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• <br />ACKNOWLEDGED AND ACCEPTED BY <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />By: Gary A. Gilot <br />Its: President <br />City of South Bend, Indiana <br />Board of Public Works <br />State of Indiana, County of St. Joseph ss: <br />ATTEST <br />By: Linda M. Martin <br />Its: Clerk <br />City of South Bend, Indiana <br />Board of Public Works <br />Before me, the undersigned, a Notary Public in and for said County and State, personally <br />appeared the within named Gary A. Gilot and Linda M. Martin, the President and Clerk, <br />respectively, of the City of South Bend, Indiana Board of Public Works, who acknowledged the <br />acceptance of the foregoing Deed on behalf of the Board. <br />• WITNESS, my hand and Seal this day of , 2007. <br />My Commission <br />Expires: <br />Signature of Notary Public <br />Printed Name of Notary Public <br />Notary Public County and State of Residence <br />This instrument was prepared Shawn E. Peterson, Attorney-at-Law <br />by; 227 W. Jefferson Boulevard, Ste. 1400, South Bend, IN 46601 <br />I affirm, under the penalties for perjtuy, that I have taken reasonable care to redact each social security number in <br />this document, unless required by law. <br />[Name] <br />NOTE: The individual's name in affirmation statement may be typed, hand written or a signature. <br /> <br />