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2015-04-28_PERMIT FILE - M2015022
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2015-04-28_PERMIT FILE - M2015022
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Entry Properties
Last modified
8/24/2016 5:59:39 PM
Creation date
4/28/2015 3:27:47 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2015022
IBM Index Class Name
PERMIT FILE
Doc Date
4/28/2015
Doc Name
Construction Materials
From
Lazy H Inc
To
DRMS
Email Name
PSH
WHE
Media Type
D
Archive
No
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Affidavit of Authority to Execute Financial Warranty Documents <br />Before me this day, the undersigned 'j ;I I i a rr1 1400 J ( rlci Ch r [name of authorized <br />person], in his/her capacity as "J M4LnA r4 e CTQ c.-) n e ,^ [title authorized person] ( "Affiant' <br />personally appeared and, being first duly s bit upon oath said: <br />1. This affidavit is being executed and submitted on behalf of L CI -a:L, r n C'_ (name <br />of business organization], a(n) J ct) c -i-;o r"N [regal form of business organization, <br />e.g., corporation, partnership, limited liability company, etc.], in good standing in the State of Colorado (the <br />"Company "). <br />2. It is in the interest of the Company to execute certain financial warranty documents associated with file <br />number (DRMS file number), which are required by the Colorado Mined Land <br />Reclamation Board and Division of Reclamation Mining and Safety pursuant to Colorado law ( "Financial <br />Warranty Documents "). <br />3. Affiant is duly authorized to sign such Financial Warranty Documents on behalf of the Company and to <br />bind the Company to the same. <br />4. Affiant is not prohibited or limited by the Company's governing documents or by any applicable law from <br />executing the Financial Warranty Documents. <br />5. Affiant will inform the Division of Reclamation Mining and Safety within thirty (30) days in the event that <br />his/her authorization to execute Financial Warranty Documents on the Company's behalf is terminated. <br />Further, Affiant sayeth not. <br />i cJ 11 g u m 44-1,1 C n !, CR r <br />Affiant's Name <br />Signature <br />STATE OF Cl .L) z l (] YJ ) <br />& ) C)/,�/ ��`1 ) ss <br />COUNTY OF ( <br />��TaY�� <br />The foregoing instrument was acknowledged before me thisQ-L day of <br />by t,',Ikkan -, as of <br />Notary Public %— <br />My Commission Expires <br />Susan K Kitzman <br />Notary Public <br />State Of Colorado <br />NotarYN) 20044041221 <br />My M 61010 Beeem 24, 2016 <br />
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