2021-08-23_REVISION - M1976007UG

• Permit No: M1976007UG
• IBM Index Class Name: Revision
• Doc Date: 8/23/2021
• Doc Name: Completeness Response
• From: Denver Brick Co.
• To: DRMS
• Type & Sequence: CN1
• Email Name: ECS
• Media Type: D
• Archive: No

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{
Jurisdiction
i
Suva address is
(Sheet m ntber and name)
(city) (State) rMP/Postal Code)
t
(Province-t(applicable) (Coovttry)
Mailing address
(leave blank if same as street address) (Street nranber and name or Past Ojflee Box information) 1
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(City) (State) (ZIPIPostal Code) j
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(Province-if applicable) (Cowtby) �I
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f
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ID Number
(Colorado Secretary of State ID manber)
{
Entity name or true name
i
Form of entity ;•.
Jurisdiction I
Street address
(Street nwnber and name)
{
(City) (State) (ZIP/Parral Code)
(Province-Japplicable) (country)
Mailin address I
(leave blank if same as street address) (Street ntonber and nme or Post QQ9ce Box information) i
(City) (State) (ZIP/Postal Code)
(Province-if applicable) (Country')
(If the following statemrnt applies,adapt the statement by marking the bat and Include an attachment.)
❑ There are more than three merging entities and the ID number(if applicable),entity name or true
name,form of entity,jurisdiction under the law of which it is formed,and the principal address of
each additional merging entity is stated in an attachment.
2. For the.surviving entity which.is a foreign entity,its entity ID number(if applicable),entity name or true
name,form of entity,jurisdiction under the law of.which it is formed,and principal address are
(Capdon: The surviving entity r be an entityformed,under the laws of Colorado.)
ID Number 2007,1593249
(Colorado Secretary of State ID mmnber)
AMERGE FGN Page 2 of Rev.M92007