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Agreement to Conduct Permitting by Electronic Means <br />5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br />(30) days in the event that his/her authorization to execute ePermitting Documents <br />on the Company's behalf is terminated. <br />Further, Affiant sayeth not. <br />Affiant's name <br />Signature <br />Notarized Affidavit of Signature <br />STATE OF: Col ot'Lc O <br />COUNTY OF: ) ss. <br />&dc� c� e. -r <br />The foregoing instrument was acknowledged <br />before me this -- day of (1�GL)r by <br />(date) (month) (year) <br />a5 <br />(Name of permittee representative) (title) <br />of 5 4 b I <br />(permittee) i <br />LORENA MEDINA <br />Notary Public - State of Colorado <br />Notary ID 20164032814 <br />My Commission Expires Sep 22, 2020 <br />q,.;. <br />0�,o - <br />N Y PU L[C <br />(seal) <br />My Commission expires: <br />Page 5 of 6 <br />