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LPA Matching Grant Agreement - 2024 Community Crossings Proj No. 124-006 – INDOT
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LPA Matching Grant Agreement - 2024 Community Crossings Proj No. 124-006 – INDOT
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5/28/2024 3:18:53 PM
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5/28/2024 3:18:48 PM
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Board of Public Works
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Contracts
Document Date
5/28/2024
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5/28/2024 3:18 PM
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5/28/2024 3:18 PM
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https://secure.in.gov/apps/idoa/contractsearch/
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Page 9 of 9 <br />Non-Collusion, Acceptance <br /> <br />The undersigned attests, subject to the penalties for perjury, that the undersigned is the Grantee, or that the <br />undersigned is the properly authorized representative, agent, member, or officer of the Grantee. Further, to <br />the undersigned's knowledge, neith er the undersigned nor any other member, employee, representative, <br />agent, or officer of the Grantee, directly or indirectly, has entered into or been offered any sum of money or <br />other consideration for the execution of this Grant Agreement 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 Grant, the <br />Grantee attests to compliance with the disclosure requirements in IC § 4 -2-6 -10.5. <br /> <br /> <br />Agreement to Use Electronic Signatures <br /> <br />I agree, and it is my intent, to sign this Grant Agreement by accessing State of Indiana Supplier Portal using <br />the secure password assigned to me and by electronically submitting this Grant Agreement to the State of <br />Indiana. I understand that my signing a nd submitting this Grant Agreement in this fashion is the legal <br />equivalent of having placed my handwritten signature on the submitted Grant Agreement and this <br />affirmation. I understand and agree that by electronically signing and submitting this Grant Agr eement in <br />this fashion I am affirming to the truth of the information contained therein. I understand that this Grant <br />Agreement will not become binding on the State until it has been approved by the Department of <br />Administration, the State Budget Agency, a nd the Office of the Attorney General, which approvals will be <br />posted on the Active Contracts Database: https://secure.in.gov/apps/idoa/contractsearch/ <br /> <br />In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered <br />into this Grant Agreement. The parties, having read and understood the foregoing te rms of this Grant <br />Agreement, do by their respective signatures dated below agree to the terms thereof. <br /> <br />CITY OF SOUTH BEND Indiana Department of Transportation <br /> <br />By:\s1\ ___________________________ By:\s 2\______________________ <br /> <br />Title:\t1\______________________________ (for) Michael Smith, Commissioner <br /> <br />Date:\d1\_________________________ Date:\d2\_____________________ <br /> <br /> <br />Electronically Approved by: Electronically Approved by: <br />Department of Administration State Budget Agency <br /> <br /> <br />By: (for) Rebecca Holwerda, Commissioner By: (for) Joseph M. Habig, Acting State <br /> Budget Director <br /> <br /> <br />Approved as to Form and Legality: <br />Form approval has been granted by the <br />Office of the Attorney General pursuant to <br />IC 4 -13-2 -14.3(e) on April 11, 2024. <br />FA 24-16 <br /> <br />This instrument was prepared by the undersigned attorney: <br />Kirstie Andersen, #20005-49 <br /> <br /> <br />DocuSign Envelope ID: 163D75AD-F3A8-4B13-8E44-7E9587006A6C <br />5/28/2024 | 10:21 EDT <br />President, Board of Public Works <br />5/28/2024 | 07:54 PDT
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