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VERIFYING AFFIDAVIT <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF ST. JOSEPH ) <br />being first duly sworn upon his/her oath, deposes and <br />says: <br />He /she is a owner of taxable real estate property located within the boundaries of the City <br />of South Bend, Indiana (the "City "), and has signed the counterpart indicated below on the line shown <br />below of a petition addressed to the Common Council of the City requesting such Common Council to <br />commence proceedings to secure a lease providing for (i) the construction, erection, equipping and <br />leasing of a fire station to replace the existing fire station located at 2221 Prairie Avenue in the City <br />which new fire station will provide approximately 3,000 square feet of living space and an apparatus bay <br />of approximately 1400 square feet and (ii) the construction, erection, equipping and lease of a new fire <br />safety training facility located on a 5.5 acre parcel located generally near Sample and High Streets in the <br />City which facility will consist of the construction of closed campus containing numerous training <br />environments and structures, including (A) a 4200 square foot classroom building with an attached <br />outdoor classroom and demonstration space; (B) a six (6) story training tower which will contain <br />moveable interior walls; (C) a 2000 square foot burn building that will support live fire and Class A <br />combustibles and provide different tactical options depending upon approach (the front of the building <br />will mimic a single family residence and the rear will mimic an apartment building); and (D) designated <br />areas and props for auto extrication, rooftop operations, collapse rescue and trench and confined space <br />rescue all to be constructed, erected or acquired by the City of South Bend Building Corporation and <br />leased to the City all in accordance with the provisions of Indiana Code 36 -1 -10, as amended. All <br />signatures appearing on the attached counterpart were affixed in his/her presence and are the true and <br />lawful signatures of the persons signing this counterpart of this petition. <br />Counterpart No. <br />Line No. <br />Signature <br />(Printed Name) <br />-5- <br />DMS_US 51827214v2 <br />