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2016-05-24_GENERAL DOCUMENTS - M2015028
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2016-05-24_GENERAL DOCUMENTS - M2015028
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Last modified
8/24/2016 6:22:29 PM
Creation date
6/3/2016 2:33:48 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M2015028
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
5/24/2016
Doc Name
Affidavit of Authority to Execute FW Documents
From
Teton Drilling
To
DRMS
Email Name
MAC
WHE
Media Type
D
Archive
No
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Affidavit of Authority to Execute Financial1Warranty Documents <br /> Before me this day,the dersigned ' k���G Y�Q-� [name of authorized <br /> person],in his/her capacity as ries 1 d [title of authorized person] ("Affiant"), <br /> personally appeared and,being first duly sworn upon oath said: � —�-� <br /> 1. This affidavit is being executed a submitted on behalf of --Fejt,\V\ l U t �Y�t, [name <br /> of business organization],a(n) L(7 f( D rC7 IA- [legal form of�ness organization, <br /> e.g.,corporation,partnership,limited liability company,etc.],in good standing in the State of Colorado(the <br /> "Company"). <br /> 2. It is in the interest of the Com any to execute certain financial warranty documents associated with file <br /> number 1M 1S–Oa?S (DRMS file number),which are required by the Colorado Mined Land <br /> Reclamation Board and Division of Reclamation Mining and Safety pursuant to Colorado law("Financial <br /> Warranty Documents"). <br /> 3. Affiant is duly authorized to sign such Financial Warranty Documents on behalf of the Company and to <br /> bind the Company to the same. <br /> 4. Affiant is not prohibited or limited by the Company's governing documents or by any applicable law from <br /> executing the Financial Warranty Documents. <br /> 5. Affiant will inform the Division of Reclamation Mining and Safety within thirty(30)days in the event that <br /> his/her authorization to execute Financial Warranty Documents on the Company's behalf is terminated. <br /> Further,Affiant sayeth not. <br /> _ RECEIVED <br /> AfIbnt' Nam <br /> JUN 0 2 2016 <br /> DIVISION OF RECLAMATION <br /> v / MINING AND SAFETY <br /> Signature <br /> STATE OF CitCre&a_40 <br /> ss. <br /> COUNTY OF `6roOY\e�d <br /> The <br /> -foregoin75-06i(1.2 <br /> nstrument was acknowledged before me this day of <br /> , <br /> by �1 V t Q✓1.2 j as ?(S i��l 'T of C � �►f� �.1�t <br /> Notary Public <br /> My Commission Expires Q <br /> DESIREE DAILEY <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20154007171 <br /> MY COMMISSION EXPIRES 02/19/2019 <br />
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