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TRANSCRIPT
Rev 3.0
Conditional Sales Agreement
WITNESSETH THIS AGREEMENT dated February ___, 2018, by and between THE STATE OF INDIANA acting through the Indiana Department of Administration, (“Seller”) and ________________________________________________________________, (“Buyer”).
In consideration of this Agreement, Seller and Buyer agree as follows:
1. Sale of Property. Seller agrees to sell to Buyer, and Buyer agrees to buy from Seller, the following property (collectively, “Property”):
1.1 Property. The property commonly known as 8841 Lima Road, Fort Wayne, IN, Allen County, Indiana, described on the attached Exhibit A (“Land”) together with all buildings, improvements and fixtures constructed or located on the Land (“Buildings”) and all easements of record and rights benefiting or appurtenant to the Land (collectively the “Property”), subject to all existing legal rights-of-way, easements, conditions and restrictions of record.
1.2 Access. The subject parcel currently has limited public access or right of entry. The buyer will be responsible for gaining legal access to the property. Ingress/Egress permits may be submitted to the Department of Transportation and approved or denied at the agencies sole discretion. No assurance of such a permit is expressed or implied.
1.3 Personal Property. No personal property is being sold or conveyed as a part of this Purchase Agreement.
2. Purchase Price, Buyer’s Premium, and Manner of Payment. The total purchase price (“Purchase Price”) to be paid for the Property shall be ________________________________ Dollars ($________________). The Purchase Price shall be payable as follows:
2.1 In conjunction with execution of this Agreement (the “Execution Date”), Buyer shall submit ____________________________________________ Dollars ($_______________) to Seller as earnest money (“Earnest Money”). In the event this Agreement is not accepted by Seller, the Earnest Money shall be promptly returned to Buyer. Upon acceptance of this Offer by Seller, such Earnest Money shall secure the Buyer's performance of this Agreement and in the event of a default by Buyer in the performance of its obligations herein specified, Seller shall have the right to terminate this Agreement and the Earnest Money shall be paid to Seller as liquidated damages as Seller’s sole remedy at law or in equity; and
2.2 The balance of the Purchase Price, subject to adjustments as set forth herein, shall be payable in certified funds or by electronic transfer of funds on the “Closing Date” (as hereinafter defined).
2.3 In addition to the Purchase Price, Buyer shall, at Closing as hereinafter defined, pay Seller’s representative a 10% Buyer’s premium pursuant to the terms of a separate addendum to this Agreement.
3. Contingencies and Inspection Period. The obligation of the Seller is contingent upon approval of the transaction contemplated by this Agreement as required by IC 4-13-2-14.1, IC 4-13-2-14.2 and IC 4-20.5-7.
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4. Closing. In the event that Seller has accepted this Agreement and the parties proceed to closing, the closing of the purchase and sale contemplated by this Agreement (the “Closing”) shall occur within thirty (30) days following State approval as set forth above (the “Closing Date”), such final closing is subject to and conditional upon approval by the Office of the Governor and the Indiana Attorney General, unless extended by mutual agreement of the parties. The Closing shall take place at a time, place, and on a date agreeable by Seller and Buyer. The Buyer will be responsible for title fees, escrow fees, and costs charged by the company with whom the earnest money is deposited as outlined in Section 5.1.
4.1 Seller’s Closing Documents. On the Closing Date, Seller shall have executed and delivered or caused to be delivered to Buyer the following (collectively, “Seller’s Closing Documents”), all in form and content reasonably satisfactory to Buyer:
4.1.1 Deed. A Quitclaim Deed conveying the Property to Buyer, an exemplar of such Quitclaim Deed is attached hereto as Exhibit B.
4.1.2 Documents. Copies of all contracts, permits and warranties affecting the Property that will survive the Closing, if any.
4.1.3 Sales Disclosure Form. An Indiana sales disclosure form.
4.1.4 Other Documents. All other documents reasonably determined by Buyer to be necessary to transfer title to the Property to Buyer free and clear except Permitted Exceptions to Title.
4.2 Buyer’s Closing Documents. On the Closing Date, Buyer will execute and deliver to Seller the following (collectively, “Buyer’s Closing Documents”):
4.2.1 Purchase Price. Funds representing the Purchase Price, by electronic transfer of immediately available funds.
4.2.2 Assumption of Contracts, Permits, Warranties and Miscellaneous Documents. An Assumption of Contracts, Permits and Warranties, if any, assuming Seller’s obligations under such documents.
4.2.3 Sales Disclosure Form. An Indiana sales disclosure form.
4.2.4 Other Documents. All other documents reasonably determined by Seller or Title Company to be necessary to complete the transaction contemplated by this Agreement.
5. Allocation of Costs. Seller and Buyer agree to the following allocation of costs regarding this Agreement:
5.1 Title Insurance and Closing Fee. Buyer shall be solely responsible for the payment of all premiums and fees associated with title insurance, including any and all closing fees or recording charges. Buyer shall be responsible for payment, at or before Closing, of search fees charged by the title company from whom Seller obtained a preliminary title review and commitment. Unless waived by the title company, said closing fees shall be payable by Buyer whether or not Buyer obtains a policy of title insurance.
5.2 Taxes and Assessments. The Property being conveyed is owned by the State of Indiana and is exempt from all real property taxes. The Seller shall assume no responsibility or liability for any real property taxes or other assessments from which it is statutorily exempt. Buyer shall be solely responsible for, and indemnify Seller against, any and all real property taxes assessed with respect to the Real Property on or after Closing.
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5.3 Utilities. Seller shall either ensure that utility service to the Property is disconnected as of the Closing Date or shall cooperate with Buyer in having such utility services transferred to Seller’s account. All contracts relating to operating the Property shall be canceled as of the Closing Date.
5.4 Attorney’s Fees. Each of the parties will pay its own attorney’s fees.
6. Evidence of Title. In the event that Buyer does not order and receive a commitment for title insurance, Seller shall, at its expense, within ten (10) days after written request from Buyer, furnish to Buyer a copy of the documents by which the State obtained or otherwise holds title or a letter from the State Land Office describing the documents by which the State obtained and otherwise holds title. Seller will cooperate with the Buyer or its title company in clarifying or resolving any perceived deficiencies or clouds in the title, but shall not be required to incur any expense beyond commitment of the time of the State Land Office. If such issues cannot be resolved to Buyer’s satisfaction, Buyer may terminate this Agreement, and the Earnest Money, if any, shall be returned.
