HomeMy WebLinkAboutOrdinance #4559 - Redevelopment Agreement with Jesse Kidd (Don & Nancy's Cafe Project) CERTIFICATE
THE UNDERSIGNED CERTIFIES THAT SHE IS THE CITY CLERK FOR THE CITY
OF CANTON, ILLINOIS, AND THAT THE CITY COUNCIL AT A REGULARLY
CONSTITUTED MEETING OF SAID CITY COUNCIL OF THE CITY OF CANTON ON
THE 2ND DAY OF JUNE, 2026, ADOPTED ORDINANCE NO. 4559, A TRUE AND
CORRECT COPY OF WHICH IS CONTAINED IN THIS PAMPHLET.
GIVEN UNDER MY HAND AND SEAL THIS 2ND DAY OF JUNE,2026.
(SEAL)
A�LaAll
/ .
DREA J. ITH-WALTERS
ITY CLERK
CITY OF CANTON, ILLINOIS
ORDINANCE NO. 4 5 5 9
AN ORDINANCE APPROVING AND AUTHORIZING THE EXECUTION OF A
CANTON BUSINESS DISTRICT NO. 1
REDEVELOPMENT AGREEMENT
by and between
THE CITY OF CANTON, FULTON COUNTY, ILLINOIS
and
JESSE KIDD
(Don& Nancy's Cafe Project)
PASSED BY THE CITY COUNCIL
OF THE CITY OF CANTON,FULTON COUNTY, ILLINOIS,
ON THE 2ND DAY OF JUNE, 2026.
PUBLISHED IN PAMPHLET FORM BY AUTHORITY OF THE CITY
COUNCIL OF THE CITY OF CANTON, FULTON COUNTY,ILLINOIS,
THIS 2N" DAY OF JUNE, 2026.
EFFECTIVE:JUNE 2,2026
ii
ORDINANCE NO. 4559
CITY OF CANTON, ILLINOIS
AN ORDINANCE APPROVING AND AUTHORIZING
THE EXECUTION OF A BUSINESS DISTRICT NO. 1 REDEVELOPMENT
AGREEMENT
by and between
THE CITY OF CANTON
and
JESSE KIDD
(Don& Nancy's Cafe Project)
WHEREAS, the Mayor and City Council of the City of Canton, Fulton County, Illinois (the
"City"), have hereby determined that the Canton, Illinois Business District No. 1 Redevelopment
Agreement by and between the City of Canton and Jesse Kidd, individually (the "Developer")
attached hereto as Exhibit `A,"is in the best interest of the citizens of the City of Canton.
NOW THEREFORE,be it ordained by the Mayor and City Council of the City of Canton,
Illinois, in the County of Fulton, as follows:
1. The City of Canton, Illinois Business District No. 1 (the "Business District") Redevelopment
Agreement attached hereto as Exhibit 'A"is hereby approved.
2. The Mayor is hereby authorized and directed to enter into and execute on behalf of the City
said Business District Redevelopment Agreement and the City Clerk of the City of Canton is
hereby authorized and directed to attest such execution.
3. The Business District Redevelopment Agreement shall be effective the date of its approval on
the 2"d day of June, 2026.
4. This Ordinance shall be in full force and effect from and after its passage and approval as
required by law.
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PASSED APPROVED AND ADOPTED by the Mayor and City Council of the City of
Canton this 2"d day of June, 2026.
MAYOR&ALDERMEN AYE VOTE NAY VOTE ABSTAIN/ABSENT
Dave Pickel
Andra Chamberlin
X
Patrick Ketcham
Ralph Grimm
Greg Gossett
Justin Nelson
John Lovell X
Angela Hale
Kent A.McDowell,Mayor X
TOTAL VOTES 5
APPROVED: Date �/ d�/2026
K nt A. McDowell,Ma ,City of Canton
C ,
ATTEST: Date: / OZ/2026
ndrea J. Smi -Walters, City Clerk, City of Canton
ATTACHMENT:
1. EXHIBIT A. City of Canton,Illinois Business District No. 1 Redevelopment Agreement by
and between the City of Canton and Jesse Kidd (Don&Nancy's Cafe Project)
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EXHIBIT A
CITY OF CANTON, ILLINOIS
BUSINESS DEVELOPEMNT DISTRICT NO. 1
REDEVELOPMENT AGREEMENT
by and between
THE CITY OF CANTON
and
JESSE KIDD
(Don & Nancy's Cafe Project)
v
CITY OF CANTON, ILLINOIS
BUSINESS DISTRICT NO. 1
REDEVELOPMENT AGREEMENT
by and between
CITY OF CANTON, ILLINOIS
and
JESSE KIDD
(Don &Nancy's Cafe Project)
JUNE 2, 2026
CITY OF CANTON, ILLINOIS
BUSINESS DISTRICT NO. 1
REDEVELOPMENT AGREEMENT
by and between
CITY OF CANTON, ILLINOIS
and
JESSE KIDD
(Don&Nancy's Cafe Project)
THIS AGREEMENT (including Exhibits, hereinafter referred to as the "Agreement") is
entered into this 2"d day of June, 2026, by the City of Canton (the "City' , an Illinois Municipal
Corporation, Fulton County, Illinois, and Jesse Kidd, individually (the "Developer'. Hereinafter
the City and the Developer, for convenience,may collectively be referred to as the"Parties."
