Laserfiche WebLink
PAYMENT (REQUEST AND ACCEPTANCE CERTIFICATE FORM <br />To: UMB Bank, n.a. <br />1010 Grand, 4th Floor <br />Kansas City, Missouri 64106 <br />and DE LAGE LANDEN PUBLIC FINANCE LLC <br />(LESSOR) <br />DE <br />Re: CITY OF SOUTH. BEND, INDIANA Equipment Acquisition Fund No. .... estab- <br />lished by the Escrow Agreement, dated as of ,,...,.NOVEMBER 26 20 18 , (the "Escrow Agreement"), among <br />DE LAGELANDEN--PUBUC_FINANCE LLC (Lessor"), <br />CITY OF SOUTH BEND INDIANA ("Lessee") <br />and LIMB Bank, n.a., as Escrow Agent (the "Escrow Agent") <br />Ladies and Gentlemen; <br />Escrow Agent is hereby requested to pay from the Acquisition Fund to the person or corporation designated below as Payee, the sum set forth below in payment <br />of a portion or all of the cost of the acquisition of the equipment described below. The amount shown below is due and payable under the invoice of the Payee attached <br />hereto with respect to the cost of the acquisition of the equipment and has not formed the basis of any prior request for payment. The equipment described below is part <br />or all of the "Equipment' that is listed in the State and Local Government Lease -Purchase Agreement (the "Agreement") described in the Escrow Agreement. <br />Lessee hereby certifies and represents to and agrees with Lessor and Escrow Agent as follows: <br />1. The Equipment described above has been delivered, installed and accepted on the date hereof. <br />2. Lessee has conducted such inspection and/or testing of said equipment as it deems necessary and appropriate and hereby acknowledges that it accepts said <br />equipment for all purposes. <br />3. Lessee is currently maintaining the insurance coverage required by Section 14 of the Agreement. <br />4. No event or condition that constitutes, or with notice or lapse of time or both would constitute, a default (as described in Section 15 of the Agreement) exists <br />at the date hereof. <br />Lim <br />20 <br />W Lessee ., CITY OF GW.,wftW War <br />ae <br />w o Signature ------ <br />� La Print Name w ��� w ... <br />NJ <br />C-u�.. _ x'<aruu.�,w�.w+� � ^ywwkuw�rvetinrewxrlu�wMwa!mom,—.�WMu�NM u�aiwM�z'"� <br />