7. Maintenance of the Real Property Prior to Closing. During the period from the date of Seller’s acceptance of this Agreement to the Closing Date, Seller shall maintain the Property and improvements in a reasonably prudent manner. Seller shall execute no contracts, leases or other agreements regarding the Property between the date hereof and the Date of Closing that are not terminable on or before the Closing Date, without the prior written consent of Buyer, which consent may be withheld by Buyer at its sole discretion.
8. Representations and Warranties by Seller. Seller represents and warrants to Buyer as follows:
8.1 Existence; Authority. Seller has the requisite power and authority to enter into and perform this Agreement and to execute and deliver Seller’s Closing Documents; such documents have been duly authorized by all necessary action.
8.2 Contracts. Seller has made available to Buyer a correct and complete copy of any Contract and its amendments which will survive a closing hereunder, if any.
8.3 Operations. Seller has received no written notice of actual or threatened cancellation or suspension of any utility services for any portion of the Property. Seller has received no written notice of actual or threatened special assessments or reassessments of the Property.
8.4 Litigation. To Seller’s knowledge, there is no litigation or proceeding pending or threatened against or relating to the Property, nor does Seller know of or have reasonable grounds to know of any basis for any such action or claim.
8.5 Physical Condition. Seller makes no representation or warranty concerning the physical condition of the Property and puts Buyer to the obligation to satisfy itself pursuant to the contingency contained in Section 3 above.
9. Casualty; Condemnation. If all or any part of the Property is materially damaged by fire, casualty, the elements or any other cause, Seller shall immediately give notice to Buyer, and Buyer shall have the right to terminate this Agreement and receive back all Earnest Money by giving notice within thirty (30) days after Seller’s notice. If eminent domain proceedings are threatened or commenced against all or any part of the Property, Seller shall immediately give notice to Buyer, and Buyer shall have the right to terminate this Agreement and receive back all Earnest Money by giving notice within thirty (30) days after Seller’s notice. Termination of this Agreement and return of all Earnest Money are Seller’s sole remedies
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10. Notices. Any notice required or permitted hereunder shall be given by personal delivery upon an authorized representative of a party hereto; or if mailed by United States certified mail, return receipt requested, postage prepaid; or if transmitted by facsimile copy followed by mailed notice; or if deposited cost paid with a nationally recognized, reputable overnight courier, properly addressed as follows:
If to Seller: Commissioner Indiana Department of Administration 402 W. Washington St., W479 Indianapolis, IN 46204 With Copy to: Attorney General Office of the Indiana Attorney General 302 W. Washington St. Indianapolis, IN 46204 If to Buyer: With a Copy to:
Notices shall be deemed effective on the date of receipt. Any party may change its address for the service of notice by giving notice of such change ten (10) days prior to the effective date of such change.
11. Miscellaneous. The paragraph headings or captions appearing in this Agreement are for convenience only, are not a part of this Agreement, and are not to be considered in interpreting this Agreement. This written Agreement constitutes the complete agreement between the parties and supersedes any prior oral or written agreements between the parties regarding the Property. There are no verbal agreements that change this Agreement, and no waiver of any of its terms will be effective unless in a writing executed by the parties. This Agreement binds and benefits the parties and their successors and assigns. This Agreement has been made under the laws of the State of Indiana, and any suit must be brought in an Indiana court of competent jurisdiction.
12. Remedies. If Buyer defaults, and if Buyer fails to cure such default within ten (10) days of the date of notice of such default from Seller, then Seller shall have the right to terminate this Agreement by giving written notice of termination to Buyer. In the event of termination Seller will receive the Earnest Money as liquidated damages, time being of the essence of this Agreement. The termination of this Agreement and retention of the Earnest Money will be the sole remedy available to Seller for such default by Buyer, and Buyer will not be liable for damages or specific performance. Buyer’s sole remedy for any default by Seller shall be termination of this Agreement and return of the Earnest Money.
13. Buyer’s Examination. Buyer is relying solely upon its own examination of the Property and inspections in determining its physical condition, character, and suitability for Buyer’s intended use of the Property and is not relying upon any representation by Seller or any broker, except for those made by Seller directly to Buyer in writing in Exhibit C, which is attached to this agreement. Buyer agrees and acknowledges that it is accepting the Property “AS IS” subject to all faults of every kind and nature whatsoever, whether latent or patent, and whether now or
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hereafter existing, and Buyer acknowledges that it has based its decision to purchase the Property solely upon information obtained independently by Buyer. Buyer shall sign a Hold Harmless Affidavit, an exemplar of such Hold Harmless Affidavit is attached hereto as Exhibit D. Buyer shall acquire the Property subject to all laws imposed upon the Property by any governmental or quasi-governmental authority having jurisdiction thereof. Buyer represents and warrants to Seller that Buyer has not relied, and will not rely, upon the representation or statement, or the failure to make any representation or statement, by Seller or Seller’s agents, employees or by any person acting or purporting to act on the behalf of Seller with respect to the physical condition of the Property.
14. Compliance with Telephone Privacy. As required by IC 5-22-3-7: (1) The Buyer and any principals of the Buyer certify that (A) the Buyer, except for de
minimis and nonsystematic violations, has not violated the terms of (i) IC 24-4.7 [Telephone Solicitation Of Consumers], (ii) IC 24-5-12 [Telephone Solicitations] , or (iii) IC 24-5-14 [Regulation of Automatic Dialing Machines] in the previous three hundred sixty-five (365) days, even if IC 24-4.7 is preempted by federal law; and (B) the Buyer will not violate the terms of IC 24-4.7 for the duration of the Contract, even if IC 24-4.7 is preempted by federal law. (2) The Buyer and any principals of the Buyer certify that an affiliate or principal of the Buyer and any agent acting on behalf of the Buyer or on behalf of an affiliate or principal of the Buyer (A) except for de minimis and nonsystematic violations, has not violated the terms of IC 24-4.7 in the previous three hundred sixty-five (365) days, even if IC 24-4.7 is preempted by federal law; and (B) will not violate the terms of IC 24-4.7 for the duration of the Contract, even if IC 24-4.7 is preempted by federal law.
