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Colorado Division of Reclamation, Mining and Safety <br />July 25, 2016 <br />Page 2 <br />IV. Notarized Statement <br />Pursuant to Rule 3.03.2(1)(e) each bond release application is required to provide a notarized <br />statement that the reclamation activities have been accomplished in accordance with the <br />requirements of the act and the approved reclamation plan. <br />I, Daniel J. Casiraro, Senior Manager Environmental Services, Tri-State Generation and <br />Transmission Association, Inc., hereby certify that the information contained within this <br />application is correct and true to the best of my knowledge. <br />Signed: <br />Name: Daniel J. Cas' <br />Title: Senior Manager Environmental Services <br />Tri-State Generation and Transmission Association, Inc. <br />State of Colorado <br />County of a fl A rrrN1'% <br />The foregoing instrument was acknowledged before me this Z� day of <br />20]1 by Daniel J. Casiraro, as the Senior Manager Environmental Services of Tri-State <br />Generation and Transmission Association, Inc., a Colorado cooperative corporation, on behalf of <br />the corporation. <br />DIANE K. 9YERS No Pub <br />NoarPPu p 20124057535 <br />Of A <br />My Commission Expires Sep 1.2020 <br />Print Nam <br />Witness my hand and official seal <br />My commission expires: <br />AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER <br />A Touchstone Energy' Cooperative( <br />