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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 print <br />current contact information: <br />Permittee Contact: <br />Andre Laroche <br />Permittee Company: <br />Continental Materials <br />Corporation <br />Address: <br />444 E. Costilla St. <br />Colorado Springs, CO 80903 <br />Phone Number: <br />(719) 475-0700 <br />(719) 491-0288 cell <br />Fax Number: <br />(719) 475-0226 <br />Email Address: <br />andre_laroche@transitmix.com <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 />Sign f of Permittee, Corporate Officer, Ow(r, or Documented Designee Date <br />11-12-2015 <br />M -AF <br />