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DocuSign Envelope ID: D8F1C726- DE7142B2-AE01- AD6D18F646AD <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 />btoothaker @agreatlakescapital.com <br />E -mail Address <br />Signature of Petitioner <br />cc: WorkOne Northern Indiana <br />Chairperson, Community and Economic Development Commi <br />City rtme st offCommunity and Economic Development Filed In CIO& O— � <br />(Rev. 5 /13/11) 7 i i <br />aUG . <br />....•30"N VJOkDBEND, 11+ <br />CrCY CLERK. SOOT -SEND <br />