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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: Bradley S.Wilson <br /> Permittee Company: CEMEX, Inc. <br /> Address: P.O.Box 529 <br /> Lyons,CO 80540 <br /> Phone Number: (303)823-2100 <br /> Fax Number: (303)823-2199 <br /> Email Address: Bradleys.Wilson(d,)cemex.com <br /> I,the undersigned,hereby state that the info a on provided in this report is true and accurate, and that site operations are <br /> being conducted in accordance with the Di s' n approved mining and reclamation plans. <br /> -*>A- - 6'-.J <br /> Signat ermittee jonailrate Officer,Owner,or ented_a gee Date <br /> -AF-01 <br />