15. Withdrawal of Offer. This Agreement shall be deemed to be withdrawn, unless accepted by Seller, after one-hundred-fifty (150) days of delivery to Seller. In the event of a withdrawal under this section, Buyer shall be entitled the return of the Earnest Money.
16. Additional terms.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
17. Non-Collusion and Acceptance. The undersigned attests, subject to the penalties for perjury, that he/she is the Buyer, or that he/she is the properly authorized representative, agent, member or officer of the Buyer, that he/she has not, nor has any other member, employee, representative, agent or officer of the Buyer, directly or indirectly, to the best of the undersigned’s knowledge, entered into or offered to enter into any combination, collusion or agreement to receive or pay, and that he/she has not received or paid any sum of money or other consideration for the execution of this Property Purchase Agreement other than that which appears upon the face of this Agreement.
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In Witness Whereof, Buyer and the Seller have, through their duly authorized representatives, entered into this Property Purchase Agreement. The parties, having read and understood the foregoing terms, do by their respective signatures dated below hereby agree to the terms thereof. BUYER: ____________________________________ Signature
____________________________________
Printed Name
____________________________________
Title
BUYER SHALL TAKE TITLE OF THE PROPERTY AS FOLLOWS:
BUYERS PRIMARY ADDRESS:
_____________________________________________________________________________________
SELLER: State of Indiana acting through the Indiana Department of Administration. By For:
EXHIBIT B
QUITCLAIM DEED THIS INDENTURE WITNESSETH, that the STATE OF INDIANA, acting through the Governor of the
State of Indiana and the Commissioner of the Indiana Department of Administration, or their respective designees,
and by the authority of Indiana Code 4-20.5-7-11, RELEASES and QUITCLAIMS to:
for good, valuable, and sufficient consideration, receipt of which is hereby acknowledged, the real property located
in ______________County, Indiana and more fully described on Exhibit A, attached hereto and incorporated fully
herein.
Subject to all existing legal rights-of-way, easements, conditions, and restrictions of record.
IN WITNESS WHEREOF, the undersigned have executed the foregoing Quitclaim Deed on behalf of the State of
Indiana this ________ day of _____________ 2011.
____________________________________
David L. Pippen, Designee for
Mitchell E. Daniels, Jr. Governor
State of Indiana )
) ss:
County of Marion )
Before me, a Notary in and for said County and State, personally appeared David L. Pippen, designee of the
Governor of Indiana pursuant to IC 4-20.5-7-17 (b), and acknowledged execution of the foregoing Quitclaim Deed
this ________ day of ___________ 2011.
Notary signature: ___________________________________
Notary name printed: ________________________________
My commission expires: __________________ I reside in _______________ County
____________________________
Anthony Green, Designee for
Robert D. Wynkoop, Commissioner
Indiana Department of Administration
State of Indiana )
) ss:
County of Marion )
Before me, a Notary in and for said County and State, personally appeared Anthony Green, designee of the
Commissioner, Indiana Department of Administration, and acknowledged execution of the foregoing Quitclaim
Deed this ________ day of ___________ 2011.
Notary signature: ___________________________________
Notary name printed: ________________________________
My commission expires: __________________ I reside in _______________ County
Approved as to form and legality:
__________________________________ Date: ______________________
Gregory F. Zoeller, Attorney General
Send tax bills to: same address above
Filed in Indiana State Land Office:
This instrument prepared by Tim A. Grogg Esq. (Attorney No. 7316-03), Legal Counsel, Indiana Department of
Administration, 402 West Washington Street, W 479, Indianapolis, IN 46204. I affirm, under the penalties for
perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by
law. ____________________________________
LA Code 4289
Parcel(s) 89
INDOT-Environmental Services Division
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ENVIRONMENTAL ASSESSMENT FOR MAJOR STATE ACTIONS State Form 54278 (R / 2-11) IC 13-12-4-5; 326 IAC 16; 327 IAC 11; 329 IAC 5
INSTRUCTIONS:
1. The responsible official of a state agency may use this form to determine if a major state action will significantly affect the quality of the human environment as defined in 326 IAC 16, 327 IAC 11, and 329 IAC 5, and require preparation of an environmental impact statement as required by IC 13-12-4-5.
2. Print or type all information. Use additional sheets if necessary. 3. The responsible official should sign and date the form when completed. 4. This document is a public record subject to IC 5-14-3. Maintain this form in accordance with the agency’s document retention schedule.
I. DESCRIPTION OF THE ACTION
Name of Agency: Indiana Department of Transportation
Identification of Action: Sale of Excess Right of Way
Location of Action: This document is being prepared for the for the sale of one (1) excess parcel, LA Code 4289, Parcel 89 which is approximately 0.38 acre. Parcel 89 is located at the southwest corner of the intersection of SR 3 and Wallen Road in Allen County.
Predicted Start Date (month, day, year): June 19, 2017
Predicted End Date (month, day, year): June 20, 2018
Projected Final Cost: 0 (Fiscal Year 20 dollars)
Preparer: Toni Lynn Giffin, Environmental Manager, INDOT Environmental Services
II. BACKGROUND INFORMATION
1. Give a brief description of the proposed action(s) and describe how your agency is involved in the action. INDOT and IDOA recognize that state-owned excess right-of-way exists at various locations throughout the state. This land provides no function to the state highway system in terms of serviceability or maintenance, and prohibits development of the property for productive use for residential, commercial, agricultural, or other private or public use. Additionally, state-ownership of land may reduce the availability of real estate that is subject to property taxation; revenue which could benefit the community as a whole. Selling such excess parcels of land would benefit the above causes, as well as providing the potential for additional revenue to the state from the proceeds of the sale.