PREAMBLE
WHEREAS, the City has the authority to promote the health, safety,and welfare of the City
and its citizens and to encourage development,job creation, and/or the full utilization of real estate;
and
WHEREAS,pursuant to the Illinois Business District Development and Redevelopment Act
(65 ILCS 5/11-74.3-1 et seg.),as amended(the"Act"),the City established the Canton Business District
No. 1 (the"Business District"or`BD'� on March 15,2022,by approving Ordinance No. 4281;and
WHEREAS,on September 30,2022,the City approved the First Amendment to the Business
District by approving Ordinance No. 4307 and further ratified the First Amendment on October 5,
2022 by approving Ordinance No. 4315;and
WHEREAS, on March 3, 2026, the City approved the Second Amendment o the Business
District by approving Ordinance No. 4531;and
WHEREAS, pursuant to Illinois Statute 65 ILCS 5/8-1-2.5, the City has the authority to
appropriate and expend funds for economic development purposes;and
WHEREAS,pursuant to the Act, the City has the authority to incur eligible business district
project costs and may enter into agreements with developers to reimburse them for their eligible
business district project costs;and
WHEREAS, the Developer owns property located within the Business District at 124 N.
Main (PIN 09-08-27-409-007),which is hereinafter referred to as the"Property;";and
WHEREAS,based in part on incentives made available by the City,the Developer intends to
update the vinyl siding of the building located on the Property at a total estimated cost of$3,528 (the
"Project';and
WHEREAS, the Developer's proposed Project is consistent with the land uses of the City
and the Business District Plan as adopted;and
WHEREAS, as an incentive to undertake the Project, the Developer has requested
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reimbursement for a portion of its BD eligible project costs as described in Exhibit "1"attached
hereto;and
WHEREAS, the City has determined that this Project requires the incentives requested and
that said Project will promote the health, safety and welfare of the City and its citizens by attracting
private investment to redevelop under-utilized property, to provide employment for its citizens, and
generally to enhance the local economy;and
WHEREAS,in consideration of the execution of this Agreement and in reliance thereon,the
Developer is prepared to redevelop said property;and
WHEREAS, the City is entering into this Agreement to induce the Developer to complete
the Project improvements described in Exhibit "1" attached hereto.
AGREEMENTS
NOW, THEREFORE, for good and valuable consideration, the receipt of which is
acknowledged, the Parties agree as follows:
A. PRELIMINARY STATEMENTS
1. The Parties agree that the matters set forth in the recitals above are true and correct and form
a part of this Agreement and are to be construed as binding statements of this Agreement.
2. Any terms which are not defined in this Agreement shall have the same meaning as they do in
the Act,unless indicated to the contrary.
3. The Developer agrees to complete the Project and verify eligible project costs as required in
Section "E"below on or before December 31,2026,subject to exception of Force Majemrr as
described in Section `7"below.
4. For the purpose of this Agreement, the Developer's Project will be deemed to be complete
when the improvements described in Exhibit "1"are completed in compliance with all
applicable ordinances and building codes of the City, and the eligible project costs have been
verified by the Developer pursuant to Section "E"below.
5. Each of the Parties represents that it has taken all actions necessary to authorize its
representatives to execute this Agreement.
(I be remainder of this page is intentionally left blank.)
