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Non -Collusion and Acceptance <br />The undersigned attests, subject to the penalties for perjury, that he/she is the Contractor, or that <br />he/she is the properly authorized representative, agent, member or officer of the Contractor, that <br />he/she has not, nor has any other member, employee, representative, agent or officer of the <br />Contractor, directly or indirectly, to the best of the undersigned's knowledge, entered into or offered <br />to enter into any combination, collusion or agreement to receive or pay, and that he/she has not <br />received or paid, any sum of money or other consideration for the execution of this Contract other <br />than that which appears upon the face of this Contract. Furthermore, if the undersigned has <br />knowledge that a state officer, employee, or special state appointee, as those terms are defined <br />in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance <br />with the disclosure requirements in IC 4-2-6-10.5. <br />In Witness Whereof, Contractor and lHCDA have, through their duly authorized representatives, <br />entered into this Contract. The parties, having read and understood the foregoing terms of this <br />Contract, do by their respective signatures dated below hereby agree to the terms thereof. <br />Indiana Housing and Community <br />City of South Bend Development Authority <br />By: <br />Printed: <br />Title: <br />Date: <br />I U4 1ROVED By: <br />--u—ni—TT of P1110lic wort;uA <br />Printed: J. Jacob S <br />Title: - Executive Director <br />Date: <br />Approved by:------, _"Approved by: <br />Indiana Department of Administration State Budget Agency <br />By: (for) By: <br />Jessica Robertson, Commissioner <br />Date: Date: <br />APPROVED as to Form and Legality: <br />Office of the Attorney General <br />Form approval has been granted by the <br />Office of the Attorney Generalpursuant to <br />IC 413-2-14.3(e) on December 12, 2017. <br />FA 17-67 <br />Jason Dudich, Director <br />This document prepared by Brigitte Collier, Compliance Attorney. <br />for <br />{00029857-1} <br />Page 20 of 29 <br />