9523-04 Authorizing the Acquistion, COnstuction and, Installation of Certain Additions

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EXHIBIT A Foluvl of 2004 Borrv Unless this Bond (as defined below) is presented by an authorized representative of The Depository Trust Company, a New York corporation ("DTC"), to the City of South Bend, Indiana, or its agent for registration of transfer, exchange or payment, and any Bond issued is registered in the name of Cede & Co. or in such other name as is requested by an authorized representative of DTC (and any payment is made to Cede & Co. or to such other entity as is requested by an authorized representative of DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch as the registered owner hereof, Cede & Co., has an interest herein. UNITED STATES OF AMERICA STATE OF INDIANA COUNTY OF ST. JOSEPH CITY OF SOUTH BEND SEWAGE WORKS REVENUE BOND OF 2004 Interest Maturity Original Authentication Rate Date Date Date CUSIP oIo 1 , 20_ , 2004 , 2004 No. R REGISTERED OWNER: Cede & Co. PRINCIPAL SUM: Million Thousand Dollars ($ ) The City of South Bend, in St. Joseph County, State of Indiana, for value received, hereby promises to pay to the Registered Owner set forth above, solely out of the special fund hereinafter referred to, the Principal Sum set forth above on the Maturity Date set forth above (unless this bond is subject to and is called for redemption prior to maturity as hereinafter provided), and to pay interest thereon until the Principal Sum shall be fully paid at the Interest Rate per annum specified above from the interest payment date to which interest has been paid next preceding the Authentication Date of this bond unless this bond is authenticated after the fifteenth day of the month preceding an interest payment date and on or before such interest payment date in which case interest shall be paid from such interest payment date, or unless this bond is authenticated on or before 15, 200_ in which case it shall bear interest from the Original Date, which interest is payable semi-annually on the first day of June and December of each year, beginning on 1, 200_.