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6F (2)
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09-13-12 Packet
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6F (2)
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1/22/2013 7:10:46 PM
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9/10/2012 1:30:28 PM
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The un ersigned attests, subject to the penalties for perjury, that he is the contract <br />party, or that he is the representative, agent, member or officer of the ENGINEER that <br />he has ilot, nor has any other member, employee, representative, agent or officer of the <br />firm, company, corporation or partnership represented by him, directly or indirectly, to <br />the besi of his knowledge, entered into or offered to enter into any combination, <br />collusio i or agreement to receive or pay, and that he has not received or paid, any sum <br />of monE y or other consideration for the execution of this Contract other than that which <br />appearE upon the face of the Contract. <br />IN TESTIMONY WHEREOF, the parties hereto have executed this Agreement. <br />ENGINEER: OWNER: <br />DLZ IN IANA, LLC CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />ti <br />l / <br />Ga K. Fi�k, P.E. <br />Vice Pr sldent <br />ATTES : <br />Timoth -W. Jacks& P.E. <br />Real E tate Manager <br />M <br />Gary A. Gilot, P.E., Board President <br />By: <br />Donald E. Inks, Member <br />Kathryn Roos, Member <br />Michael Mecham, P.E., Member <br />Mark Neal, Member <br />ATTEST: <br />Linda M. Martin, Clerk <br />Approved as to Legality and Form: <br />Attorney for City of South Bend <br />1 \6160 - ROW Survey \Real Estate \City of South Bend \Ireland Road RW \agreement.docx <br />Ireland Road Right of Way Acquisition Services <br />Page 10 of 10 <br />Agreement <br />September 2012 <br />
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