C150186 Feasibility Study

• Contract/PO #: C150186
• Contractor Name: Lower Bauer West Lateral, Inc.
• Contract Type: Loan
• Water District: 34
• County: Montezuma
• Loan Projects - Doc Type: Feasibility Study

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(City)

(State) (Poiilalllip Code)

(province - if applicable)

(Country - if not US)

(If more than three incorporators. mark this box 0 and include a/I auachment stating the names and addresses of all
incorporators.)

12. The nonprofit corporation is formed under the Colorado Revised Nonprofit Corporation Act.

13. The corporation will 0 OR will not 0 have voting members.

14. A description of the distribution of assets upon dissolution is attached.

15. Additional information may be included pursuant to S7-l22-l02, C.R.S. and other organic statutes. If
applicable, mark this box 0 and include an attachment stating the additional information.

Notice:

Causing this document to be delivered to the secretary of state for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of petjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the
person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity
with the requirements of part 3 of article 90 oftitIe 7, C.R.S., the constituent documents, and the organic
statutes, and that the individual in good faith believes the facts stated in the document are true and the
docwnent complies with the requirements of that Part, the constituent documents, and the organic statutes.

This petjury notice applies to each individual who causes this document to be delivered to the secretary of
state, whether or not such individual is named in the document as one who has caused it to be delivered.

16. Namc(s) andaddress(es) of the
individual(s) causing the document
to be delivered for filing:

Keith
6875 CR~)

Raymond
(First)

E

(Middle)

(SujJU)

(Street name and number or Post Office Box information)

Mancos

co

81328

(City)

(State)

(postal/Zip Code)

(prOVince - if applicable)

(Country - if not US)

(The document need not state the true name and address of more than one individual. However. if you wish to state the name and address
of any additional individuals causing the document to be delivered for filing. mark this box Dand include an attachme/lt stating the name
and address of such individuals.)

Disclaimer:

This form, and any related instructions, are not intended to provide legal, business or tax advice, and are
offered as a public service without representation or warranty. While this form is believed to satisfy minimwn
legal requirements as of its revision date, compliance with applicable law, as the same may be amended from
time to time, remains the responsibility of the user of this form. Questions should be addressed to the user's
attorney.

Rev. 7/13/2004
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