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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: Clint Fletcher <br /> Permittee Company: Ouray Silver Mines Inc. <br /> Address: 1900 Main Street,Unit 564 <br /> Ouray, CO 81427 <br /> Phone Number: CF.PR.telephone_number <br /> Fax Number: <br /> Email Address: Cflletcher@ouraysilvermines.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 /> :4g <br /> S urve of Permittee Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 �' ' <br />