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Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to <br /> opt in to ePermit: GERALD J. DAUB <br /> Title: PRESIDENT, DAUB & ASSOCIATES, INC. <br /> Name of permittee: <br /> SIMPLE OIL LLC <br /> Signature: <br /> ePermitting Administrator(if different from <br /> representative signing agreement) <br /> Email Address for ePermit Account: gjdaub@daubandassociates.com <br /> Notarized Affidavit of Signature <br /> STATE OF: I ) <br /> Cv�csr-ad o <br /> COUNTY OF: ) ss. <br /> 01� <br /> The foregoing instrument was acknowledged <br /> before me this �y day of �Q by <br /> (date) ( onth) (year) <br /> as <br /> GERALD J. DAUB PRESIDENT, DAUB & ASSOCIATES, INC. <br /> (Name of permittee representative) (title) <br /> of <br /> SIMPLE OIL LLC <br /> (permittee) <br /> ��-WL�A <br /> NOTARY PUBLIC <br /> DANIELLE LYNN DE WITT <br /> (seal) NOTARY PUBLIC <br /> STATE OF COLORADO <br /> My Commission expires: NOTARY ID#20084042294 <br /> raw U0 1-7 My Commiuion Expire'January 9,2017 <br /> Page 3 of 6 <br />