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07-09-121 08:39 FROG}-- T-380 P0004/0006 F-200 <br /> Form of entity Corporation <br /> Jurisdiction Colorado <br /> Street address 2273 River Road <br /> (Street numberand name) <br /> Grand Junction 00 81515 <br /> (017) US(st" (MIP-01Code) <br /> (Province—ijapplieable) (Counery) <br /> Mailing address <br /> (leave blank if same at street address) (Srrret number and name or Past Office Box h)farmaftarr) <br /> (City) (Swig) (7JPIPastar code) <br /> (Province-(foppliaabb) (Country) <br /> 3. ]Each merging entity has been merged into the surviving entity. <br /> 4.(lfthejollowfnQ statenrem apphar.adopt the statement by naarkiag the baxj <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 tho <br /> Secretary of State for filing pursuant to Part 3 of Article 90 of Title 7,C.R.S. <br /> 5.fif rhejollar,inr srarearent appiiet.adapt the starament by marking the tar and stare the appropriate doci oreni monba fs)j <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 fled document is <br /> Document number <br /> Document number <br /> Document number <br /> (if thiefollowingstaftnimf applies,adopt lheataremmi by matting die bax and ineludrOro auaehntens) <br /> ❑There are more than three trademarks and the document number of each additional trademark is <br /> stated in an attachment. <br /> b. (ljapplteable.adopt thejollosving statement by morkhi$rAe bur and hrdhrde at artachment.) <br /> ❑This document contains additional information as provided by law. <br /> 7.(Catidan: leave Mai if the document does not have a delayed effective daie. Slaib)g a delayed effective date h t signlFeant <br /> legal consequences. Read insir uciiorrs before uttering a date) <br /> (ljrhejollowhtg statement apprks,adopt tlu statuotrd by entering a date and,(fapplicable;finta ruing the roquirad jomor.) <br /> The delayed effective date and,if applicable,time of this document are <br /> (amt/dd/yyyy horn minute oxvpad <br /> MERGt:_OOM P&gd 3 of Rev 529R007 <br />