2. Describe the geographical area or areas which will be affected by the proposed action(s), including distinguishing natural and man-made characteristics and a brief description of the present use of the area(s). INFRASTRUCTURE: Potential buyers should be informed that two (2) trails, one (1) open and one (1) planned, are located adjacent to Parcel 89. WATER RESOURCES: Potential buyers should be informed the subject parcel is located within the Fort Wayne UAB. HAZMAT CONCERNS: Potential buyers should be informed of the five (5) USTs, the associated piping, dispensers, and approximately 1,790.98 tons of petroleum‐impacted soils were removed from the Parcel 89 in 2009 and 2010. Potential buyers should also be informed that corrective actions completed to date and the potential for impacts. The IDEM issued a NFA Approval Determination Pursuant to RISC letter, dated September 24, 2014, granting unconditional closure for soil, groundwater, and vapor intrusion exposure and requested the monitoring well network be abandoned. Three (3) monitoring wells (MW‐1 through MW‐3) were installed in 2009. Monitoring well MW‐3 was properly abandoned prior to road construction activities, and it appears as though monitoring wells MW‐1 and MW‐2 were destroyed during the road‐widening activities as well. The activities completed to date appear to have improved the overall condition of the site; however, the potential for residual low-level petroleum soil and groundwater impacts exists. Potential buyers should be informed of the corrective actions completed to date and the potential for impacts.
Exhibit C - Property Conditions
LA Code 4289
Parcel(s) 89
INDOT-Environmental Services Division
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CULTURAL RESOURCES: With regard to above‐ground resources, no buildings are located on Parcel 4289‐89. Nonetheless, the Indiana Register of Historic Sites and Structures (State Register) and National Register of Historic Places (National Register) lists for Allen County were checked by an INDOT‐ Cultural Resources Office (CRO) historian who meets the Secretary of the Interior’s Professional Qualification Standards per 36 CFR Part 61. No listed properties are recorded near this parcel. The Indiana Historic Sites and Structures Inventory (IHSSI) survey information for Washington Township, Allen County (2014) was referenced through the Indiana State Historic Architectural and Archaeological Research Database (SHAARD) and SHAARD GIS. Two properties are recorded within 0.125 mile of the parcel: 003‐214‐18052, Ranch House, 8943 Lima Rd., “contributing”; and Site No. 003‐286‐18072, L.C. Pratt Residence, 1615 W Wallen Rd., “notable.” Generally, properties rated "contributing" do not possess the level of historical or architectural significance necessary to be considered National Register eligible. If they retain material integrity, properties rated “notable” might possess the necessary level of significance after further research. However, Site No. 003‐286‐18072 is located in the southeast quadrant of the intersection of SR 3 and Wallen Rd. and the excess parcel is located in the southwest quadrant of the intersection. SR 3 is a 4‐lane divided highway that creates a large barrier between the IHSSI property and the excess parcel such that the sale of the excess parcel should not impact the IHSSI property. Views through online street‐level photography show that an electrical substation is located at the northeast quadrant of this intersection; modern commercial development is located in the southeast quadrant along with Site No. 003‐286‐18072; mid‐20th century commercial properties are in the northwest quadrant; and altered mid‐20th century residences are located in the southwest quadrant along with the excess parcel. INDOT‐CRO does not think that the sale of this parcel is an activity that will cause effects on any aboveground resources eligible for or listed in the National Register and no further work is recommended. With regard to archaeological resources, parcel 4289‐89 was included in the 2004 Phase Ia reconnaissance for the SR 3 Added Travel Lanes project completed by Landmark Archaeology (Carson 2004). The entire corridor was found to be disturbed by residential, commercial and utility impacts at that time. SHPO concurred with this assessment in a letter dated 4/30/2005. 2005 aerial imagery shows a gas station on the parcel which has since been removed. The construction of this gas station and associated underground tanks destroyed any potential for archaeological resources to exist within the parcel. Therefore, no further archaeological work is required prior to the sale of the parcel.
3. Briefly describe the need for the proposed action(s). This land provides no function to the state highway system in terms of serviceability or maintenance, and prohibits development of the property for productive use for residential, commercial, agricultural, or other private or public use. Additionally, state-ownership of land may reduce the availability of real estate that is subject to property taxation; revenue which could benefit the community as a whole.
4. Estimate the anticipated duration of the environmental effects of the proposed action(s).
Short term: Availability of land for development or reuse
Long term:
LA Code 4289
Parcel(s) 89
INDOT-Environmental Services Division
3
III. ASSESSMENT OF POTENTIAL ENVIRONMENTAL IMPACT
Answer the following questions by placing a check in the appropriate space. Consider both short and long term impact. Wherever “Yes” is checked, indicate the nature of the effect below the question. Short Term Long Term
1. Could the action(s) adversely affect the use of a recreational area or area of important aesthetic value?
YES
NO
YES
NO
2. Are any of the natural or manmade features which may be affected in the area(s) unique, that is, not found in another part of the state or nation?
YES
NO
YES
NO
3. Could the action(s) adversely affect an historical or archeological structure or site? See remarks section above in regards to above-ground and archaeological resources. YES
NO
YES
NO
4. Could the action(s) adversely affect fish, wildlife, or plant life? The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
5. Have any fish, mammals or plant species on the rare or endangered species list been sighted in the affected area(s)? YES
NO
YES
NO
Will those sighted be adversely affected?
YES
NO
YES
NO
6. Could the action(s) change existing features of any of the state’s fresh waters or wetlands? The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
7. Could the action(s) change existing features of a state beach? YES
NO
YES
NO
8. Could the action(s) result in the elimination of significant acreage of land presently utilized for agriculture or forestry purposes?
YES
NO
YES
NO
9. Will the action(s) require certification, authorization or issuance of a permit by any local, state or federal environmental control agency? YES
NO
YES
NO
LA Code 4289
Parcel(s) 89
INDOT-Environmental Services Division
4
III. ASSESSMENT OF POTENTIAL ENVIRONMENTAL IMPACT (continued)
Short Term Long Term
10.
Will the action(s) involve the application, use or disposal of potentially hazardous materials? The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
11.
Will the action(s) involve construction of facilities in a flood plain? The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
12.
Could the action(s) result in the generation of a significant level of noise? The direct action of the land sale could not, unforeseen future development could.
