaSalle Street
Date:1/5/2018
Contract Title: PINMAP Maintenance (Year 2 Extension)
Subcontractor/Supplier/Subconsultant to be Pro-West & Associates, Inc.added or substitute:Authorized Contact forSubcontractor/Supplier/Annette TherouxSubconsultant:Email Address(Subcontractory aderouxeProwemgls corn
Com an Address8239 State 371 NW
(Subcontractor):
City, State andZip (Contractor). Chicago, illinois 60605
Telephone and 312-726-4848Fax (Contractor):Estimated Start sndCompletion Dates 3/1/2018 - 2/28/2019(Contractor):
City, State and ZipISubcontractory Walker, MN 56484
Telephone and Fax218 547 3374 x1 08(Subcontractor):
Estimated Start andCompletion Dates 3/1/201 8 - 2/28/2019(Subcontractor):
Note: Upon request, a copy of all written subcontractor agreements must be provided to the OCPO.
Descrlotlon of Services or SueolleaTotal Price of
Subcontract forServices or Suoolies
Desktop Appl Code Maint; Spat DB and Pare Fabr Maint; Assist w/Map Gen; Rel Tasks T & M to $27,720 max
The subcontract documents will incorporate all requirements of the Contract awarded to the Contractor as applicable.The subcontract will in no way hinder the Subcontractor/Supplier/Subconsultant from maintaining its progress on anyother contract on which it is either a Subcontractor/Supplier/Subconsultant or principal contractor. This disclosure ismade with the understanding that the Contractor is not under any circumstances relieved of its abilities andobligations, and is responsible for the organization, performance, and quality of work. This fons does not approveany proposed changes, revisions or modifications to the contract approved MBE/WBE Utilization Plan. Anychanges to the conbact's approved MBE/WBE/Utilization Plan must be submitted to the Office of theContract Compliance.
Great Arc Technologies, Inc.
Contractor
Michael Scanlon
Name
President
Prime Cbf(tractor Signature
1/5/201 8
Date
Version I.o
Contract fk TOR No. 1630-15767 (Ext)
ocpo otsLv:Cook County S Discueliaeetion
ONce of the Chief Procurement Officer +I Cheek Cemelete
Identification of Subcontractor/Supplier/Subconeultant Form
Ths Bidder/Proposer/Respondent ("the Contractor"} will fully complete and execute and submit an Identification ofSubcontractor/Supplier/Subconsultant Form ("ISF")with each Bid, Request for Proposal, and Request forQualification. The Contractor must complete the ISF for each Subcontractor, Supplier or Subconsultant whichshall be used on the Contract In the event that there are any changes in the utilization of Subcontractors,Suppliers or Subccnsultants, the Contractor must fils an updated I SF.
Bid/RFp/RFQ NoTOR No. 1 630-15767 (Ext)
Total Bid or Proposal Amount:
Contractor Great Arc Technologies, Inc.
Authorized Contaotfor Contractor: Michael Scanlon
Email Address(Contractor) mscanlon @9reatarc.corn
~ sn Address401 S. LaSalls Street
(Contra~or)."Suits 1005
Date: 1/5/2018
Contract Title: PINMAP Maintenance (Year 2 Extension)
Subcontractor/Supplier/Subconsultant to be Scarfs Consulting, LLCadded or substitute:Authorized Contact forSubcontractor/Supplier/ Danielle ScarfsSubconsultant:Emsfi Address(Subcontractory sc d O
Com an Addmm60 W. Terra Cotta Avenue
Ciiy, State andZip (Contractor) Chicago, illinois 60605
Fax (Contractor).Estimated Start andCompletion Dates 3/1/2018 - 2/28/201 9(Contractorl:
(Subcontract r)CrYstal Lake, llhnois 60014(Subcontractor):
Telephone and Fax 815-970-2418(Subcontractor):Estimated Start andCompletion Dates 3/1/2018 - 2/28/2019(Subcontractorl:
Note: Upon request, a copy of all written subcontractor agreements must be provided to the OCPO.
Descrlotion of Services or SuoollesTotal Price of
Subcontract forServices or Suoalies
PM, Needs Assmnt, Documentation, BugTracking, Training, Testing and rel. services T & M to $48,510 max
The subcontract documents will incorporate sll requirements of the Contract awarded to the Contractor as applicable.The subcontract will in no way hinder ths Subcontractor/Supplier/Subconsultant from maintaining its progress on anyother contract on which it is either a Subcontractor/Supplier/Subconsultant or principal contractor. This disclosure ismade with the understanding that the Contractor is not under any. circumstances relieved of its abilities andobligations, and is responsible for the organization, performance, and quality of work. This form does not approveany proposed changes, revisions or modifications to the contract approved MBE/WBE Utilization Plan. Anychanges to the contract's approved MBE/WBE/Utilizanon Plan must be submitted to the Office of theContract Co m piia n ce.Great Arc Technologies, Inc.
Contractor
Michael Scanlon
Name
President
eu
Prime Contractbr Signature
1/5/2018
Date
Version 1.0
teFBCE OF COFITIViCV 60MFUANCE
JJLC66tJBLthtg 6OhaBB
hIRECTQh
.11aN chtdc securit auildittfh Roast 1DED e ctuutaa. Elinars 60aoa esv12I Eoihsso2
TOIEI I%66KWttttKL6
FRESIDSNT
oshk'ccssstyeaumctr dtt JaJsvssutw
RBS)ARD R, EDVRIN
1st Crutrrct
DsttNIBPmtl
Su<I @Itacl
J368V durtvg
Scd Offal!Rt
STANIEv Mooecc
ctlh Qtshlcv
ONQRAH, SIMS
5th'rstuct'DWARD
M MDOOV
5th-Dtctttct
Imps c',4RRCA
Tthhfstrtcc
I,UB ARRQvo: acSth,atsutce
PETER N, SILVEET6I
stts oat tnt
svtonET Nasisa,1cth Dist tat
JOHN F.OAIEI'1th
Ihstrkt
JOHN.A, FRITCHEV
12th Dtsrctct
JWupffl 3f), W}h8
Ms, ghaanon-E; Andrewa
CIERLPIEEhtremhnt Qfheer
116ti);.Blafhgtfaht
Cdu'lity Buffdfh)pf66hfh1018
Clihphph IL.60602
ffei Congactfto..163fPIBT6vtAfnendntmftMo.i)
plMMAP Maintenanoe
Bumhirdf Tthhthdlhg)I
Gear MS. Andrews:
The OBE@of Bonfracf Compliance is ln reeeipl of Ihm ~nee: contract amendment-and lme Teviswed it for
adfnpffartce dtth 6fe Mhtofffy-. end women- oiimed BhairtasaEnhdtfffsev (MBBfvvBE} odfnanca. Affhphgrefui review„ if
hahhaan degfftfflfed 6lhhainent)irihfftipreeponifvahtftfe'~
ewer.'redtbro Tachnohfgfds, inc.
Odghaf Bonh'act Vafuep3136,I)000fivdswid Cohtrhht tthddri 61366f600 tfgdhndmeht fto. I)Maw Csndtact ttelun; ftBP7,Jti)0.05
fhteddtwf'Biintraot Term. 12rndnthe
NdaBahtddt Tartri'rfhfdh 1 Bl}iggffuugh Fahrualy 3))c@tgCenhact Boah 26% hfBB, 10%WBK
~u Ceritvvhu Commhment
llif66) tT) Co~egaftrdyBtpft
'Coapltitnrhnt per~ are haatnk an tha ravieed agntract vatue;
Reviamt MBEfwBE fofms tvere used in thedetermfnahcn of Iheraspurvdverievs ofihB conpant,
Bhicerely,
IARRYSUFSREDIN
11th Oisttht
dREeo aosUN
14th Dlsmct
TIMOTHV O SOISIHDER
15th Dtsttlct
IIFFEET R, TQeglstr
15th Dtstctct
sEINN, uoesscu17th OlsuhS
ach Bonis a
Cottrapt Bempihmce Btrector
JIats
Attgela Benches, QQPQ
Carl'yn Augustave BCT
Jim Bavin; BOT
Enclosure: pfetnaed MBEIWBE Forum
fFiscal Resppnsitnllty f Innovative Leadership g Transparency at Accountability, Q Improved Services
MBBWBE UTILIZATION PLAN ~ FORM 1
BlDDEPJPROPOSER HEREBY STATES that sii MBE/WBE firms induded in Ibis Plan are certified MBEs/WBEs by at least one of the entities listed in the GeneralConditions —Section 19.
I. BIDDER/PROPOSER MBEIWBE STATUS: (check the appropriate line)
Bidder/Proposer is a certified MBE or WBE firm. (If so, attach copy of current Loiter of Certification)
Bidder/Proposer is a Joint Venture and one or more Joint Venture partners are certified MBEs or WBEs. (It so, attach copies of Letter(s) of
Certification, a copy of Joint Venture Agreement clearly describing the role of Sie MBE/WBE firm(s) and ils ownership interest in the Joint
Venture and a completed Joint Venture Affidavit —available online at www cookcountvil.cov/coniractcomoliance)
Bidder/Proposer is not a certified MBE or WBE firm, nor a Joint Venture with MBE/WBE partners, hut will utilize MBE and WBE firms eitherIZ directly or indksdly in ths psdormmce of ths Contract. (If so complete Sections II hslovi and the Letter(s) of intent- Form 2).
II. x Direct Participarion of MBEiWBE Firms Indirect Participation of MBE/WBE Firms
NOTE: Whwe goals have not been achieved through direct participation, BidderlProposer shag include documentation ouMning efforts toachieve Direct Participation at ths time of Bid/Proposal submission. Indirect Participation will only be considered after all efforts toachieve Direct Participation have been exhausted. Only after written documentation of Good Faith Efforts ls received will Indirect
Paklclpation be considered.
MBEs/WBEs that will perhrm as subcontrachirs/suppliers/consultants include the following;
MBE/wBE FiScarfs Consulting, LLC
Add„,w60)/I/. Terra Cotta Avenue, ¹239, Crystal Lake, IL 60014
Contam PersonDanielle Scarfe 815-970-2418
DollarAmountP~i ation STime and Materials to rnaxirnurn $48,510
Percent Amount of Participation:
*Letter of Intent attached? YesX
No
*Current Letter of Certification attached? Yes ir No
MBE/WBE Firm:
Address:
E-maili
Contact Person:
Dollar Amount Participation: $
Percent Amount of Participation:
Phone:
*Letter ol intent aitached7 Yes*Current Letter of Certification attached? Yes
No
No
Attach additional sheets as needed.
* Letter(s) of Intent and current Letters of Certification must be submitted at the time of bid.
M/WSE utilization Plan - Form 1 Revised: 01/29/2014
MBE/WBE LETTER OF
MRIIQE F, Scarfe Consulting, LLCMRWBE Firm,
c~p nDanielle Scarfe
Contact Pemon:
, 80 W, Terra Cotta Avenue, ¹239Address:
City/Sale: , Crystal Lake >, 80014ZIP:
P~ 815 970 2418
Email,dacarfedagia.corn
Parkdpslion: g Direct Indirect
INTENT ~ FORSI 2
Cook County ONce ci Ccntracl CcmprnuumCerfifying Agency:
Csrlacation Expimfian Date:12/23/2020
Ethnicitycaucasian (wsE)
TOR No. 1660-15767 (Ext)Bid/Prcponagconkact
¹I'EIN¹,034)418566
Wifi Ihe M/WBE firm be subcontracting any of the goods or senrices of this contract Io another firm7
g No Yes- Please attach explsnafion. Pmpooed Subcontractor(s):
The undersigned M/WBE is prepared to provide the following CommodiTies/Servkfm far the above named ProJect/ Contract p/mnm space is ndndsd fn ANy dsscrihn kr/yyBE Rm's pro pc and scope af work nnd/nr pnymenl schndu/o, n/inch ndfffionnf ahen/sI
Provide Project Management, Needs Assessment, Documentation, Bug/Bug-fix Tracking, Training, Testing snd
related services in support of this Task Order,
Indkate the Dagnr Atnaunt, Pnrcsntnas, and fite Terms of Pnvmsnt for the aboveufescribed Commodaes/ Services:sos at actual della ra usad on tins rima and Matadns ccnhsct (aslltnatad mmimum cf sss stol. Ccnhstscf lc lnvc tea mcnthly lat sos completed tha asm mcnth.
prima tc psy wnhln Io days sl receipt of payment fmm cack ccunly.
THE UNDERSIGNED PARTiES AGREE that this Letter of Ifdnnt will become s binding Subcontract Agreement for Ihe abovework, conditioned upon (I) the Bidder/Proposer's receipt af a signed contract from the County of Cook; (2) UndersignedSubcontractor remaining compliant with all relevant credenfials, codes, ordinances and statutes requked by Contractor, CookCounty, and the Slate to participate ss s MBEANBE firm for Ihe above work. The Undersigned Parfies do also ceNIy that they~dl Lggt aNx their si to is document until all areas under Descriplio Se 'nd Fee/Cost were completed.
c&l/PA'Sii)no&re (M/WBE)f Sgnature (Prime Bidder/Proposer)
DIlnielle Scoff~ Michael Scanlon
Print None Print Name
Scarfs Consulting, LLC Great Arc Technologies, Inc.
Firm Name Firm Name
1/4/201 8 1/4/2018
Date
Subscribed and swam before me Subscribed and swam before me
this ~ dayof~If'otary
Pubfic I///f k
M/WSE Letter of Int
ubl
MdVa,2O&.
SEAL DFFIQAL SEALAMANDA DURAN
NOTARY PUBLIC- STATE OF ILLNCISMY COMMISSION EXPIRES Ct/Iff21
Revised: 1/29/14
MBEIWBE LETTER OF INTENT ~ FORM 2
/ W8E FirmSca rfe Ccn su It i n g, LLC
Contw PersonDanielle Scarfe
, 60 W. Terra Cotta Avenue, ¹239
City/State:C+/~, Crystal Lake z. 60014Zip:
Ph815-9 0- 418
Phone: Fax:
d scarf e dsgis .
corn
Pargcipation: g Direct Indirect
cook county chico of contract complianceCertifying Agency:
Certification Expiration Date:12/23/2020
Ethn c', Caucasian (WBE)
TOR No. 1630-15767 (Ext)Bid/Proposal/Contract ¹:
FEIN ¹ 03-0416566
Will the M/WBE firm be subcontracting any of the goods or services of this contract to another firm?