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B. INCENTIVES
In consideration for the Developer completing its Project,the City agrees to extend to the Developer
the following incentives to assist the Developer's Project:
1. Upon the timely completion of the Project and verification of Business District eligible project
costs incurred in furtherance of the Project by the Developer pursuant to Section "E"below,
the City shall reimburse the Developer a single, lump-sum amount not to exceed Fifty
Percent (50%) of the verified BD eligible project costs incurred by the Developer for
the Project as shown in "Exhibit 1,"or One Thousand Seven Hundred Sixty-Four and
00/100 Dollars ($1,764.00),whichever is less,which shall be payable solely from the Canton
BD Special Tax Allocation Fund pursuant to the Act.
C. LIMITATION OF INCENTIVES TO DEVELOPER
1. The Developer shall be reimbursed by the City, subject to the limitations of Section "B"
above, from the Business District Tax Allocation Fund, but only up to an amount not to
exceed Fifty Percent (50%) of their BDD Eligible Project Costs which are verified pursuant
to Section E below or the amount of One Thousand Seven Hundred Sixty-Four Dollars
($1,764.00),whichever is less.
D. OBLIGATIONS AND RESPONSIBILITIES OF DEVELOPER
1. The Developer shall timely complete the Project located on the Property. Failure of the
Developer to timely complete such the Project as set forth herein will result in the denial of
the reimbursements to be otherwise made hereunder.
2. The failure of the Developer to provide any information reasonably required herein after
notice from the City,and the continued failure to provide such information within 30 days to
the City after such notice shall be considered a material breach of this Agreement and shall be
cause for the City to deny payments hereunder to the Developer, which payments are
conditional upon receipt of the forgoing information.
3. The Developer agrees to execute any and all documents necessary to effectuate the provisions
of this Agreement.
E. PAYMENT OF ELIGIBLE PROJECT COSTS
1. To receive the incentives set forth in Section "B" above, the Developer must submit
documentation evidencing all Business District Eligible Project Costs incurred by it with
respect to the Project on or before December 31,2026. Satisfactory evidence of such costs
shall include verified bills or statements of suppliers, contractors, or professionals together
with mechanic's lien waivers (whether partial or full),cancelled checks,statements or invoices
marked paid from each of the parties entitled to payment with respect to work done for the
Project,or other proofs payment for such bills,statements,or invoices for such costs.
2. Absent the City's written consent for an extension provided to the Developer, any costs
submitted after December 31,2026,will not be eligible for reimbursement.
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3. Payment to the Developer for BD Eligible Project Costs as set forth by the BD Act shall be
made by the City following submission by Developer of a final Requisition for Payment of Private
Development Redevelopment Costs(the "Requisition's attached hereto as Exhibit "2"to Jacob &
Klein, Ltd. and the Economic Development Group, Ltd. (collectively the `BD
Administrator', and the BD Administrator's approval of the BD eligible project costs and
the availability of funds in the Canton BD Special Tax Allocation Account.
4. If any costs which are submitted by the Developer are not approved by the Administrator,the
reasons for disallowance will be set forth in writing and the Developer may resubmit the costs
with such additional information as may be required and the same procedures set forth herein
shall apply to such re-submittals.
5. All Business District Eligible Project Costs which have been approved shall then be paid
pursuant to the terms set forth in Section "B"above.
F. LIMITED OBLIGATION OF CITY
The City's obligation hereunder to reimburse the Developer as stated herein is a limited
obligation. Said obligation does not now and shall never constitute an indebtedness of the City within
the meaning of any State of Illinois constitutional or statutory provision and shall not constitute or
give rise to a pecuniary liability of the City or a charge or lien against any City fund nor obligate the
City to utilize its taxing authority to fulfill the terms of this Agreement.
G. LIMITED LIABILITY OF CITY TO OTHERS FOR DEVELOPER'S EXPENSES
There shall be no obligation by the City to make any payments to any person other than the
Developer, nor shall the City be obligated to make payments to any contractor, subcontractor,
mechanic,or materialman providing services or materials to the Developer for the Project.
H. DEFAULT; CURE;REMEDIES
In the event of a default under this Agreement by any Party hereto (the "Defaulting Party"),
which default is not cured within the cure period provided for below,then the other Party(the"Non-
defaulting Party") shall have an action for damages, or in the event damages would not fairly
compensate the Non-defaulting Party's for the Defaulting Party's breach of this Agreement,the Non-
defaulting Party shall have such other equity rights and remedies as are available to them at law or in
equity. Any damages payable by the City hereunder shall be limited to the Municipal Sales Tax
Revenues payable under the terms of this Agreement.