YES
NO
YES
NO
13.
Could the action(s) result in the generation of significant amounts of dust? The direct action of the land sale could not, unforeseen future development could.
YES
NO
YES
NO
14.
Could the action(s) result in a deleterious effect on the quality of the air? The direct action of the land sale could not, unforeseen future development could.
YES
NO
YES
NO
15.
Could the action(s) result in a deleterious effect on the quality or quantity of any portion of the state’s water resources? (If yes, indicate whether surface, ground water, or offshore.) The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
16.
Could the action(s) affect an area of important scenic value?
YES
NO
YES
NO
17.
Could the action(s) result in increased congestion and/or traffic in an already congested area or an area incapable of absorbing increase? The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
18.
Could the action(s) require a variance from or result in a violation of any statute, ordinance, by-law, regulation or standard, the major purpose of which is to prevent or minimize damage to the environment? The direct action of the land sale could not, unforeseen future development could
YES
NO
YES
NO
19.
Could the action(s) result in any form of adverse environmental impact not included in the above questions? (If yes, identify the impacted resource or area.) The direct action of the land sale could not, unforeseen future development could. YES
NO
YES
NO
LA Code 4289
Parcel(s) 89
INDOT-Environmental Services Division
5
IV. LIST OF AGENCIES AND PERSONS CONSULTED
Mitchel Zoll Indiana Department of Natural Resources Division of Historic Preservation and Archaeology
V. CONCLUSIONS
1. FINDING OF NO SIGNIFICANT IMPACT: I have determined that the proposed major state action will not significantly
affect the quality of the human environment. An environmental impact statement will not be prepared. 2. I have determined that the proposed major state action may significantly affect the quality of the human environment.
An environmental impact statement will be prepared by _________________________________. (approximate date)(month, day, year)
Signature of Responsible State Official:
____________________________________________________ _____________________ (date signed)(month, day, year)
Print Name: Ronald E. Bales
Title/Position: Enviromental Policy Manager
Branch/Division: Division of Environmental Services, Indiana Department of Transportation
Telephone number: (317) 234-4916
Address (number and street, city, state, and ZIP code):
Indiana Government Center North 100 North Senate Avenue, Room N642 Indianapolis, IN 46204
Table of Contents Page(s)
Appendix A: Cultural Resources (Section 106) A-1
Appendix B: Red Flag Investigation B-1 Appendix C: Parcel Documentation
Specific Parcel Information C-1
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Giffin, Toni
From: Miller, Shaun (INDOT)Sent: Thursday, April 16, 2015 10:36 AMTo: Giffin, ToniCc: Bales, Ronald; Kennedy, MarySubject: RE: 4289-89, SR 3, Allen County
With regard to archaeological resources, parcel 4289‐89 was included in the 2004 Phase Ia reconnaissance for the SR 3 Added Travel Lanes project completed by Landmark Archaeology (Carson 2004). The entire corridor was found to be disturbed by residential, commercial and utility impacts at that time. SHPO concurred with this assessment in a letter dated 4/30/2005. 2005 aerial imagery shows a gas station on the parcel which has since been removed. The construction of this gas station and associated underground tanks destroyed any potential for archaeological resources to exist within the parcel. Therefore, no further archaeological work is required prior to the sale of the parcel. Pertinent pages from the archaeology report can be found in PW here: 4289‐89_archaeology.pdf Shaun Miller Archaeological Team Lead INDOT, Cultural Resources Office [email protected] (317) 233‐6795
From: Kennedy, Mary Sent: Thursday, April 16, 2015 10:07 AM To: Bales, Ronald; Mathas, Marlene; Miller, Shaun (INDOT); Giffin, Toni Subject: RE: 4289-89, SR 3, Allen County With regard to above‐ground resources, no buildings are located on Parcel 4289‐89. Nonetheless, the Indiana Register of Historic Sites and Structures (State Register) and National Register of Historic Places (National Register) lists for Allen County were checked by an INDOT‐ Cultural Resources Office (CRO) historian who meets the Secretary of the Interior’s Professional Qualification Standards per 36 CFR Part 61. No listed properties are recorded near this parcel. The Indiana Historic Sites and Structures Inventory (IHSSI) survey information for Washington Township, Allen County (2014) was referenced through the Indiana State Historic Architectural and Archaeological Research Database (SHAARD) and SHAARD GIS. Two properties are recorded within 0.125 mile of the parcel: 003‐214‐18052, Ranch House, 8943 Lima Rd., “contributing”; and Site No. 003‐286‐18072, L.C. Pratt Residence, 1615 W Wallen Rd., “notable.” Generally, properties rated "contributing" do not possess the level of historical or architectural significance necessary to be considered National Register eligible. If they retain material integrity, properties rated “notable” might possess the necessary level of significance after further research. However, Site No. 003‐286‐18072 is located in the southeast quadrant of the intersection of SR 3 and Wallen Rd. and the excess parcel is located in the southwest quadrant of the intersection. SR 3 is a 4‐lane divided highway that creates a large barrier between the IHSSI property and the excess parcel such that the sale of the excess parcel should not impact the IHSSI property. Views through online street‐level photography show that an electrical substation is located at the northeast quadrant of this intersection; modern commercial development is located in the southeast quadrant along with Site No. 003‐286‐18072; mid‐20th century commercial properties are in the northwest quadrant; and altered mid‐20th century residences are located in the southwest quadrant along with the excess parcel. INDOT‐CRO does not think that the sale of this parcel is an activity that will cause effects on any above‐ground resources eligible for or listed in the National Register and no further work is recommended. Records check map: 4289‐89_above‐ground.pdf. Mary E. Kennedy Architectural Historian/History Team Lead Cultural Resources Office
2
Environmental Services 100 N. Senate Ave., Room N642 Indianapolis, IN 46201 Office: (317) 232‐5215 Email: [email protected]
