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Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: Martin R. Bauer <br />Permittee Company: JUBILEE VENTURE LLC <br />U& 1_E 67.(JeF&R 1 6_1 /AJ C <br />Address: 19754 E Euclid Dr <br />Centennial, CO 80016 <br />Phone Number: 303) 617-1813 720 —245q Ak- S <br />Fax Number: 303) 693-0601 <br />Email Address: ri /`. nA-g-r <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conducted in accordance with the Division approved mining and reclamation plans. <br />Signature <br />M -AF -02 <br />AYZ 0-6-0 <br />Officer, Owner, or Documented Designee Date <br />a