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CERTIFICATION <br />The undersigned. P6 :1tip (print name), `p-.- (print <br />title), City of Lafayette does hereby catify that, to the Wad aut oii cd by law, Lafayette will <br />indemnify Qweat for any costs inured resulting from damage to the above listed structure <br />located on or within 200 Poet of the proposed affected area described within Exhibit A, of the <br />Construction Materials Mining Permit Application, Goose Haven Reservoir #2 - Complex <br />B.rpaasioa resulting from the proposed mining or reclamation activities. <br />City of Lafayette: <br />Name Feurtk Pc.: J t. p s , o r <br />STATE of COLORADO) <br />Boulder County ) <br />The forexing was ad�wledged before me this b day ot` , 2011 by : ' o 1 <br />(Name) 'trunk. h %W.:We, _, as(Title) Clo. , of the City of Lafayette. <br />My corm iasion expires: t. (.tom mss. t . <br />Nay Trblk <br />ACCEPTED BY: (Print Name) /L6vL 486/74 Migie.e.e_. , for <br />Qweet <br />Signature l / . i a- Date: July // , 2011. <br />2 of 2 <br />