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6D(1)
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08-15-13
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1/13/2014 12:08:01 PM
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8/13/2013 9:29:04 AM
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The undersigned attests, subject to the penalties for perjury, that he is the contract <br />party, or that he is the representative, agent, member or officer of the ENGINEER that <br />he has not, nor has any other member, employee, representative, agent or officer of the <br />firm, company, corporation or partnership represented by him, directly or indirectly, to <br />the best of his knowledge, entered into or offered to enter into any combination, <br />collusion or agreement to receive or pay, and that he has not received or paid, any sum <br />of money or other consideration for the execution of this Contract other than that which <br />appears upon the face of the Contract. <br />IN TESTIMONY WHEREOF, the parties hereto have executed this Agreement. <br />ENGINEER: <br />DLZ INDIANA, LLC <br />('; I<_ 7;; �P_ <br />Gary K. Fi4k, P.E. <br />Vice President <br />ATTEST: <br />Samuel E. Wolfe, P.E., L.S. <br />Department Manager <br />OWNER: <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />By: <br />Gary A. Gilot, P.E., Board President <br />By: <br />David P. Relos, Member <br />By <br />Kathryn E. Roos, Member <br />By: <br />Michael C. Mecham, P.E., Member <br />By: <br />Mark W. Neal, Member <br />ATTEST: <br />By: <br />Linda M. Martin, Clerk <br />Approved as to Legality and Form: <br />Attorney for City of South Bend <br />MAProposa1s \2011 \6160 - ROW Survey \Real Estate \City of South Bend \Bowen Street Agreement.docx <br />Bowen Street Right of Way Engineering, Staking and Acquisition Services Agreement <br />August 2013 <br />Page 10 of 10 <br />
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