From: Bales, Ronald Sent: Thursday, April 09, 2015 9:18 AM To: Mathas, Marlene; Kennedy, Mary; Miller, Shaun (INDOT); Giffin, Toni Subject: RE: 4289-89, SR 3, Allen County Marlene, Mary, Shaun, and Toni, Please consider this email your request to prepare the necessary documentation for the parcel indicated below. Toni will be the environmental document preparer for this parcel. However, please cc: me on correspondences. Thank you. Ron
From: Reller, John Sent: Wednesday, April 08, 2015 3:25 PM To: Bales, Ronald Cc: Crowe Jr., Brad A Subject: 4289-89, SR 3, Allen County Please see the link below for the new parcel. 4289‐89,SR 3, Allen Co This parcel is .379 acres John W. Reller Property Management Specialist, Real Estate Division 100 North Senate Ave, Room N642 Indianapolis, IN 46204 Office: (317)232‐5186 Email: [email protected]
003-286-18171003-286-18152QR3
QR3_D
W Wallen Rd
Gillmore Dr
Windsor Rd
Freehold Ln
003-286-18072
003-286-18246
003-214-18052
State of Indiana 2012
º
LA Code 4289-89SR 3, Allen County
0.065 0 0.0650.0325Miles
1:3,173Scale
Sources: Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
qp National Register propertiesIHSSI propertiesNational Register districts
State RoutesHighways
InterstatesState Routes
US RoutesLocal Road
Approx. 0.125 mile buffer
Approx. location ofParcel 89 Allen Ct
All houses c1985
www.in.gov/dot/ An Equal Opportunity Employer
INDIANA DEPARTMENT OF TRANSPORTATION Driving Indiana’s Economic Growth
100 North Senate Avenue Room N642 Indianapolis, Indiana 46204-2216 (317) 232-5348 FAX: (317) 233-4929
Eric Holcomb, Governor Joe McGuinness, Commissioner
Date: 13, 2017
To: Marie JettProperty Management SupervisorReal Estate DivisionIndiana Department of Transportation100 N Senate Avenue, Room N642Indianapolis, IN 46204
From: Nicole Fohey BretingHazMat Specialist, Environmental Policy OfficeEnvironmental Services Division100 N Senate Avenue, Room N642Indianapolis, IN [email protected]
Re: RED FLAG INVESTIGATIONLA 4289 Parcel 89Excess Parcel8841 Lima Road, Southwest Corner of SR 3 and Wallen RoadAllen County, Indiana
NARRATIVE
This RFI is being performed for the sale of one (1) excess parcel which is approximately 0.38 acre. Parcel 89 is located atthe southwest corner of the intersection of SR 3 and Wallen Road in Allen County. INDOT has decided that this surplusland will not be needed for right of way or other transportation purposes in the foreseeable future. A legal descriptionof the excess parcel is available in a separate document.
SUMMARY
InfrastructureIndicate the number of items of concern found within 0.5 mile and an explanation why each item withinthe 0.5 mile search radius will/will not impact the project. If there are no items, please indicate N/A:
Religious Facilities 3 Recreational Facilities 3
Airports 1 Pipelines N/A
Cemeteries N/A Railroads 1
Hospitals N/A Trails 3
Schools 1 Managed Lands N/A
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Explanation:
Religious Facilities: Although not mapped on the ArcGIS layer, three (3) religious facilities are located within the 0.5mile search radius. The nearest religious facility is located approximately 0.24 mile southwest of the subject parcel. Noimpact is expected.
Schools: Although not mapped on the ArcGIS layer, one (1) school is located within the 0.5 mile search radius. Theschool is located approximately 0.12 mile northwest of Parcel 89. No impact is expected.
Airports: One (1) public airport is mapped within 3.8 miles of the subject area. The airport, Smith Field Airport, islocated approximately 1.05 miles southeast of the subject parcel. No impact is expected.
Recreational Facilities: Three (3) recreational facilities are located within the 0.5 mile search radius. The nearestrecreational facility is located 0.17 mile northwest of the subject parcel. No impact is expected.
Railroads: One (1) railroad is located within the 0.5 mile search radius. The nearest railroad is located 0.44 mile west ofthe subject parcel and has been abandoned. No impact is expected.
Trails: Three (3) trails are located within the 0.5 mile search radius. Two of the trails, one open and one planned, arelocated adjacent to Parcel 89. The open trail, Ludwig Road to Dupont Road trail, runs north to south adjacent to thesubject parcel. The second adjacent trail, a planned trail called New York Central to Auburn Road, is proposed to runeast to west along Wallen Road. No impact is expected; however, potential buyers should be informed.
Water ResourcesIndicate the number of items of concern found within 0.5 mile and an explanation why each item withinthe 0.5 mile search radius will/will not impact the project. If there are no items, please indicate N/A:
NWI Points N/A NWI Wetlands 8
Karst Springs N/A IDEM 303d Listed Lakes N/A
Canal Structures – Historic N/A Lakes 1
NWI Lines N/A Floodplain DFIRM N/A
IDEM 303d Listed Rivers andStreams (Impaired)
N/A Cave Entrance Density N/A
Rivers and Streams 2 Sinkhole Areas N/A
Canal Routes Historic N/A Sinking Stream Basins N/A
Urbanized Area Boundary(UAB)
1 N/A
Explanation:
Rivers and Streams: Two (2) rivers and streams are located within the 0.5 mile search radius. The nearest river islocated 0.41 mi southwest of Parcel 89. No impact is expected.
Wetlands: Eight (8) wetlands are located within the 0.5 mile search radius. The nearest wetland is located 0.17 mileeast of the subject parcel. No impact is expected.
Lakes: One (1) lake is located within the 0.5 mile search radius. The nearest lake is located 0.17 mile east of the subjectparcel. No impact is expected.
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Urbanized Area Boundary (UAB): The subject parcel is mapped within the Fort Wayne UAB. No impact is expected;however, potential buyers should be informed.
The subject parcel is not located within the Karst Memorandum of Understanding (MOU) Potential Karst FeaturesRegion. No impact to karst features is expected.
Mining/Mineral ExplorationIndicate the number of items of concern found within 0.5 mile and an explanation why each item withinthe 0.5 mile search radius will/will not impact the project. If there are no items, please indicate N/A:
Petroleum Wells 1 Petroleum Fields N/A
Mines – Surface N/A Mines – Underground N/A
Explanation:
PetroleumWells: One (1) petroleum well is located within the 0.5 mile search radius. The nearest petroleum well islocated 0.44 mile southwest of the subject parcel and is presumed plugged. No impact is expected.
