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DocuSign Envelope ID:DBF1C726-DE71-4282-AE01-AD6Dl8F646AD <br /> CITY OF SOUTH BEND, INDIANA <br /> WORKONE NORTHERN INDIANA FORM <br /> Pursuant to Section 2-83.2 of the South Bend Municipal Code, the <br /> Petitioner referred to herein agrees to work with WorkOne Northern <br /> Indiana, 851 South Marietta Street, South Bend, Indiana 46601 , or its <br /> successor agency as a condition of receiving property tax abatement. <br /> Great Lakes Capital Development <br /> Petitioner's Name <br /> Agent's Name Acting on Behalf of the Petitioner <br /> Brad Toothaker <br /> Contact Person <br /> 112 W. Jefferson Blvd. <br /> Street Address <br /> South Bend, IN 46601 <br /> City, State, Zip Code <br /> 574-251-4400 <br /> Business Telephone Number <br /> btoothakerOgreatlakescapital .com <br /> E mail Address <br /> Signature of Petitioner <br /> cc: WorkOne Northern Indiana <br /> Chairperson, Community and Economic Development Commi <br /> Department of Community and Economic Development 1�Plc'tt °� <br /> City Clerk's Office File d in <br /> (Rev. 5/13/11) <br /> i;ilG '1.. 1 i.(113 <br /> I, ...3Ong S®uTM BEtdD,4�+ <br /> l cc"GLERK,r _ _w-- <br />