In the event a Defaulting Party shall fail to perform a monetary covenant which it is required
to perform under this Agreement,it shall not be deemed to be in default under this Agreement unless
it shall have failed to perform such monetary covenant within thirty(30) days of its receipt of a notice
from a Non-defaulting Party specifying that it has failed to perform such monetary covenant. In the
event a Defaulting Party fails to perform any non-monetary covenant as and when it is required to
under this Agreement,it shall not be deemed to be in default if it shall have cured such default within
thirty (30) days of its receipt of a notice from a Non-defaulting Party specifying the nature of the
default, provided, however, with respect to those non-monetary defaults which are not capable of
being cured within such thirty(30) day period,it shall not be deemed to be in default if it commences
curing within such thirty (30) day period, and thereafter diligently and continuously prosecutes the
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cure of such default until the same has been cured.
I.TIME;FORCE MAJEURE
For this Agreement,time is of the essence. The Developer agrees to complete the Project on
or before December 31,2026,subject to extension due to Force Majeure(defined below). Failure to
do so shall be cause for the City to declare the Developer in default and unilaterally terminate the
Agreement after notice and the opportunity to cure as provided in Section H. However,the Developer
and the City shall not be deemed in default with respect to any obligations of this Agreement on its
part to be performed if the Developer or the City fails to timely perform the same and such failure is
due in whole, or in part, to any strike,lock-out,labor trouble (whether legal or illegal),civil disorder,
inability to procure materials, weather conditions, wet soil conditions, failure or interruptions of
power, restrictive governmental laws and regulations, condemnation, riots, insurrections, war, fuel
shortages,accidents, casualties,Acts of God or any other cause beyond the reasonable control of the
Developer or the City.
J.ASSIGNMENT
The rights (including,but not limited to, the right to payments contemplated by Section "B"
of this Agreement) and obligations (or either of them) of the Developer under this Agreement shall
not be assignable.
K WAIVER
Any Party to this Agreement may elect to waive any remedy it may enjoy hereunder,provided
that no such waiver shall be deemed to exist unless the Party waiving such right of remedy does so in
writing. No such waiver shall obligate such Party to waive any right of remedy hereunder or shall be
deemed to constitute a waiver of other rights and remedies provided said Party pursuant to this
Agreement.
L. SEVERABILITY
If any section, subsection, term or provision of this Agreement or the application thereof to
any Party or circumstance shall, to any extent, be invalid or unenforceable, the remainder of said
section, subsection, term or provision of this Agreement or the application of same to parties or
circumstances other than those to which it is held invalid or unenforceable, shall not be affected
thereby.
(lhe remainder of this page is intentionally left blank.)
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M.NOTICES
All notices,demands,requests,consents,approvals or other instruments required or permitted
by this Agreement shall be in writing and shall be executed by the Party or an officer,agent or attorney
of the Party,and shall be deemed to have been effective as of(i)the date of actual delivery,if delivered
personally,or(ii)as of the third(31 day from and including the date of posting,if mailed by registered
or certified mail, return receipt requested,with postage prepaid or (iii) the next business day if sent
overnight delivery using a nationally recognized delivery service, addressed as follows:
TO CITY TO DEVELOPER
City of Canton Jesse Kidd
`/o City Clerk 351 N. Elmwood Road
2 N. Main Street Farmington,Illinois 61531
Canton,Illinois 61520 Ph:
Ph: (309) 647-0065
With copy to City BD Administrator. With copy to:
Jacob&Klein,Ltd. and
The Economic Development Group,Ltd.
1701 Clearwater Avenue
Bloomington,Illinois 61704
Ph: (309) 664-7777
N. SUCCESSORS IN INTEREST
Subject to the provisions of Section "J"above, this Agreement shall be binding upon and
inure to the benefit of the Parties hereto and their respective successors and assigns.
O. NO JOINT VENTURE,AGENCY, OR PARTNERSHIP CREATED
Neither anything in this Agreement nor any acts of the Parties to this Agreement shall be
construed by the Parties or any third person to create the relationship of a partnership,agency,or joint
venture between or among such Parties.
P. LIMITATIONS OF LIABILITY
As it relates to this Agreement, no recourse under or upon any obligation, covenant or
agreement of this Agreement or for any claim based thereon or otherwise in respect thereof shall be
had against the City, its officers, agents and employees, in excess of any specific sum agreed by the
City to be paid to Developer, hereunder, subject to the terms and conditions herein, and no liability,
right or claim at law or in equity shall attach to or shall be incurred by its officers,agents and employees
in excess of such amounts, and all and any such rights or claims of Developer against the City, its
officers, agents and employees are hereby expressly waived and released as a condition of and as
consideration for the execution of this Agreement by the City.