VF No Yes - Please attach explanation. Proposed subcontractor(s):
The undersigned M/NSE is prepared to provide the following Commodities/Services for the above named Project/ Contract (lfmore space is needed lo /idly describe fyfitfVBE Firm'3 proposed scope oi work and/or paymsol schedule, affoch add5anol sheets)
Provide Project Management, Needs Assessment, Documentation, Bug/Bug-fix Tracking, Training, Testing and
related services in support of this Task Order.
Indicate the Dollar Amount, Percentaae, and ths Terms of Pavment for the above-described Commodities/ Services:ssyc of actual do coro used on Ihic Time ood Materials ccmmct iootlmolod mmtlmum of stsst of. Contractor lo Invoice monthly for code
corn
plolcd the prior month.
Primo to poy within t 5 days of receipt of payment from Cook County.
THE UNDERSIGNED PARTIES AGREE that this Letter of Intent will become a binding Subcontract Agreement for the abovework, conditioned upon (1) the Bidder/Proposer's receipt of a signed contract from the County of Cook; (2) UndersignedSubcontractor remaining compliant with all relevant credentials, codes, ordinances and statutes required by Contractor, CookCounty, and the State to participate as a MBE/WBE firm for the above work, The Undersigned Parges do also certify that Iheydid not affix their signatures to this document until all areas under Descriptio Se i snd Fee/Cost were completed.
w
Signature (M/WBE) Signature (Prime Bidder/Proposer)
Daniege Scarfs Michael Scanlon
Print Name
Scarfe Consulting, LLC
Firm Name
1/4/201 8
Date
Print Name
Great Arc Technologies, Inc.
Firm Name
1/4/2018
Date
Subscribed and sworn before me
this day of
Notary Public
, 20
Subscribed and sworn before me
this ~aNotary Publ
SEAL
M/WBE Letter of Intent - Form 2 Revised: 1/29/14
PETITION FOR REDUCTION/WAIVER OF NIBE/WBE PARTICIPATION —FORM 3
A.BIDDER/PROPOSERHEREBY REQUESTS:
FULL MBE WAIVER FULL WBE WAIVER
REDUCTION (PARTIAL MBE and/or WBE PARTICIPATION)
% of Reduction for MBE Participation
% of Reduction for WBE Participation
B.REASON FOR FULL/REDUCTION WAIVER REQUEST
Bidder/Proposer shall check each item applicable to its reason for a waiver request. Additionally, supportingdocumentation shall be submitted with this request.
(1) Lack of sufficient qualified MBEs and/or WBEs capable of providing the goods or services requiredby the contract. (Please explain)
(2) The specifications and necessary requirements for performing the contract make it impossible oreconomically infeasible to divide the contract to enable the contractor to utilize MBEs and/or WBEs in
accordance with the applicable participation. (Please explain)
(3) Price(s) quoted by potential MBEs and/or WBEs are above competitive levels and increase cost ofdoing business and would make acceptance of such MBE and/or WBE bid economically impracticable,taking into consideration the percentage of total contract price represented by such MBE and/or WBEbid.(Please explain)
(4) There are other relevant factors making it impossible or economically infeasible to utilize MBE and/orWBE firms. (Please explain)
C. GOOD FAITH EFFORTS TO OBTAIN MBE/WBE PARTICIPATION
(1) Made limely written solicitation to identified MBEs and WBEs for utilization of goods and/or services;and provided MBEs and WBEs with a timely opportunity to review and obtain relevant specifications,terms and conditions of the proposal to enable MBEs and WBEs to prepare an informed response tosolicitation. (Attach of copy written solicitations made)
(2) Used the services and assistance of the Office of Contract Compliance staff. (Please explain)
(3) Timely notified and used the services and assistance of community, minority and women businessorganizations. (Attach of copy written solicitations made)
(4) Followed up on initial solicitation of MBEs and WBEs to determine if firms are interested in doingbusiness. (Attach supporting documentation)
(5) Engaged MBEs & WBEs for direct/indirect participation. (Please explain)
D. OTHER RELEVANT INFORMATION
Attach any other documentation relative to Good Faith Efforts in complying with MBE/WBE participation.
M/WBE Reduction/VVaiver Request —Form 3 Revised: 01/29/14
CONTRACT M /4'po /JggT
COOK COUNTYECONOMIC DISCLOSURE STATEMENT
AND EXECUTION DOCUMENTINDEX
Section Description Pages
Instructions for Completion of EDS EDS i-ii
CertiTrcations
Economic and Other Disclosures, Affidavit of ChildSupport Obligations, Disclosure of Ownership Interest
and Familial Relationship Disclosure Form
Cook County Affidavit for Wage Theft Ordinance
Contract and EDS Execution Page
EDS 1-2
EDS 3 —12
EDS 13-14
EDS 15-17
CONTRACT¹:/430« /57b7SECTION 1
INSTRUCTIONS FOR COMPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT
This Economic Disclosure Statement and Execution Document ("EDS") is to be completed and executedby every Bidder on a County contract, every Proposer responding to a Request for Proposals, and everyRespondent responding to a Request for Qualifications, and others as required by the Chief ProcurementOfficer. The execution of the EDS shall serve as the execution of a contract awarded by the County. TheChief Procurement Officer reserves the right to request that the Bidder or Proposer, or Respondentprovide an updated EDS on an annual basis.
Definitions. Terms used in this EDS and not otherwise defined herein shall have the meanings given tosuch terms in the Instructions to Bidders, General Conditions, Request for Proposals, Request forQualifications, as applicable.
Affiliate means a person that directly or indirectly through one or more intermediaries, Controls isControlled by, or is under common Control with the Person specified.
Applicant means a person who executes this EDS.
Bidder means any person who submits a Bid.
Code means the Code of Ordinances, Cook County, illinois available on municode.corn.
Contract shall include any written document to make Procurements by or on behalf ofCook County.
Contractor or Contracting Party means a person that enters into a Contract with theCounty.
Control means the unfettered authority to directly or indirectly manage governance,administration, work, and all other aspects of a business.
EDS means this complete Economic Disclosure Statement and Execution Document,including all sections listed in the Index snd any attachments.
Joint Venture means an association of two or more Persons proposing to perform a for-profit business enterprise. Joint Ventures must have an agreement in writing specifyingthe terms and conditions of the relationship between the partners and their relationshipand respective responsibility for the Contract
Lobby or lobbying means to, for compensation, attempt to influence a County official orCounty employee with respect to any County matter.
Lobbyist means any person who lobbies.
Person or Persons means any individual, corporation, partnership, Joint Venture, trust,association, Limited Liability Company, sole proprietorship or other legal entity.
Prohibited Acts means any of the actions or occurrences which form the basis fordisqualification under the Code, or under the Certifications hereinafter set forth.
Proposal means a response to an RFP.
Proposer means a person submitting a Proposal.
Response means response to an RFQ.
Respondent means a person responding to an RFQ.
RFP means a Request for Proposals issued pursuant to this Procurement Code.
RFQ means a Request for Qualifications issued to obtain the qualifications of interested parties.
EDS-i
CONTRACT¹: /$gD -/S/P 7
INSTRUCTIONS FOR COMPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT
Section 1:Instructions. Section 1 sets forth the instructions for completing and executing this EDS.
