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2019-06-26_REVISION - M1979103
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2019-06-26_REVISION - M1979103
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Entry Properties
Last modified
12/18/2024 7:42:15 AM
Creation date
7/2/2019 1:15:43 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1979103
IBM Index Class Name
Revision
Doc Date
6/26/2019
Doc Name
Approval Document
From
DRMS
To
Fremont Paving & Redi Mix
Type & Sequence
SO5
Email Name
DMC
Media Type
D
Archive
No
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Affidavit of Authority to Execute Financial Warranty Documents <br /> Before me this day,the dersigned ��phy� `P-�yr-u [name of authorized <br /> person],in his/her capacity as r-p Si(iA ,r- Ititle of authorized person]("Affiant'), <br /> personally appeared and,being first duly sworn upon oath said: (� <br /> l. This affidavit is being executed and submitted on behalf of Firm ova-PA- t yul Mix [name <br /> of business organization],a(n) 0,0 y:,D f4 jj�, [legal form business organization, <br /> e.g.,corporation,partnership,limited taI bility company,etc.],in good standing in the State of Colorado(the <br /> "Company"). <br /> 2. It is in the interest of the Company to execute certain financial warranty documents associated with file <br /> number M [q 19- / 03 (DRMS file number),which are required by the Colorado Mined Land <br /> Reclamation Board and Division of Reclamation Mining and Safety pursuant to Colorado law("Financial <br /> Warranty Documents"). <br /> 3. Affiant is duly authorized to sign such Financial Warranty Documents on behalf of the Company and to <br /> bind the Company to the same. <br /> 4. Affiant is not prohibited or limited by the Company's governing documents or by any applicable law from <br /> executing the Financial Warranty Documents. <br /> 5. Affiant will inform the Division of Reclamation Mining and Safety within thirty(30)days in the event that <br /> his/her authorization to execute Financial Warranty Documents on the Company's behalf is terminated. <br /> Further,Affiant sayeth not. <br /> Af nt'sN me REC IVLD <br /> Signae JUN 2 6 2019 <br /> DIVISION OF RECLAMATION <br /> MINING AND SAFETY <br /> STATE OF <br /> ss.: <br /> COUNTY OF <br /> The foregoing instrument was acknowledged before me this 1-rday of Vll— l9 <br /> by��1 as 'P 'C.blr�_0A of—'�nt �>=A t In1k jr r 111 . <br /> Notary Publ <br /> JODI D SCHREIBER <br /> NOTARY PUBLIC My Commission Expires <br /> STATE OF COLORADO <br /> NOTARY ID 20064001792 <br /> MY COMMISSION EXPIRES OCTOBER 6,2022 <br />
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