Q. ENTIRE AGREEMENT
The terms and conditions set forth in this Agreement supersede all prior oral and written
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understandings and constitute the entire agreement between the City and the Developer with respect
to the subject matter hereof.
R. TERM OF THE AGREEMENT
Notwithstanding anything in this Agreement to the contrary, this Agreement shall expire on
December 31, 2026, or upon the Developer receiving the incentives provided for in Section "B"
above. The Agreement shall expire sooner if the Developer files for bankruptcy or otherwise becomes
insolvent, upon the Property being the subject of foreclosure, or upon any default by the Developer
of any term or condition set forth in this Agreement after applicable notice and cure periods.
S. ILLINOIS PREVAILING WAGE ACT
It is the understanding of the Parties that the position of the Illinois Department of Labor(the
"Department's is that the Illinois Prevailing Wage Act does not apply to Sales Tax Reimbursements
received by private developers as reimbursement for private redevelopment project costs. This
position of the Department is stated as an answer to a FAQ section on the Department's website.'
The Developer shall indemnify and hold harmless the City,and all City elected or appointed officials,
officers, employees, agents, representatives, engineers, consultants, and attorneys (collectively, the
"indemnified Parties"), from any and all claims that may be asserted against the Indemnified Parties
or one or more of them,in connection with the applicability, determination, and/or payments made
under the Illinois Prevailing Wage Act (820 ILCS 130/0.01 et. seq.), the Illinois Procurement Code,
and/or any similar State or Federal law or regulation. This obligation to indemnify and hold harmless
obligates Developer to defend any such claim and/or action, pay any liabilities and/or penalties
imposed, and pay all defense costs of City, including but not limited to the reasonable attorney fees
of City. Failure to comply with any of these requirements may cause all benefits hereunder to be
terminated by the City.
T. OTHER GENERAL PROVISIONS
1. Titles of Paragraphs: Titles of the several parts, paragraphs, sections, or articles of this
Agreement are inserted for convenience of reference only and shall be disregarded in
construing or interpreting any provisions hereof.
2. Amendments to this Agreement. The Parties hereto may amend this Agreement at any
time by their mutual consent which amendment must be in writing and executed by the
Parties.
3. Warranty of Signatories: The signatories of Developer warrant full authority to both execute
this Agreement and to bind the entity in which they are signing on behalf of.
4. Countetparts:This Agreement may be executed in counterparts,which when taken together
shall constitute a single signed original as though all Parties had executed the same page.
5. Choice of Law/Venue: This Agreement shall be governed by and construed in accordance
with the laws of the State of Illinois with venue lying in the Circuit Court of Fulton County,
Illinois.
ISeeonline: httns://Iabor.ilhnois.go(v
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THIS AGREEMENT IS INTENDED TO BE A LEGAL DOCUMENT. AN ATTORNEY AT
LAW SHOULD BE CONSULTED PRIOR TO THE EXECUTION OF THIS DOCUMENT.
IN WITNESS WHEREOF the Parties hereto have caused this Agreement to be executed
by their duly authorized officers on the above date at the City of Canton,Illinois.
CITY DEVELOPER
CITY OF CANTON,ILLINOIS,an Illinois JESSE KIDD,individually
Municipal Co oration
lil": �sy
BY; 0J sse Kidd
Ma or
Date: OU0 Date:
A ST B .
ity Clerk tq
Date:
ATTACHMENTS:
Exhibit 1. Estimated BD Eligible Project Costs
Exhibit 2. Request for Verification of Private Redevelopment Costs
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EXHIBIT 1
ESTIMATED BD ELIGIBLE PROJECT COSTS
Jesse Kidd
City of Canton,Fulton County,Illinois / Canton BD No. 1
Project Description: The Developer is replacing the vinyl siding of the building located on the
building located on the Property at a total estimated cost of$3,528.
Property: 124 N. Main (PIN 09-08-27-409-007)
Estimated BD Eligible Project Costs:
Flooring and Vinyl Siding Replacement (materials and contracted labor)..............................................$3,528
Developer's BD Eligible Project Costs..................................................................
