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4 <br /> GRANTEE: <br />City of South Bend, Indiana, by and through its Board of <br />Public Works <br /> <br /> <br />By: ________________________________________ <br /> Elizabeth A. Maradik, President <br /> <br />ATTEST: <br /> <br /> <br />By: _______________________________________ <br /> Anne Fuchs, Clerk <br /> <br /> <br />STATE OF INDIANA ) <br /> ) SS: <br />ST. JOSEPH COUNTY ) <br /> <br /> Before me, the undersigned, a Notary Public for and in said County and State this ____ day of <br />_____________ 20_____ appeared Elizabeth A. Maradik and Anne Fuchs, known to me to be, <br />respectively, President and Clerk of the City of South Bend, Indiana, Board of Public Works, the Grantee, <br />and acknowledged the execution of the foregoing Lien and Restrictive Covenant Agreement for Rental <br />Property, being authorized pursuant to Resolution No. _______________. <br /> <br /> IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal. <br /> <br /> <br /> <br /> <br /> ___________________________, Notary Public <br /> Resident of _______________ County, _______ <br />Commission expires: _____________ <br /> <br /> <br /> <br /> <br /> <br />This instrument was prepared by Sandra L. Kennedy, Assistant City Attorney, City of South Bend, Indiana, 227 W. <br />Jefferson Blvd. 1200S, South Bend, IN 46601. <br /> <br />I affirm, under the penalties of perjury, that I have taken reasonable care to redact each Social Security <br />number in this document, unless required by law. Sandra L. Kennedy