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Page 3 of 3 <br /> <br />Non-Collusion and Acceptance <br />The undersigned attests, subject to the penalties for perjury, that the undersigned is the LPA, or that the <br />undersigned is the properly authorized representative, agent, member or officer of the LPA. Further, to the <br />undersigned's knowledge, neither the undersigned nor any other member, employee, representative, agent <br />or officer of the LPA, directly or indirectly, has entered into or offered any sum of money or other <br />consideration for the execution of this Contract other than that which appears upon the face <br />hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state <br />appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the LPA <br />attests to compliance with the disclosure requirements in IC § 4-2-6-10.5 <br />Agreement to Use Electronic Signatures <br /> <br />I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the <br />secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I <br />understand that my signing and submitting this Contract in this fashion is the legal equivalent of having <br />placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree <br />that by electronically signing and submitting this Contract in this fashion I am affirmi ng to the truth of the <br />information contained therein. I understand that this Contract will not become binding on the State until it <br />has been approved by the Department of Administration, the State Budget Agency, and the Office of the <br />Attorney General, which approvals will be posted on the Active Contracts Database: <br />https://secure.in.gov/apps/idoa/contractsearch/. <br /> <br />In Witness Whereof, the LPA and the State have, through their duly authorized r epresentatives, entered <br />into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their <br />respective signatures dated below agree to the terms thereof. <br />CITY OF SOUTH BEND Indiana Department of Transportation <br /> <br />By:\s1\ ___________________________ By:\s 2\______________________ <br /> <br />Title:\t1\______________________________ Title:\t 2\_______________________ <br /> <br />Date:\d1\_________________________ Date:\d 2\_____________________ <br /> <br /> <br /> <br /> <br /> <br /> <br /> Electronically Approved by: <br />Department of Administration <br /> <br />By: (for) <br />Rebecca Holwerda, Commissioner <br /> <br />Electronically Approved by: <br />State Budget Agency <br /> <br />By: (for) <br />Zachary Q. Jackson, Director <br /> <br />Electronically Approved as to Form and Legality: <br />Office of the Attorney General <br /> <br />By: (for) <br />Theodore E. Rokita, Attorney General <br /> <br /> <br /> <br />DocuSign Envelope ID: B5F4B67E-11BF-4BC8-ABE4-2F66A4E8D952 <br />11/28/2023 | 13:44 EST <br />President, Board of Public Works Director, Local Programs <br />11/28/2023 | 11:00 PST