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If To City: <br />Public Works [Department <br />City of South Bend <br />227 W. Jefferson Blvd., Ste. 1316 <br />South Bend, IN 46601 <br />Attention: License Administrator <br />Countervarts <br />This Agreement may be executed in any number of counterparts, each of which shall be <br />deemed an original, but all of which together shall constitute one and the same agreement. <br />N WITNESS WHEREOF, the Parties hereto have caused this Agreement to be effective as of <br />the Effective Date stated ahave. <br />Ir <br />Prialed Name and Tree <br />d /\ 0 k�-?mp 3 VT <br />eI A d0 re Ss <br />P.Li. Boy <br />0/1�- �,) eo� 1P0 4!� <br />!r/wp" / � ) L-'p 040 <br />t.y. State Zop <br />&( 7 <br />Telephone Fat <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />r0m <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Jordan V. Gathers, Member <br />Attest: Theresa M. Heffner, Clerk <br />�. - ►�, i 1 <br />