Hazardous Material ConcernsIndicate the number of items of concern found within 0.5 mile and an explanation why each item withinthe 0.5 mile search radius will/will not impact the project. If there are no items, please indicate N/A:
Brownfield Sites N/A Restricted Waste Sites N/A
Corrective Action Sites (RCRA) N/A Septage Waste Sites N/A
Confined Feeding Operations N/A Solid Waste Landfills N/A
Construction Demolition Waste N/A State Cleanup Sites N/A
RCRA Generators Tire Waste Sites N/A
Infectious/Medical Waste Sites N/A Waste Transfer Stations N/A
Lagoon/Surface Impoundments N/ARCRA Waste Treatment, Storage,
and Disposal Sites (TSDs)
Leaking Underground StorageTanks (LUSTs)
3Underground Storage Tanks
(USTs)2
Manufactured Gas Plant Sites N/A Voluntary Remediation Program N/A
NPDES Facilities N/A Superfund N/A
NPDES Pipe Locations N/A Institutional Control Sites N/A
Open Dump Sites N/A N/A
Explanation:
Leaking Underground Storage Tanks (LUSTs): Three (3) LUST are located within the 0.5 mile search radius andthe subject parcel is one of the mapped LUST sites (FID No. 3153). Based on a review of the Indiana Departmentof Environmental Management (IDEM) Virtual File Cabinet (VFC) five USTs, the associated piping, dispensers, and1,239.48 tons of petroleum impacted soils were removed from the site in June and July of 2009 in advance ofupcoming road widening activities. In addition, three monitoring wells (MW 1 through MW 3) were installed. Theeastern portion of the property was not included in the excavation activities performed in 2009 due to proximityto Lima Road; however, in 2010, an additional 551.50 tons of petroleum impacted soil was removed during the
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activities. Details of the excavation activities and confirmation sampling results weresummarized in a CAP Implementation Report (CAP IR), dated September 15, 2010. The CAP IR indicatedconcentrations of adsorbed BTEX, MTBE, and TPH GRO were below the applicable IDEM Risk Integrated System ofClosure (RISC) Residential Default Closure Levels (RDCLs). The IDEM issued a No Further Action (NFA) ApprovalDetermination Pursuant to Risk Integrated System of Closure letter, dated September 24, 2014, granting unconditionalclosure for soil, groundwater, and vapor intrusion exposure and requested the monitoring well network be abandoned.
A review of available documentation indicates monitoring well MW 3 was abandoned in 2010 due to its location withinthe proposed construction footprint. Monitoring wells MW 1 and MW 2 were reported as damaged, and likelydestroyed, during the construction activities. In order to determine the current condition of monitoring wells MW 1and MW 2, a site visit was completed on February 27, 2017. The wells were not identified during the site visit. Overall, atotal of 1,790.98 tons of petroleum impacted soil w removed from the site before and during road wideningactivities.
RCRA : One (1) is located within the 0.5 mile search radius. The nearest is located0.48 mile northwest of the subject parcel. No impact is expected.
Underground Storage Tanks (USTs): Two (2) USTs are located within the 0.5 mile search radius. The nearest UST islocated 0.40 mile southeast of the subject parcel. No impact is expected.
Ecological Information
The Allen County listing of the Indiana Natural Heritage Data Center information on endangered, threatened, or rare(ETR) species and high quality natural communities is attached with ETR species highlighted. Endangered, threatened,or rare species have not been observed within the 0.5 mile search radius. In addition, a review of the USFWS databasedid not indicate the presence of endangered bats in or within 0.5 mile of Parcel 89. No impact is expected.
Cultural Resources
Cultural Resources information will be submitted separately.
RECOMMENDATIONS
Include recommendations from each section. If there are no recommendations, please indicate N/A:
INFRASTRUCTURE: Two trails, one open and one planned, are located adjacent to Parcel 89. No impact is expected;however, potential buyers should be informed.
WATER RESOURCES: The subject parcel is located within the Fort Wayne UAB. No impact expected; however,potential buyers should be informed.
MINING/MINERAL EXPLORATION: N/A
HAZMAT CONCERNS: Five USTs, the associated piping, dispensers, and approximately 1,790.98 tons ofpetroleum impacted soils were removed from the Parcel 89 in 2009 and 2010.
Three monitoring wells (MW 1through MW 3) were installed in 2009. Monitoring well MW 3 was properly abandoned prior to road constructionactivities and it appears as though monitoring wells MW 1 and MW 2 were destroyed during the road
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activities as well.
ECOLOGICAL INFORMATION: N/A
CULTURAL RESOURCES: Cultural Resources information will be submitted separately.