The total,cumulative reimbursement of BD Funds for BD Eligible Project Costs payable by the City to the
Developer shall not exceed 50%of verified BD eligible project costs incurred by the Developer or$1,764.00,
whichever is less,as set forth in this Redevelopment Agreement.
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EXHIBIT 2
PRIVATE REDEVELOPMENT PROJECT
REQUEST FOR VERIFICATION OF ELIGIBLE PROJECT COSTS
Requisition No.
Developer/Requestor name: Date submitted: / /20
Developer/Requestor mailing address:
Developer daytime phone: Email address:
This request for verification of eligible project costs relate to a written Redevelopment Agreement approved on
/ /20 by and between and
(Municipality) (Developer)
Project Name and Site Address:
Property PIN(s)as found on most recent real estate tax bill:
❑ Applicable Tax Increment Financing (TIF)District Name:
❑ Applicable Business District(BD)Name:
This form is a request by the Developer to the Municipality for verification of eligible project costs which may be relied
upon by the Municipality in advance of future disbursements of funds,if any are payable,from the Special Tax Allocation
Fund(s) pursuant to the above referenced Redevelopment Agreement and applicable laws and statutes. The terms
used herein shall have the same meanings as those terms in the Redevelopment Agreement.
List of Project Costs Incurred Pursuant to the Redevelopment Agreement and Paid by the Developer for which Verification
of Eligibility is Hereby Requested:
Proof of
Invoice(s) Payment
Description Amount Paid Attached Attached'
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
$ ❑ ❑
Total Amount Requested for Verification of Eligible Costs: $
The undersigned hereby certifies and swears under oath that the following statements are true and correct:
1 Proof of payment may include: bills,statements,invoices and/or waivers of lien marked as paid,signed,and dated by suppliers,
contractors,or professionals;processed/cancelled check or bank draft payments(i.e.,photocopies of both sides of check);or other
proofs payment for costs as may be requested by the Municipality. This information is to be attached to this form and available for
review when submitted.
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1. the items herein provided as the "List of Project Costs Incurred Pursuant to the Redevelopment Agreement
and Paid by the Developer for which Verification of Eligibility is Hereby Requested"were incurred and/or
financed by the Developer as deemed necessary and in furtherance of the Project, and such materials and or
services for which said costs were incurred have been applied to the Project in accordance with applicable
City Codes and requirements of the Redevelopment Agreement, including Exhibits and amendments, if any,
attached thereto; and
2. the Project Costs for which amounts are herein requested for verification of eligibility represent proper
redevelopment project costs as identified in the "Limitation of Incentives to Developer' described in the
Redevelopment Agreement, are not duplicated from any previous Request for Verification of Eligible Project
Costs, have been properly recorded on the Developers books, are set forth herein with invoices and proof of
payment attached for all sums for which reimbursement is requested; and
3. the amounts requested and set forth herein are not greater than those necessary to meet obligations due and
payable or to reimburse the Developer for its funds actually paid or advanced for such redevelopment project
costs; and
4. the Developer is not in default per the terms of the Redevelopment Agreement, and nothing has occurred to
the knowledge of the Developer that would prevent the performance or fulfillment of its obligations under the
Redevelopment Agreement.
The undersigned hereby certifies and warrants he/she is of legal age and that to the best of his/her knowledge the information
contained in and attached to this Request for Verification of Eligible Project Costs is true, correct, and complete and
furthermore agrees to the statements and representations provided herein. Any violation of this oath shall constitute a default
of the Redevelopment Agreement and shall be cause for the City to unilaterally terminate the Redevelopment Agreement.
By; DATE: 20
Developer/Requestor Signature
Print Developer/Requestor Name:
STATE OF ILLINOIS )
)SS
COUNTY OF )
I,the undersigned Notary Public,do hereby affirm that personally appeared before me on the day of
,20 ,and signed the above statement as a free and voluntary act and deed.
Notary Public
Date of Commission Expiry:
Revised 11/12/2024
THIS SECTION FOR MUNICIPAL USE
❑ Request reviewed by TIF/BD Administrator for the Municipality: Date: /---/20_
(name and title)
❑ Request approved by authorized municipal official: Date: /_�20_
(name and title)
❑ Project reviewed/inspected by authorized municipal official: Date: /___/20_.
(name and title)
❑ Project completed pursuant to Municipal Code Requirements.
❑ Project not completed pursuant to Municipal Code Requirements per attached report of authorized municipal official.