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Sec. IS.Effective dale- Ihis contract becomes efrective as indicated below. <br /> ❑� if this contract becomes effective on the date BLNI signs the contract,BLNI will check this box. <br /> ❑ If this contract becomes effective only after certain conditions are met.BLNI will check this box,list the conditions below,and Indicate the <br /> effective date. <br /> SeC. 19.appeal-You may appeal any decision that BLM makes in regard to this contract under Pans 4 and 1940 of Title 43 of the Codc of Federal <br /> Regulations. <br /> The following parties have executed this contract as of <br /> PURCHASER THE UNITED STATES OF AMERICA <br /> Gunnison Aggregate Resources,LLC <br /> By David Lazorchak <br /> (Individual or Firm Name) (Print Name of BLM Official) <br /> P.O.Sox 42,Gunnison CO 81230 <br /> DAVID LAZORCHAK - ---------^- <br /> (Address) (Signature of BLM Official) <br /> (970)209A442 Geologist <br /> (Phone Number—include area code) (Title) <br /> 9123/2015 <br /> (Signature) (Date) <br /> (Signature) <br /> If you an a corporation,affix corporate seal here: <br /> Tide 19 U_S.C.1001,makes it a crime for any person kingly or willfully to make to any departrnent or agency of the United States any false,fictitious or lhauk lent <br /> Moments or repwseaations as to any matter Within its jarisdiction,subject to a fine of up to$10,000 and impliawancri up to 3 years. <br /> NOTICES <br /> The Privacy Act of 1974 and the regulation in 43 CFR 2.48(d)provide that you be furnished the following information in connection with information <br /> required by this application. <br /> AUTIIORITY:30 U.S.C.601 ct seq.:43 CFR Group 3600 <br /> PRINCIPAL PURPOSE:BLM uses this information to identify the parties entering into contracts for disposing of mineral materiais. <br /> ROUTINE USES:BLM will transfer information from the record or the record itself to appropriate Federal,State,local,or foreign agencies,when <br /> relevant to criminal,civil,or regulatory investigations or prosecutions. <br /> EFFECT OF NOT PROVIDING INFORMATION:If you do not provide this information to BLM,we will not be able to process your application for <br /> a contract. <br /> The Paperwork Redaction Act requires us to inform you that: <br /> The BLM is collecting this information to process your application and effect a binding contract. <br /> The BLM will use this information to identify and communicate with applicants. <br /> You must respond to this request to get a benefit. <br /> You do not have to respond to this or any other Federal agency-sponsored information collection unless it displays a valid OMB control number. <br /> BURDEN I IOURS STATEMENT: Public reporting burden for this forth is estimated to average about I hour per response,including the time for <br /> reviewing instructions,gathering and maintaining data,and completing and reviewing the form.You may submit comments regarding the burden estimate <br /> or any other aspect of this form to: U.S.Department of the Interior.Bureau of Land Management(1004-0103).Bureau Information Collection Clearance <br /> Officer(WO.630),1949 C Street,N.W.,Room 2134LM,Washington,D.C.20240. <br /> (Form 3600-9,page 3) <br />