Section 2: Certifications. Section 2 sets forth certifications that are required for contracting parties underthe Code and other applicable laws. Execution of this EDS constitutes a warranty that all the statementsand certifications contained, and all the facts stated, in the Certifications are true, correct and complete asof the date of execution.
Section 3: Economic and Other Disclosures Statement. Section 3 is the County's required Economicand Other Disclosures Statement form. Execution of this EDS constitutes a warranty that all theinformation provided in the EDS is true, correct and complete as of the date of execution, and binds theApplicant to the warranties, representations, agreements and acknowledgements contained therein.
Required Updates. The Applicant is required to keep all information provided in this EDS current andaccurate. In the event of any change in the information provided, including but not limited to any changewhich would render inaccurate or incomplete any certification or statement made in this EDS, theApplicant shall supplement this EDS up to the time the County takes action, by filing an amended EDS orsuch other documentation as is required.
Additional Information. The County's Governmental Ethics and Campaign Financing Ordinancesimpose certain duties and obligations on persons or entities seeking County contracts, work, business, ortransactions, and the Applicant is expected to comply fully with these ordinances. For further informationplease contact the Director of Ethics at (312) B03-4304 (69 W. Washington St. Suite 3040, Chicago, IL60602) or visit the web-site at cookcountyil.gov/ethics-board-of.
Authorized Signers of Contract and EDS Execution Page. If the Applicant is a corporation, thePresident and Secretary must execute the EDS. In the event that this EDS is executed by someone otherthan the President, attach hereto a certified copy of that section of the Corporate By-Laws or otherauthorization by the Corporation, satisfactory to the County that permits the person to execute EDS forsaid corporation. If the corporation is not registered in the State of ll(inois, a copy of the Certificate ofGood Standing from the state of incorporation must be submitted with this Signature Page.
If the Applicant is a partnership or joint venture, all partners or joint venturers must execute the EDS,unless one partner or joint venture has been authorized to sign for the partnership or joint venture, inwhich case, the partnership agreement, resolution or evidence of such authority satisfactory to the Officeof the Chief Procurement Officer must be submitted with this Signature Page.
If the Applicant is a member-managed LLC all members must execute the EDS, unless otherwiseprovided in the operating agreement, resolution or other corporate documents. If the Applicant is amanager-managed LLC, the manager(s) must execute the EDS. The Applicant must attach either acertified copy of the operating agreement, resolution or other authorization, satisfactory to the County,demonstrating such person has the authority to execute the EDS on behalf of the LLC. If the LLC is notregistered in the State of illinois, a copy of a current Certificate of Good Standing from the state ofincorporation must be submitted with this Signature Page.
If the Applicant is a Sole Proprietorship, the sole proprietor must execute the EDS.
A "Partnership" "Joint Venture" or "Sole Proprietorship operating under an Assumed Name must beregistered with the illinois county in which it is located, as provided in 805 ILCS 405 (2012), anddocumentation evidencing registration must be submitted with the EDS.
Effective October 1, 2015 all foreign corporations and LLCs must be registered with the illinoisSecretary of State's (&ice unless a statutory exemption applies to the applicant. Applicants who areexempt from registering must provide a written statement explaining why they are exempt fromregistering as a foreign entity with the illinois Secretary of State's Office.
EDare
CONTRACT ¹: /'BED -/S 7 fry 7SECTION 2
CERTIFICATIONS
THE FOLLOWING CERTIFICATIONS ARE MADE PURSUANT TO STATE LAW AND THE CODE. THE APPLICANT IS CAUTIONEDTO CAREFULLY READ THESE CERTIFICATIONS PRIOR TO SIGNING THE SIGNATURE PAGE. SIGNING THE SIGNATUREPAGE SHALL CONSTITUTE A WARRANTY BY THE APPLICANT THAT ALL THE STATEMENTS, CERTIFICATIONS ANDINFORMATION SET FORTH WITHIN THESE CERTIFICATIONS ARE TRUE, COMPLETE AND CORRECT AS OF THE DATE THESIGNATURE PAGE IS SIGNED. THE APPLICANT IS NOTIFIED THAT IF THE COUNTY LEARNS THAT ANY OF THEFOLLOWING CERTIFICATIONS WERE FALSELY MADE, THAT ANY CONTRACT ENTERED INTO WITH THE APPLICANT SHALLBE SUBJECT TO TERMINATION.
A. PERSONS AND ENTITIES SUBJECT TO DISQUALIFICATION
No person or business entity shall be awarded a contract or sub-contract, for a period of five (5) years from the date ofconviction or entry of a plea or admission of guilt, civil or cdminal, if that person or business entity:
1) Has been convicted of an act committed, within the State of filinois, of bribery or attempting to bribe an officer oremployee of a unit of stats, federal or local government or school district in the Stats of filinois in that officer's oremployee's official capacity;
2) Has been convicted by federal, state or local government of an act of bid-rigging or attempting to rig bids as definedin the Sherman Anti-Trust Act and Clayton Act. Act. 15 U.S.C. Section 1 ef ssqri
Has been convicted of bid-rigging or attempting to rig bids under the laws of federal, state or local government;
Has been convicted of an act committed, within the State, of price-fixing or attempting to fix prices as defined by theSherman Anti-Trust Act and ths Clayton Act. 15 U.S.C. Section 1, ei seqri
Has been convicted of price-fixlng or attempting to fix prices under the laws the State;
Has been convicted of defrauding or attempting lo defraud any unit of state or local government or school districtwithin the State of illinois;
3)
4)
5)
6)
7) Has made an admission of guilt of such conduct as set forth in subsections (1) through (6) above which admission isa matter of record, whether or not such person or business entity was subject to prosecution for the offens oroffense admitted to; or
8) Has entered a plea of nolo contendere to charge of bribery, price-fixing, bid-rigging, or fraud, as set forth in sub-paragraphs (1)through (6) above.
In the case of bribery or attempting to bribe, a business entity may not be awarded a contract if an official, agent or employeeof such business entity committed the Prohibited Act on behalf of the business entity and pursuant to the direction orauthorization of sn officsr, director or other responsible official of the business entity, snd such Prohibited Act occurred withinthree years prior to the sward of the contract. In addition, a business entity shall be disqualified If sn owner, partner orshareholder controlling, directly or indirectly, 20% or more of the business entity, or an officer of the business entity hasperformed any Prohibited Act within five years prior to the award of the Contract.
THE APPLICANT HEREBY CERTIFIES THAT: The Applicant has read the provisions of Secfion A, Persons and EntitiesSubject to Disqualification, that the Applicant has not committed any Prohibited Act set forth in Section A, and that award ofthe Contract to the Applicant would not violate the provisions of such Section or of the Code.
B. BID-RIGGING OR BID ROTATING
THE APPLICANT HEREBY CERTIFIES THAT: In accordance with 720 ILCS 5/33 E-ff, neither the Applicant nor anyAiffifafed Entity is baaed from sward of this Contract as s result of a conviction for the violation of State laws prohibiting hid-rigging or hid rotating.
DRUG FREE WORKPLACE ACT
THE APPLICANT HERES Y CERTIFIES THAT: The Applicant will provide a drug free workplace, as required by (30 ILC6 580/3).
