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Document processing fee 20 15 1834 C-65 35 <br /> If document is filed on paper $150.00 $150,00 <br /> If document is filed electronically Currently Not Available SECRETARY OF STATE E <br /> Fees&forms/cover sheets are <br /> 12?"1/2015 09:19:16 <br /> subject to-change. i <br /> To file electronically,access instructions <br /> for this form/cover sheet and other <br /> F <br /> information or print copies of filed <br /> documents,visit www.sos.state.co.us <br /> and select Business. E <br /> Paper documents must be typewritten or machine printed. ABOVE SPACE FOR OMCE USE ONLY <br /> { <br /> Statement of Merger <br /> (Surviving Entity is a Foreign Entity) <br /> { <br /> filed pursuant to§7-90-203.7 and§7-90-204.5 of the Colorado Revised Statutes(C.R.S.) <br /> 1. For each merging entity,its ID number(if applicable),entity name or true name, form of entity,jurisdiction j <br /> under the law of which it is formed,and principal address are <br /> (Caution: At least one merging entity must be an entily formed under the laws of Colorado) � <br /> ID Number 19961127170 ' <br /> (Colorado Secretary ofState ID number) <br /> 3 <br /> Entity name or true name <br /> American Soda,L.L.P. <br /> Form of entity Limited liability partnership <br /> Jurisdiction Colorado <br /> Street address 2717 County Road 215 <br /> (Street number and name) <br /> 3 <br /> Parachute CO 81635 <br /> (City) (State) (ZIP/Postal Code) <br /> United States <br /> (Province-if applicable) (co-try) i <br /> Mai in address <br /> (leave blank if same as street address) (Street number and name or Post Office Box infornualon) <br /> (City) (Stale) (ZIP/Postal Code) <br /> (Province-!#applicable) (Country) <br /> ID Number <br /> (Colorado Secretary of State ID number) <br /> Entity name or true name <br /> Form of entity <br /> MERGE FGN Page I of Rev.5I29/2007 <br />