INDOT Environmental Services concurrence: (Signature)
Graphics:
A map for each report section with a 0.5 mile search radius buffer around all project area(s) showing all items identifiedas possible items of concern is attached. If there is not a section map included, please change the YES to N/A:
GENERAL SITE MAP SHOWING PROJECT AREA: YES
INFRASTRUCTURE: YES
WATER RESOURCES: YES
MINING/MINERAL EXPLORATION: YES
HAZMAT CONCERNS: YES
UAB MAP: YES
Prepared by:Nicole Fohey BretingHazMat SpecialistEnvironmental Policy OfficeINDOT Environmental Services
Marlene MathasDigitally signed by Marlene Mathas DN: cn=Marlene Mathas, o=INDOT Environmental Services, ou=Hazardous Materials, [email protected], c=US Date: 2017.06.15 13:57:12 -04'00'
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º
Red Flag Investigation - Site LocationWallen Road and SR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
LA 4289 - 89
HUNTERTOWN QUADRANGLEINDIANA
7.5 MINUTE SERIES(TOPOGRAPHIC)This map is intended to serve as an aid in graphic
representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
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Red Flag Investigation - InfrastructureSR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
0.15 0 0.150.075Miles 0 Religious Facility
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Religious FacilityIndiana Map#I
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State of Indiana
º
Red Flag Investigation - Water ResourcesSR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
0.15 0 0.150.075Miles
County Boundary
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LA 4289 - 89
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State of Indiana
º
Red Flag Investigation - Mining and Mineral ResourcesSR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
0.15 0 0.150.075Miles
Interstate
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LA 4289 - 89
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WO
OD
BIN
E A
V
HA
RB
OR
PIN
ES
PR
ET
TY
RID
GE
CT
WY
CK
FO
RD
PL
S MAYFIELD
FOX ORCHARDFOXMOOR RUN
RO
SS
AV
STA
NLE
Y A
V
IND
IAN
A A
V
HAERTLAND DR
WOODLANDSPRINGS
HA
NA
UE
R R
D
TILL RD
PEPPERWOOD CT
WALLEN RD
WH
ITIE
R C
T
CA
LER
A D
R
COREE DR
FREEHOLD DR
NO
RTH
BURY D
R
HIC
KO
RY
GLE
N
FOXBORO DR
NORTHLAND BLVD
VILLA
GE
DR
AUGUST DR
HIC
KO
RY
KN
OLL
POLO RUN
CREMER AV
UPLAND RIDGE
RU
MM
EL
AV
ASHLEY AVE
MAYFIELD PL
WINDSOR RD
OAKBAY RUN
RABUS DR
LIMA VALLEY
BROADMOOR DR
GILMORE DR
EA
ST
ER
DA
Y R
DN
OR
FO
LK S
OU
TH
ER
N R
R
¬«3
State of Indiana
º
Red Flag Investigation - Hazardous Material ConcernsSR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography
Data - Obtained from the State of Indiana Geographical Information Office Library
Orthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org)
Map Projection: UTM Zone 16 N Map Datum: NAD83
0.15 0 0.150.075Miles
kj Brownfield
!& Confined Feeding Operation
XW Construction/Demolition Site
.- Leaking Underground Storage Tank
!@ Manufactured Gas Plant
!< Open Dump Waste Site
A@ NPDES Facilites
O NPDES Pipe Locations
A@ RCRA Corrective Action Sites
"E$ Infectious/Medical Waste Site
Interstate
State Route
US Route
Local Road
County Boundary
Half Mile Radius
Project Area
Institutional Controls
!. Septage Waste SiteMP Restricted Waste Site
![ Superfund
:9 Solid Waste Landfill
_̀ State Cleanup Site
!? Tire Waste Site
!A Waste Transfer Station
$# Underground Storage Tank
SR RCRA Generator/TSD
WV Voluntary Remediation Program
LA 4289 - 89
ALLEN
NORTHBURY
CT
SILV
ER
SP
RIN
GS
SH
AD
ELA
ND
CT
N LIM
A
CE
NT
ER
ST
ALLEN ST
FR
ON
T S
T
GROVE DR
MC
MA
N P
L
DA
RT
FO
RD
CT
PRAIRIE LN
STA
NLE
Y A
V
CA
LER
A C
T
BRITTANY PL
GROVER LN
WILLO
W H
ILL
HILL CT
HA
RB
OR
PIN
ES
PR
ET
TY
RID
GE
CT
WY
CK
FO
RD
PL
S MAYFIELD
FOX ORCHARDFOXMOOR RUN
RO
SS
AV
STA
NLE
Y A
V
IND
IAN
A A
V
HAERTLAND DR
WOODLANDSPRINGS
TILL RD
PEPPERWOOD CT
WALLEN RD
WH
ITIE
R C
T
CA
LER
A D
R
CO
OK
AV
COREE DR
FREEHOLD DR
NO
RTH
BURY D
R
HIC
KO
RY
GLE
N
FOXBORO DR
NORTHLAND BLVD
VILLA
GE
DR
EDGEWOOD DR
AUGUST DR
HIC
KO
RY
KN
OLL
DANNY DR
WO
OD
BIN
E A
V
POLO RUN
CREMER AV
HA
NA
UE
R R
D
UPLAND RIDGE
RU
MM
EL
AV
BILLEY DR
MAYFIELD PL
WINDSOR RD
OAKBAY RUN
RABUS DR
LIMA LN
LIMA VALLEY
ASHLEY AVE
BROADMOOR DR
GILMORE DR
KLUG DR
EA
ST
ER
DA
Y R
DN
OR
FO
LK S
OU
TH
ER
N R
R
¬«3Fort Wayne
State of Indiana
º
Red Flag Investigation - Urban Area BoundarySR 3, Excess Parcel
LA 4289 Parcel 89Allen County, Indiana
This map is intended to serve as an aid in graphic representation only. This information is not warranted for accuracy or other purposes.
Sources:Non Orthophotography Data - Obtained from the State of Indiana Geographical Information Office LibraryOrthophotography - Obtained from Indiana Map Framework Data(www.indianamap.org) Map Projection: UTM Zone 16 N Map Datum: NAD83
0.15 0 0.150.075Miles
County Boundary
<< Sinkhole Area
ÜÜSinking-Stream Basin
Wetlands
Lake - Impaired
Floodplain - DFIRM
WW Cave Entrance Density
Lake
Interstate
State Route
US Route
Local Road
Half Mile Radius
Project Area
River
Canal Route - Historic
\ NWI - Point
ò Karst Spring
0 Canal Structure - Historic
NWI- LineXWXW! ! Stream - Impaired
NPS NRI listed" "
LA 4289 - 89
11
EXHIBIT D
Hold Harmless Affidavit
STATE OF INDIANA )
)SS:
COUNTY OF ___________ )
AFFIDAVIT
Comes now the Affiant(s), _______________________________, and swear and
affirm to the following:.
1) That the above Affiant(s) shall hold harmless and indemnify the
State of Indiana and its agent Indiana Department of Transportation and
accept
the property transfer through Quit Claim Deed without any Warrants and
receive
property As-Is.
SUBSCRIBED AND SWORN TO THIS _______DAY OF ________________,
20___.
__________________________
Affiant’s printed name
___________________________
Affiant’s signature
State of Indiana )
) SS:
County of _________ )
Subscribed and sworn to before me a Notary Public this ______ day of _____________,
20___.
___________________________
Notary Public
A Resident of ________________ County Indiana
My Commission expires: ______________