EDS-1
DELINQUENCY IN PAYMENT OF TAXES
CONTRACT M /Ypgco -/5 7 7afr
THE APPLICANT HEREBY CERTIFIES THAT: The Appilcant is not an owner or a party responsible for the payment of anytsx or fee administered by Cook County, such as bar award of a contract or subcontract pursuant to the Code, Chapter 34,Section 94-171.
HUMAN RIGHTS ORDINANCE
No person who is a party to a contract with Cook County ("County" ) shall engage in unlawful discdmination or sexual harassmentagainst any individual in the terms or conditions of employment, credit, public accommodations, housing, or provision of Countyfacfiities, services or programs (Code Chapter 42, Section 4240 et seq.).
ILLINOIS HUMAN RIGHTS ACT
THE APPLICANT HEREBY CERTIFIES THAT: Itis in compliance with the illinois Human Rights Act (775 ILCS 5f2-105), andagrees to abide by the requirements of the Act as part ofits contractual obligations.
INSPECTOR GENERAL (COOK COUNTY CODE, CHAPTER 34, SECTION 34-174 and Section 34-260)
The Appffcsnt has not willfully failed to cooperate In an investigation by the Cook County Independent Inspector General or toreport to the Independent Inspector General any and all information concerning conduct which they know to involve corruption, orother cdminal activity, by another county employee or oificial, which concerns his or her office of employment or County relatedtransaction.
The Applicant has reported directly and without any undue delay any suspected or known fraudulent activity in the County'sProcurement process to the Offics of the Cook County Inspector General,
CAMPAIGN CONTRIBUTIONS (COOK COUNTY CODE, CHAPTER 2, SECTION 2488)
THE APPLICANT CERTIFIES THAT: It has read and shall comply with the Cook County's Ordinance concerning campaigncontributions, which is codified at Chapter 2, Division 2, Subdivision II, Section 585, and can be read in its entiretyat www.municode corn.
GIFT BAN, (COOK COUNTY CODE, CHAPTER 2, SECTION 2-874)
THE APPLICANT CERTIFIES THAT: lt has read and shall comply with the Cook County's Ordinance concerning receiving andsolicifing gifts and favors, which is codified at Chapter 2, Division 2, Subdivision 0, Section 574, and can be read in its entiretyat www. muni code. corn.
LIVING WAGE ORDINANCE PREFERENCE (COOK COUNTY CODE, CHAPTER 34, SECTION 34-160;
Unless expressly waived by the Cook County Board of Commissioners, the Code requires that a living wage must be paid toindividuals employed by a Contractor which has a County Contract and by aff subcontractors of such Contractor under a CountyContract, throughout the duration of such County Contract. The amount of such living wage is annually by the Chief FinancialOflicer of the County, and shall be posted on the Chief Procurement Officer's wsbsite.
The term "Contract" as used in Section 4, I, of this EDS, speclffcally excludes contracts with the following.
1) Not-For Profit Organizations (defined as a corporation having tax exempt status under Section 501(C)(3)of the UnitedStats Internal Revenue Code and recognized under the fflinois State not-for -profit law);
2) Community Development Block Grants;
3) Cook County Works Department;
4) Sheriff's Work Alternative Program; and
5) Department of Correction inmates.
FDS-2
CONTRACT ¹:rre 3ltp - /5 7k/
SECTION 3
REQUIRED DISCLOSURES
1. DISCLOSURE OF LOBBYIST CONTACTS
List all persons that have made lobbying contacts on your behalf with respect to this contract:
Name
N/A
Address
2. LOCAL BUSINESS PREFERENCE STATEMENT (CODE, CHAPTER 34, SECTION 34-230)
Local business means a Person, including a foreign corporation authorized to transact business in illinois, having a bona gdeestablishment located within the County at which it is transacting business on the date when a Bid is submitted to the County, andwhich employs the majority of its regular, full-time work force within the County. A Joint Venture shall constitute a Local Business if oneor more Persons that qualify as a "Local Business" hold interests totaling over 50 percent in the Joint Venture, even if the Joint Venturedoes not, at the time of the Bid submittal, have such a bona fide establishment within the County.
a) Is Applicant s "Local Business" as defined aboveg
Yes K No:
b) If yes, list business addresses within Cook County:
401 S. LaSalle Street, Suite 1005, Chicago, illinois 60605
c) Does Applicant employ the majority of its regular full-time workforce within Cook County7
Yes: g No;
3. THE CHILD SUPPORT ENFORCEMEaff ORDINANCE (CODE, CHAPTER 34, SECTION 34-172)
Every Applicant for a County Privilege shall be in full compliance wilh any child support order before such Applicant Is entiaed to receive orrenew a County Privilege. When delinquent child support exists, the County shall not issue or renew any County Privilege, and mayrevoke any County Privilege.
All Applicarde are required to review the Cook County Affidavit of Child Support Obligations attached to this EDS (BOS'N) andcomplete the Affidavit, based on the instructions in the Affidavit
EDS-3
CONTRACT ¹:/&PO /S 75 fr
4. REAL ESTATE OWNERSHIP DISCLOSURES.
The Applicant must indicate by checking the appropriate provision below and providing all required information that either:
a) The following is s complete list of all real estate owned by the Applicant in Cook County:
PERMANENT tNDEX NUMBERts) 00 ( Y e )14-29-120-012-0000 (Scanlon)
(ATTACH SHEET IF NECESSART TO LIST ADDITIONAL INDEXNUMBERS)
OR:
b) ~The Applicant owns no real estate in Cook County.
5. EXCEPTIONS TO CERTIFICATIONS OR DISCLOSURES.
If the Applicant is unable to cerbTy to any of the Cerfifications or any other statements contained in this EDS and not explained elsewhere inthis EDS, the Applicant must explain below:
None
If ths letters, "NA", the word "None" or "No Response" appears above, or if the space is lelt blank, It will be conclusively presumed that theApplicant cerfNed to all Certifications and other statements contained in this EDS.
EDS4
CONTRACT ¹: /kgb -/5 74,7
COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATESIENT
The Cook County Code of Ordinances (I2-610 ef seq.) requires that any Applicant for any County Action must disclose informationconcerning ownership interests in the Applicant. This Disclosure of Ownership Interest Statement must bs completed with all
information current as of the date this Statement is signed. Furthermore, this Statement must be kept current, by filing an amendedStatement, until such time as the County Board or County Agency shall take action on the application. The information containedin this Statement will be maintained in a database and made available for public viewing. County reserves the right to requestadditional information to verify veracity of information containted in this statement.
If you are asked to list names, but there are no applicable names to list, you must stats NONE. An incomplete Statement will bereturned and any action regarding this contract will be delayed. A failure to fully comply with ths ordinance msy result in the actiontaken by the County Board or County Agency being voided.
"Applicant" means any Entity or person making an application to the County for any County Action.
County Action" means any action by a County Agency, a County Department, or the County Board regarding an ordinance orordinance amendment, a County Board approval, or other County agency approval, with respect to contracts, leases, or sale orpurchase of real estate.
'Person" "Entity" or "Legal Eniiiy" means a sole proprietorship, corporation, partnership, association, business trust, estate, two ormore persons having a Joint or common interest, trustee of a land trust, other commercial or legal entity or any beneficiary orbeneficiaries thereof.
This Disclosure of Ownership Internet Statement must be submitted by:
1. An Applicant for County Action and
2. A Person that holds stock or a beneficial Interest in the Applicant Bnddis listed on ths Applicant's Statement (a "Holder" ) must file aStatement and complete ¹1 only under Ownership Interest Declaration.
