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AFFIDAVIT FOR IMPORT OF MATERIAL <br />INTO MID-CONTINENT QUARRY <br />Material: <br />Date or Time Period of Import: <br />Description of Import Material: <br />Entity Providing Material to Pit (not the trucking Company): <br />I hereby certify that the material described above and brought to the Mid-Contient Quarry is inert, <br />which means it is free from any chemicals, toxic substances, acid forming material, or any other <br />material which would violate the material waste disposal laws of the State of Colorado. <br />Signature <br />Written Name of Signer <br />Signer's Position in Company Company <br />Date: <br />CaIX Acceptance of Import <br />Signature <br />Written Name of Signer <br />Ca1X Minerals, LLC (720)881-7987 (Phone) 2080 W. Hamilton PI <br />www.calxminerals.com (303)761-4778 (FAX) Sheridan, CO 80110 <br />