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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: Glynda Yoder <br /> Permittee Company: Precious Offerings Mineral <br /> Exchange, Inc. <br /> Address: 200 Alder Ln <br /> Boulder,CO 80304 <br /> Phone Number: (303)544-1188 <br /> Fax Number: (303)442-3822 <br /> Email Address: <br /> 1,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 /> —A42ztA2 64:nw��� o. , l <br /> Signat e f Permittee Cor orate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />