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IT IS AGREED that the foregoing is the entire contract between the parties hereto, and that this written <br />agreement is complete in all its terms and provisions and shall be binding on their respective representatives, heirs, successors, <br />and assigns. <br />THE UNDERSIGNED PERSON executing this document on behalf of Grantor, represents and certifies that <br />he /she is duly authorized by the Grantor and has been fully empowered to execute and deliver this document; that Grantor has <br />full capacity to convey the real estate described here; and that all necessary action for the making of such conveyance has been <br />taken and done. <br />IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal on 20. <br />STATE OF <br />) SS. <br />COUNTY OF <br />CITY OF SOUTH BEND, a Governmental Municipality, <br />By: <br />, its <br />(Please print your name and title on this line exactly as it appears above.) <br />Before me, a Notary Public in and for said County and State, on , 20_, personally appeared <br />, the of CITY OF SOUTH BEND, a Governmental Municipality, and acknowledged <br />execution of the foregoing document for and on behalf of said Grantor, and who, having been duly sworn, stated that the representations therein <br />contained are true. <br />WITNESS my hand and Notarial Seal. <br />(SEAL) <br />I affirm, under the penalties for perjury, that I have <br />taken reasonable care to redact each social security <br />number in this document, unless required by law: <br />S. M. Durham <br />Notary Public, <br />County, <br />My Commission Expires: <br />Prepared by: <br />Sylvia M. Durham, Right of Way Agent <br />AEP — Indiana Michigan Power Company <br />2929 W. Lathrop, South Bend, IN 46628 <br />574.283.1870 <br />