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Dow <br />S 9 C U a 9 0 <br />Certificate Of Completion <br />Envelope Id: 66B58277EDB44740AA4843D9EO751599 <br />Status: Completed <br />Subject: Please DocuSign: South Bend Station - I_M - City of South Bend - South Bend <br />Station - Permissio... <br />Source Envelope: <br />Document Pages: 4 Signatures: 1 <br />Envelope Originator: <br />Certificate Pages: 3 Initials: 1 <br />Amy S Clipperton <br />AutoNav: Enabled <br />1 Riverside Plz FL 1 <br />Enveloped Stamping: Enabled <br />Columbus, OH 43215-2373 <br />Time Zone: (UTC-05:00) Eastern Time (US & Canada) <br />asclipperton@aep.com <br />IP Address: 161.235.2.88 <br />Record Tracking <br />Status: Original Holder: Amy S Clipperton Location: DocuSign <br />6/26/2020 3:54:49 PM asclipperton@aep.com <br />Signer Events Signature Timestamp <br />Cindy Buckbee lci's <br />Sent: 6/26/2020 3:57:15 PM <br />cdbuckbee@aep.com Viewed: 6/29/2020 7:59:35 AM <br />American Electric Power Service Corporation Signed: 6/29/2020 7:59:53 AM <br />Security Level: Email, Account Authentication <br />(None) Signature Adoption: Pre -selected Style <br />Using IPAddress: 161.235.221.85 <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Todd Ireland EDOCUSigned <br />by: Sent: 6/29/2020 7:59:54 AM <br />ptireland@aep.com 7p..si cr,A Viewed: 6/29/2020 8:30:46 AM <br />9 9 9Mana er Real Estate Asset Mana ement C7F9EB570525421 Signed: 6/29/2020 8:31:02 AM <br />Appalachian Power Company <br />Signature Adoption: Uploaded Signature Image <br />Security Level: Email, Account Authentication <br />(None) Using IPAddress: 174.233.0.192 <br />Electronic Record and Signature Disclosure: <br />Accepted: 9/9/2015 1:39:12 PM <br />ID:b88d9a61-54c6-4049-8659-9d8a34e93235 <br />In Person Signer Events <br />Signature <br />Timestamp <br />Editor Delivery Events <br />Status <br />Timestamp <br />Agent Delivery Events <br />Status <br />Timestamp <br />Intermediary Delivery Events <br />Status <br />Timestamp <br />Certified Delivery Events <br />Status <br />Timestamp <br />Carbon Copy Events <br />Status <br />Timestamp <br />Witness Events <br />Signature <br />Timestamp <br />Notary Events <br />Signature <br />Timestamp <br />Envelope Summary Events <br />Status <br />Timestamps <br />Envelope Sent <br />Hashed/Encrypted <br />6/29/2020 7:59:54 AM <br />Certified Delivered <br />Security Checked <br />6/29/2020 8:30:46 AM <br />