Please print or type responses clearly and legibly. Add additional pages if needed, being careful to identify each portion of the form towhich each additional page refers.
This Statementis being made by the [ g ] Applicant or [ ] Stock/Beneficial interest Holder
This Statement hr an: I g ] Original Statsmentor [ J Amended Statement
State: Illinois
Identifying Information:
Name Great Arc Technologies, Inc.
D/8/A same
Street Address: 401 S. LaSalle St, Suite 1005
city Chicago
Phone No 312-726 4848 Fax Number:
FEIN ¹ Only: 36-4302520
Zip Code: 60605
Email mscanlongreatarc.corn
Cook County Business Registration Number:(Sole Proprietor, Joint Venture Partnership)
Corporate File Number (if applicable):
Form of Legal Entity:
Sole Proprietor Partnership Corporation Trustee of Land Trust
Business Trust Estate Association Q Joint Venture
Q Other (describe)
EDS-6
CONTFIACTff//f'go -/$ 7fv7
Ownership Interest Declaration:
1. List the name(s), address, and percent ownership of each Person having a legal or beneficial interest (including ownership) ofmore than five percent (5%) in the Applicant/Holder.
Name
Michael Scanlon
David Skyles
Address
1541 W. Oakdale, Chicago, illinois 60657
2073 W. Greenleaf, Chicago, illinois 60645
Percentage Interest in
Applicant/Holder
50%
50%
If the interest of any Person listed in (1)above is held as an agent or agents, or a nominee or nominees, list the name andaddress of the principal on whose behalf the interest is held.
Name of Agent/Nominee
N/A
Name of Principal Principal's Address
Is the Applicant constructively controlled by another person or Legal Entity? [ ) Yes [ g ) No
lf yes, state ths name, address and percentage of beneficial interest of such person, and the relationship under which suchcontrol is being or may bs exercised.
Name
N/A
Address Percentage ofBeneficial Interest
Relationship
Corporate Officers, Members and Partners Information:
For afi corporations, list the names, addresses, and terms for all corporate officers. For all limited liability companies, list the names,addresses for afi members. For afi partnerships and joint ventures, list ths names, addresses, for each partner or joint venture.
Name
Michael Scanlon
David Skyles
Address Title (specify title ofOffice, or whether manageror partner/joint venture)
1541 W. Oakdale, Chicago, illinois 60657 President
2073 W. Greenleaf, Chicago, illinois 60645 Secretary
Term of Qffice
Perpetual
Perpetual
Declaration (chsck the applicable box):
QVI stats under oath that the Applicant has withheld no disclosure ss to ownership interest in ths Applicant nor reservedany information, dale or plan as to ths intended use or purpose for which ths Applicant seeks County Board or other County
Agency action.
Q I state under oath that the Holder has withheld no disclosure as to ownership interest nor reserved any information required tobe disdosed.
EDS-7
CONTRACT¹: /d ger - />7(7
COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST'TATEMENT SIGNATURE PAGE
Michael Syanlon~ PresidentName of A or 'nt/Holder Representative (please print or type) Title
1/04/2018Signature Date
mscanlon@g reatarc.corn 312-726-4848E-mail address Phone Number
Subthis
~afore rite My commission expi
~ Notary Public Signature Notary Seal
EDs-s
CONTRACT ttt.'/6'r pdi -/3 76 7
COOK COUNTY BOARD OF ETHICS69 W. WASHINGTON STREET, SUITE 3040
CHICAGO, ILLINOIS 60602312/603-4304 Office 312/603-9988 Fax
FAMILIAL RELATIONSHIP DISCLOSURE PROVISION
Neuotism Disclosure Reouirement:
Doing a significant amount of business with the County requires that you disclose to the Board of Ethics the existence of any familialrelationships with any County employee or any person holding elective oiyice in the State of Illinois,.the County, or in anymunicipality within the County. The Ethics Ordinance defines a significant amount of business for the purpose of this disclosurerequirement as more than $25,000 in aggregate County leases, contracts, purchases or sales in any calendar year.
If you are unsure of whether the business you do with the County or a County agency will cross this threshold, err on the side ofcaution by completing the attached fainilial disclosure form because, among other potential penalties, any person found guilty offailing to make a required disclosure or knowingly filing a false, misleading, or incomplete disclosure will be prohibited &om doingany business with the County for a period of three years. The required disclosure should be filed with the Board of Ethics by January1 of each calendar year in which you are doing business with the County and again with each bid/proposal/quotation to do businesswith Cook County. The Board ofEthics may assess a late filing fee of $100 per day atter an initial 30My grace period.
The person that is doing business with the County must disclose his or her familial relationships. If the person on the County lease orcontract or purchasing /rom or selling to the County is a business entity, then the business entity must disclose the familialrelationships of the individuals who are and, during the year prior to doing business with the County, were:
~ its board of directors,~ its officers,~ its employees or independent contractors responsible for the general administration of the entity,~ its agents authorized to execute documents on behalf of the entity, and~ its employees who directly engage or engaged in doing work with the County on behalf of the entity.
Do not hesitate to contact the Board of Ethics at (312) 603-4304 for assistance in determining the scope of any required familialrelationship disclosure.
Additional Definitions:
"Fantfiial relationship" means a person who is a spouse, domestic partner or civil union partner of a County employee or State,County or municipal official, or any person who is related to such an employee or official, whether by blood, marriage or adoption, asm
DParent
D ChildDBrotherD SisterDAuntDUncle
DNiece
DNephew
GrandparentDGrandchild
D Father in-law
DMotherin-IawDSoirin-lawDDaughterin-lawDBrothcrin-IawD Sister-in-law
Dr Stepfather
D Stepmother
D StepsonD Stepdaughter
D Stepbrother
D Stepsister
D H alp brother
D Halfsister
EDS-9
COOK COUNTY BOARD OF ETHICSFAMILIAL RELATIONSHIP DISCLOSURE FORM
CONTRACT¹: /do/50 /J /tote
PERSON DOING OR SEEKING TO DO BUSINESS WITH THK COUNTY
Name of Person Doing Business with the County: Great Arc Technciouiea, Inc.
Address of Person Doing Business with the County 401 S. LaSaiie St, Suite 1005, Chicago, IL 60605
Phone number ofPerson Doing Business with the County; 312.726.4848
Email address ofPerson Doing Business with the County: mgcanfcnt80reafarcccm
If Person Doing Business with the County is a Business Entity, provide the name, title and contact information for theindividual completing this disclosure on behalf of the Person Doing Business with the County:Michael Scanion, President, 401 S. LaSaiie Street, Suite 1005, Chicago, IL 60605, Phone 312-726-4848, mscanicnoureatarc.corn
DESCRIPTION OF BUSINESS WITH THE COUNTYAppend additional pages as needed and for each County lease, contract, purchase or sale sought andlor obtainedduring the calendar year of this disclosure (or the proceeding calendar year ifdisclosure is made on January l),identify:
The lease number, contract number, purchase order number, request for proposal number snd/or request for qualificationnumber associated with the business you are doing or seeking to do with the County: r« teaeterav e'i
The aggregate dollar value of the business you are doing or seeking to do with the County: $ tsfke«
The name, title and contact information for the County official(s) or employee(s) involved in negotiating the business you aredoing or seeking to do with the County:
carlyn Auguetave, vendor contract Manager, sureau of Technology, 312-303-4333, cariyn.auguataveocookcountys.gov
The name, title and contact information for the County official(s) or employee(s) involved in managing the business you aredoing or seeking to do with the County:
Wig Ingante, eureau of Technology iols), 3t2-303-1339,wtg.ingenteecookcouniyi.gov
DISCLOSURE OF FAMILIAL RELATIONSHIPS WITH COUNTY EMPLOYEES OR STATE. COUNTY ORMUNICIPAL ELECTED OFFICIALS
Check the box that applies and provide related informagon where needed
The Person Doing Business with the County is an individual and there is ne familial relationship between this individualand any Cook County employee or any person holding elective office in the State of Illinois, Cook County, or anymunicipality within Cook County.
