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07-09-'21 03:39 FROM- T-380 P0004/0006 F-200 <br /> Form of entity Corporation <br /> Jurisdiction Colorado <br /> Street address 2273 River Road <br /> (Street number and name) <br /> Grand Junction co 81515 <br /> (City) USAIeJ (ZIP/Postal Coda) <br /> (Province-japplicable) (Caoury) <br /> Mailine address <br /> (leave blank if same as street address) (Street number and name or Post Office Box itformadan) <br /> (City) (State) (ZIP/Postal Code) <br /> (Province-ifapplicable) (Cotitrtty) <br /> 3. Each merging entity has been merged into the surviving entity. <br /> 4.(lfthe folowing statement applies,adopt the statement by marking the box.) <br /> ❑ The plan of merger provides for amendments to a constituent filed document of the surviving entity and <br /> an appropriate statement of change or other document effecting the amendments will be delivered to the <br /> Secretary of State for filing pursuant to Part 3 of Article 90 of Title 7,C.R.S. <br /> 5.(lfthefalianing starentant applies,adopt the statament by marking the box and state the appropriate dacnn+eal number(s).) <br /> ❑ One or more of the merging entities is a registrant of a trademark described in a filed document in the <br /> records of the secretary of state and the document number of each filed document is <br /> Document number <br /> Document number <br /> Document number <br /> (lfthe following statemenr applies,adopt the statement by marking the box and inchide an attachment.) <br /> There are more than three trademarks and the document number of each additional trademark is <br /> stated in an attachment. <br /> 6. (lf applicable,adopt thefollowing statenrew by marking the box and Include an attachnsew) <br /> ❑ This document contains additional information as provided by law. <br /> 7.(Cashion: Ieave blank if the document does not have a delayed effective date. Stating a delayed effective date has signifeant <br /> legal consequences. Read insbuctions before entering a date.) <br /> (fdre following statement applies,adopt the statement by entering a date and,if applicable,lime using the raquired formal.) <br /> The delayed effective date and,if applicable,time of this document are <br /> (nmrlddlyyyy hour:minute anelpm) <br /> MERGE_DOM Pagc 3 of 4 Rev.512912007 <br />