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Form 3504-3
<br />(May 2014) UNITED STATES
<br />DEPARTMENT OF THE INTERIOR
<br />BUREAU OF LAND MANAGEMENT
<br />BOND' UNDER LEASE FOR
<br />MINING DEPOSITS
<br />
<br />FORM APPROVED
<br />OMB NO. 1004-41121
<br />Expires: March 31, 2f1�fi
<br />Serial Number
<br />COC76319
<br />Bond Number
<br />1098852
<br />-0
<br />e-
<br />KNowALL MEN BYTHESE PRESENTS, That Oxbow Mining Oak Mesa LLC v ;
<br />of 1601 Forum Place, Suite 1400, West Palm Beach, FL 33401,1L�! ` ;�as principal,
<br />A t~
<br />and Lexon Insurance Company
<br />1
<br />of 10002 Shelbyville Road, Suite 100, Louisville, KY 40223 11 as surety,4
<br />are held and firmly bound unto the United States in the sum of Eighteen Thousand and 00/100 ---------------------------------
<br />---------- ------------------------- --- dollars
<br />($ 18,000.00 1, lawful money of the United States, for the payment of which, well and truly to be made, we bind
<br />ourselves, and each of us, and each of our heirs, executors, administrators, and successors, jointly and severally,
<br />firmly by these presents
<br />The conditions of this obligation are such, that whereas the saidE principal entered into a lease of the lands described
<br />therein and upon conditions therein expressed, which lease bears the above serial number.
<br />Now, THEREFORE, if the said principal, his heirs, executors, administrators, or
<br />out the obligations and observe the requirements of said lease, and will duly keep,
<br />every term and provision of said lease as therein stipulated and agreed, then this
<br />otherwise to remain in full force and effect.
<br />Signed on this 25th day of August ,'2014 , in the presence of.-
<br />Oxb
<br />Mining Oak es
<br />iPMted Name of
<br />successors, will faithfully carry
<br />perform, and abide by each and
<br />obligation will be null and void;
<br />LLC
<br />Benjamin L. Klein,Treasurer
<br />(Printed Name of Signer)
<br />1b01 Forum Place, Ste 1400, W. Palm Beach FL 1601 Forum Place, Ste 1+00, W. Palm Beach FL 334
<br />(Address of Witness} 3401 (Address of Principal)
<br />Lexon Insurance Company
<br />Rachel Pankh Koestel, Attorney -in -Fact
<br />�j
<br />(Signature of Witness) (Printed Name of Witness) (Signature of Surety) (Printed Name of Si3ner)
<br />2307 River Road S.tiite 200 Louisville KY 40206 10002 Shelbyville Road Suite 100 Louisville KY 40223
<br />(Address of Witness)
<br />(Address of Surety)
<br />of Wi(ness)
<br />(Printed Name of Witness)
<br />(Signa(ure of Surety) (Printed Name of Signer)
<br />(Address of Witness) (Address of Surety)
<br />Title 18 U.S.C. Section 1001 and Title 43 U.S.C. Section 1212, make it a crime for any person knowingly and willfully to snake to any department or agency of the
<br />United states any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction
<br />*This form of bond may be used in connection with coal, phosphate, and sodium leases, Act of February 25, 1920, as amended (30 U.S.C. 181 et seq.); potassium
<br />leases, Act of February 7, 1927, as amended (30 U.S.C. 281 et seq.); sulphur leases, Act of April 17, 1926, as amended (30 U.S.C. 271 et seq.); all such leases
<br />involving acquired lands, Act of August 7, 1947 (30 U.S.C. 351), and asphalt leases, Act of June 28, 1944 (58 Stat. 463, 483-485), by inserting the particular mineral
<br />applicable in the space provided therefore. If this bond is executed by a corporation, it must bear the corporate seal.
<br />(Continued on page 2)
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