The Person Doing Business with the County is a business entity and there is no familial relationship between any memberof this business entity's board of directors, officers, persons responsible for general administration of the business entity,agents authorized to execute documents on behalf of the business entity or employees directly engaged in contractual workwith the County on behalf of the business entity, and any Cook County employee or any person holding elective office in theState of Illinois, Cook County, or any municipality within Cook County.
EDS-10
COOK COUNTY BOARD OF ETHICSFAMILIAL RELATIONSHIP DISCLOSURE FORM
CONTRACT ¹; /rtr Pes (5 /r /o7
Ij The Person Doing Business with the County is an individual and there is a familial relationship between this individualand at least one Cook County employee and/or a person or persons holding elective office in the State of Illinois, CookCounty, and/or any municipality within Cook County. Tbe familial relationships are as follows:
Name of Individual DoingBusiness with the County
Name ofRelated County Title and Position of Related Nature ofFamilialEmployee or State, County or County Employee or State, County RelationshipMunicipal Elected Official or Municipal Elected Official
Ifmore space is needed, attach an additional sheet following the above format.
0 The Person Doing Business with the County is a business entity and there is a familial relationship between at least onemember of this business entity's board ofdirectors, officers, persons responsible for general administration of the businessentity, agents authorized to execute documents on behalf of the business entity and/or employees directly engaged incontractual work with the County on behalf of the business entity, on the one hand, and at least one Cook County employeeand/or a person holding elective office in tbe State of Illinois, Cook County, and/or any municipality within Cook County, onthe other. The famiTtal relationships are as follows:
Name of Member of BoardofDirector for BusinessEntity Doing Business withthe County
Name ofRelated County Title and Position of Related Nature ofFamilialEmployee or State, County or County Employee or State, County RelationshipMunicipal Elected Official or Municipal Elected Oflicial
Name ofOffic for Business Name ofRelated County Title and Position of Related Natmu ofPamilialEntity Doing Business with Eraployee or State, County or County Employee or State, County Relationshipthe County Municipal Elected Oflicial or Municipal Elected Official
EDS-11
Name ofPerson Responsiblefcr the GeneralAdministration of theBusiness Entity DoingBusiness with the County
CONTRACT ¹:i'tr /CD /W/tr fr
Name ofRelated County Title aad Position of Related Nature ofFamilialEmployee or State, County or County Employee or State, County RelationshipMunicipal Elected Otficisl or Municipal Elected OBiciat
Name of Agent Authorizedto Execute Documents forBusiness Entity DoingBusiness with tbe County
Name of Related County Title and Position of Related Nature ofpamilialEmployee or State, County or County Employee or Stale, County Relationship
Municipal Elected Otficisl or Muaicipal Elected Official
Name of Employee ofBusiness Entity DirectlyEngaged in Doing Businesswith the County
Name of Related County Title and Position of Related Nature ofFamilial
Employee or State, County or County Employee or State, County Relationship*
Municipal Elected Glacial or Municipal Elected Official
ffmore space is needed, attach an additional sheet following the above format.
VERIFICATIO . o the best of my knowledge, the information I have provided on this disclosure form is accurate and complete. Iacknowledge t an in r e or incomplete disclosure is punishable by law, including but not limited to fines and debarment.
1/04/2018Signature ofRecipient Date
SUBMIT COMPLETED FORM TO: Cook County Board ofEthics69 West Washington Street, Suite 3040, Chicago, Illinois 60602Office (312) 603-4304 —Fax (312) 603-9988CookCounty.Ethicsgcookcountyil.gov
Spouse, domestic partner, civil union partner or parent, child, sibling, aunt, uncle, niece, nephew, grandparent or grandchild
by blood, marriage (i.e in laws and step relations) or adoption.
EDS-12
CONTRACT ¹://xrgcp -/r+/r r ySECTION 4
COOK COUNTY AFFIDAVIT FOR WAGE THEFT ORDINANCE
Effective May 1, 2015, every Person, Inc/ed/no Subsfanee/ Owners, Seeking a Contract with Cook County must comply with the Cook County Wage TheltOrdinance set forth in Chapter 34, Article IV, Section 179. Any Person/Substantial Owner, who falls to comply with Cook County Wage Theft Ordinance,
may request that ths Chief Procurement Offlcer grant s reduction or waiver In accordance with Section 34-179(d).
"Contracl" means any written document to make Procurements by or on behalf of Cook County.
"Person" means any individual, corporation, partnership, Joint Venture, trust, association, limited liability company, sole proprietorship or other legal entity.
"Procuremenff means obtaining supplies, equipment, goods, or services of any kind.
"Substantial Owner'eans any person cr persons who own or hold a twenty-five percent (25%) or more percentage of interest in any business enNyseeking s County Privilege, Including those shareholders, general or limited partners, beneficiaries and principals; except where a business entity Is anindividual or sole proprietorship, Substantial Owner means that Individual or sole proprietor.
All Persons/Substantial Owners are required to complete this affidavit and comply with the Cook County Wage Thefl Ordinance before any Contract isawarded. Signature of this form consNutes a certification the information provided below is barred and complete, and that the individual(s) signing this formhas/have pemonal knowledge o( such information. County reserves the right to request additional Informafion to verify veracity of informationcontained In this Affidavit.
I. Contract Information:
TOR 1630-15767 (Ext)
County using Agency (requesring procurement): LireaU O eo nc O9Y
state. Illinois
Home Phone:
III. Compliance with Wage Laws:
II. Person/Substantial Owner Information:
person (Corporate Entity Name):GI'Bat ArC TeChnOIOgieS, InC.
Substantial Owner Complete Name:
FEIN¹ 36-4302520
E-mall address; mSCanlcnogreatarC.COm
st (Add .i 1541 W. Oakdale
city Chicago zip:60657
Within the past five years has the Person/Substantial Owner, in any judicial or administrative proceeding, been convicted of, entered aplea, made an admission of guilt or liability, or had an administrative finding made for committing a repeated or willful violation of any ofthe following laws/
No illinois Wage Payment and Collection Act, 820 ILCS 115/1 et seq.,
No illinois Minimum Wage Act, 820 ILCS 105/1 et seq.,
No illinois Worker Adjustment and Retraining Notification Act, 820 ILCS 55/1 etseq,
No Employee Classification Act, 820 ILCS 185/1 etseq.,
No Fair Labor Standards Act of 1938, 29 L.S.C.201, et seq.,
No Any comparable state statute or regulation of any state, which governs the payment of wages
If the Person/Substantial Owner answered "Yes" to any of the questions above, it is ineligible to enter into a Contract with CookCounty, but can request a reduction or waiver under Section IV.
