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07-09-'21 08:39 FROM- T-380 P0005/0006 F-200 <br /> Notice: <br /> Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or <br /> acknowledgment of each individual causing such delivery,under penalties of perjury,that such document is <br /> such individuaft act and deed,or that such individual ifl good faith believes such document is the art and deed <br /> of the person on whose behalf such individual is causing such document to be delivered for filing,taken in <br /> conformity with the requirements of part 3 of article 90 of title 7,C.R.S.and,if applicable,the constituent <br /> documents and the organic statutes,and that such individual in good faith believes the facts stated in such <br /> _..document are true and such document complies with the requirements of that Part,the constituent documents, <br /> and the organic statutes. <br /> This perjury notice applies to each individual who causes this document to be delivered to the Secretary of <br /> State,whether or not such individual is identified in this document as one who has caused it to be delivered. <br /> 8. The true name and mailing address of the individual causing this document to be delivered for filing are <br /> Latini Melissa <br /> (Last) (Fiat) (Allddle) 01014 <br /> 1401 Lawrence Street, Suite 2300 <br /> (Street number and tame or Pow 0Jflce Dox h jorntarion) <br /> Denver CO 80202 <br /> (city) USA($ate) (LIP/PortaI Code) <br /> (Avvinee—if applicable) (Country) <br /> (If applicable,adopt the following Staremeni by marking the box and include an attachment.) <br /> This document contains the true name and mailing address of one or more additional individuals <br /> causing the document to be delivered for filing. <br /> Disclaimer: <br /> This form/cover sheet,and any related instructions,are not intended to provide legal,business or talc advice, <br /> and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy <br /> minimum legal requirements as of its revision date,compliance with applicable law,as the same may be <br /> amended from time to time,remains the responsibility of the user of this form/cover sheet. Questions should <br /> be addressed to the user's legal,business or tax advisor(s). <br /> MERGE DOM page 4 of 4 Rev.$129/2007 <br />