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ExhibitB <br />SEWER REPAIR REIMBURSEMENT AGREEMENT <br />City of South Bend, Indiana <br />Billing Address: Date: <br />Borrower's SSN: _ <br />, (Borrower) of <br />South <br />Bend, Indiana promise to pay to the order of the Sewer Repair Fnnd, South Bend Water Works, 125 West <br />Colfax Avenue, P.O. Box 1714, South Bend, Indiana 46634, the sum of $500 as follows: <br />One hundred dollars ($100) at the time of the execution of t <br />note, followed by I I monthly payments of $33.34, and one <br />final payment of $33.26 (total 12), all added to my South <br />Bend water bill at the address listed above which I agree to <br />1 understand that there will be no interest charged on the amount due pursuant to this note as long as my <br />payments are current, but that during any period of delinquency, I will be charged interest at the rate of <br />eight percent per annum. 1 hereby waive presentment for payment, protest, notice of protest, and <br />nonpayment of this note, and agree that upon default in payment of this note, or any part when due, the <br />whole amount remain ng.unpaid shall, without notice or nonpayment or demand of payment, immediately <br />become due and payable, with attorney's fees and without relief whatsoever from valuation of <br />appraisement laws. <br />I understand that if the total cost of repair is less than $500, that Water Works shall amend my payment <br />schedule to match the actual cost of the repairs. <br />Contact Person for Borrower (excluding spouse): <br />BORROWER: <br />Naine & relationship to Borrower (Please print) (Signature) <br />Telephone No: <br />Telephone No: - F <br />State of Indiana ) <br />SS: <br />St. Joseph Comity ) <br />Subscribed and sworn to before me, a Notary Public in and for said County and State this day of <br />,20 <br />Notary Public <br />Commission Expiration Date <br />