EOS-13
CONTRACT ¹:yin3b- IS 7(e7
IV. Request for Waiver or Reduction
If Person/Substantial Owner answered "Yes" to any of the questions above, it may request a reduction or waiver in
accordance with Section 34-179(d), provided that the request for reduction of waiver is made on the basis of one or more ofths following actions that have taken place:
No There has been a bona fide change in ownership or Control of the ineligible Person or Substantial Owner
No Disciplinary action has been taken agamst the individual(s) responsible for the acts giving rise to lhs violation
No Remedial ection has been taken to prevent a recurrence of the acts giving rise to the disqualification or default
No Other tsctors that the Person or Substantial Owner believe are relevant.
The person/Substantial Owner must submit documentation to suooort ths basis of its reousst for a reduction or waiver. The ChiefProcurement Oliicer reserves the rioht to make additional inoui ries and reouest addkional documentation.
ASirmationThe Person/Substantial 0 ments contained in the Afhdavit are true, accurate and complete.
Oats. 1 /4/201 8
Name of Person signing (Print)i MICheel SCSnlon Title Preeident
1
d d tkk thi 4)hsy t ~nmrn&u ,2D l0J
X)qtrtary Public Signature Notary Seal
Note: The above information is subject to verNcetlon prior to the award of the Contract.
EDS-14
CONTRACT¹:/$ 9cp -/5 /797
SECTION 4
COOK COUNTY AFFIDAVIT FOR WAGE THEFT ORDINANCE
Effect/ve May 1, 2015, every Person, lna/ud/na Subarea//s/ Owrrers, seeking s Contract with Cook County must comply with the Cook County Wage ThefiOrdinance set forth in Chapter 34, Ardcle IV, Section 179. Any Person/Substantial Owner, who falls to comply with Cook County Wage Theft Ordinance,may request that the Chief Procurement Officer grant a reduction or waiver in accordance with Secdon 34-179(d).
"Contract" means any written document to make Procurements by or on behalf of Cook County.
"Person" means any individual, carporatia, partnership, Joint Venture, trust, association, limited liability company, sole proprietorship ar other legal entity,
"Procuremenf'eans obtaining supplies, equipment, goads, or services of any kind.
"Substantial Owner" means eny person ar persons who awn or hold a twenty-live percent (25%) or more percentage of interest ln any business entityseeking a County Privilege, including those shareholders, general or limited partners, benetlcisries and principals; except where s business entity is snindividual or sole proprietorship, Substantial Owner mesne that individual or sole proprietor.
All Persons/Sutwtanfial Owners are required to complete this affidavit and camply with the Cook County Wage Theft Ordinance before any Contract isawarded. Signature of this form constfiutes a certification the information provided below is oorred snd complete, and that the individual(s) signing this formhas/have personal knowledge of such information. County reserves the right to request additional information to verify veracity of informationcontained in this Affidavi.
I. Contract Information:
TOR 1630-15767 (Ext)
county Using Agency (requesfing procurement): BUreaij Of TeChnOIOgy, GIS
II. Person/Substantial Owner (nfoffhatlon:
person (Corporate Entity Name): Great ArC TeChnOIOgieS, InC.
Substantial Owner Complete Name:
FEIN¹ 36-4302520
E-mail address: dSkyleSgreatarC.COrn
St I Add . 2073 W. Greenleaf
c tyChicago
Home Phone; (
illinois z„:60645
gl. Compliance with Wage Laws:
Within the past five years has the Person/Substantial Owner, in any judicial or administrative proceeding, been convicted of, entered aplea, made an admission of guilt or hability, or had an administrafive finding made for committing a repeated or willful violation of any ofthe following laws:
No /I/inc/s Wage Paymenl and Ca//sc//an Ac/, 820 /LCS 115/1 e/saq.,
No Illinois Minimum Wage Acl, 820 /LCS 105/1 e/seq.,
No ll/lna/s Worker Adjusfmenf and Retraining Na////ca//an Acf, 820 /LCS 6511ef seq.,
No Employee C/assif/ca/ion Acl, 820 /LCS 185/1 el seq.,
No Pair Labor S/andards Acl of 1938, 29 L.S.C.201, at ssq.,
Nc Any comparable state statute or regulation of any state, which governs the payment of wages
If the Person/Substantial Owner answered "Yee" to any of the questions above, it is ineligible to enter into a Contract with CookCounty, but can request a reduction or waiver under Section IV.
EDS-13
CONTRACT ff: jfp $O -yF7'V.
Request for Waiver or Reduction
If Person/Substantial Owner answered "Yes" to any of the questions above, it may request a reduction or waiver in
accordance with Section 34-179(d), provided that the request for reduction of waiver Is made on the basis of one ar more ofths following actions that have taken place;
Nd There hes been e bona fide change in ownership or Control of the Ineligible Person or Substantial Owner
Nd Disciplinary action has been taken against the individual(s) responsible for the acts giving rise to the violation
Nc Remedial action has been taken to prevent a recurrence of ths acts giving rise to the disqualification or default
No Other factors that the Person or Substantial Owner believe are relevant.
The PersonrSubstentisl Owner must submit documentation to suaaapt ths basis of its rsauest for s reduction or waiver. The ChiefProcurement Officer reserves the nab t ta make additional lnaui ries and reauest additional dacumentstion.
V. AffirmationThe PersoniSubstanfial e affirms that all slatemenls contained in the Afhdavit are true, accurate and complete.
1 /4/20 1 8
~ f p p ~ p lp ~ tpadkld Sky les „hl,l Secretary
u a sworn to before me this W day of ~IQMIQk'IA ,2o t9Jnjyiub ilc Signature Notary Seal
Nots: The above Information is subject to verltlcatlon prior to the award of the Contract.
EDS-td
SECTION S
CONTRACT ¹:/$ Q /3 /rf'.7
CONTRACT AND EDS EXECUTION PAGEPLEASE EXECUTE THREE ORIGINAL COPIES
The Applicant hereby certifies and warrants that all of ths statements, certificatlons and representations set forth in this EDS are true,complete and correct; that the Applicant ls in full compliance and will continue to be in compliance throughout the term of the Contract orCounty Privilege issued to the Applicant with all the policies and requirements set forth in this EDS; and that all facts and informationprovided by the Applicant in this EDS are true, complete and consct. The Applicant agrees to inform the Chief Procurement Officer in
writing if any of such statements, certifications, representations, fade or information becomes or is found to be untrue, incomplete orincorrect during the term of the Contract or County Privilege.
Great Arc Technologies, Inc.Corporation's Name
312-726-4848Telephone
Secretkrf Signature
Execution by Corporation
President's Printed Name and Signature
mscanlon Igreatarc.cornEmail
1/04/2018Dale
Execution by LLC
LLC Name *Member/Manager Printed Name and Signature
Date Telephone and Email
Execution by Partnership/Joint Venture
Partnership/Joint Venture Name *Partner/Joint Venturer Printed Name and Signature
Date Telephone and Email
Execution by Sole Proprietorship
Printed Name and Signature
Telephone Email
Sub~end sworirefore mails
(Mk ~Notaiy ~uffc Signature
My commission expires:
Notary Seal
EDS-17