Laserfiche WebLink
07-09-'21 08:39 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) U 1Ate) ale/Postal code) <br /> (Province-ifapplicable) .(Country) <br /> Mailin address <br /> (leave blank if same as street address) (Street nunrher and name or Post Office Box i+formadan) <br /> (City) (State) (VP/Postal Code) <br /> (Province-ifopplicable) (Comrny) <br /> 3. Each merging entity has been merged into the surviving entity. <br /> 4.(lfthe fol►orvheg statenrent app►tet,adopt the stutenwo 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.(Ifthefa/landng statement applies,adopt the valoment by marking the box and state the appropriate dotanttn!namba(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 /> (ifdte following statemenr applies,adopt the statement by orarking the box and inchtde are attachment) <br /> ❑ There are more than three trademarks and the document number of each additional trademark is <br /> stated in an attachment. <br /> 6. (7f opplicable,adopt thefollowing statement by marking the boor and fachide an attacha,enr.) <br /> ❑ This document contains additional information as provided by law. <br /> 7.(Catitiott: 4eave blatrk if the document does not have a delayed effective date. Stating a delayed effective date has significant <br /> legal consequences. Rend insowcaons before entering a date) <br /> (lf the folfowingslaterntnl applies,adopt the statuneol by entering a date and,if applicable,lime taing the required format.) <br /> The delayed effective date and,if applicable,time of this document are <br /> (mm/dd/yyyy how-:urinate an✓pat) <br /> MERGE-DOM Page 3 of 4 Rev.5/29/2007 <br />