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New Horizon Mine <br />IV. Notarized Statement <br />Pursuant to Rule 3.03.2(1)(e) each bond release application is required to provide a notarized <br />statement that the reclamation activities have been accomplished in accordance with the <br />requirements of the act and the approved reclamation plan. <br />I, Daniel J. Casiraro, Senior Manager, Environmental Services, Tri-State Generation and <br />Transmission Association, Inc., hereby certify that the information contained within this <br />application is correct and true to the best of my knowledge. <br />Signed: �) a-,-�Z / <br />Name: Daniel J. Casir o <br />Title: Senior Manager Environmental Services <br />Tri-State Generation and Transmission Association, Inc. <br />State of Colorado <br />County of A ck+Zi M S <br />The foregoing instrument was acknowledged before me this ]5}t1 day of dkLw, <br />2016' by Daniel J. Casiraro, as the Senior Manager Environmental Service of Tri-State <br />Generation and Transmission Association, Inc., a Colorado cooperative corporation, on behalf of <br />the corporation. <br />C�� <br />NoNo ryPublic <br />l ' <br />Print Name: 34 +, 1 f e -/ y0 q, <br />Witness my hand and official seal <br />My commission expires: 1ANICE NORGREN <br />40TARY PUBLIC STATE Of COLORADO <br />Notary Identification #20034007464 <br />3 — 8 M Commission Expires 31BJ2019 <br />SL -15 Phase II Bond Release Application Page 7 <br />