2015-04-24_GENERAL DOCUMENTS - M1978221

• Permit No: M1978221
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 4/24/2015
• Doc Name: Officer Affidavit of Authority
• From: Scott Stewart
• To: DRMS
• Email Name: THM
• Email Name: GRM
• Media Type: D
• Archive: No

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Affidavit of Authority to Execute Financial Warranty Documents
Before me this day, the undersigned Se a C-1 7 145WA'4'T [name of authorized
person], in his/her capacity as PR>Sed EAJTT [title of authorized person] ( "Affiant "),
personally appeared and, being first duly swom upon oath said:
1. This affidavit is being executed and submitted on behalf of #17 Enterprises, LLC [name
of business organization], a(n) LLC [legal form of business organization,
e.g., corporation, partnership, limited liability company, etc.], in good standing in the State of Colorado (the
"Company")-
2. It is in the interest of the Company to execute certain financial warranty documents associated with file
number M -1978 -221 (DRMS file number), which are required by the Colorado Mined Land
Reclamation Board and Division of Reclamation Mining and Safety pursuant to Colorado law ( "Financial
Warranty Documents ").
3. Affiant is duly authorized to sign such Financial Warranty Documents on behalf of the Company and to
bind the Company to the same.
4. Affiant is not prohibited or limited by the Company's governing documents or by any applicable law from
executing the Financial Warranty Documents.
5. Affiant will inform the Division of Reclamation Mining and Safety within thirty (30) days in the event that
his/her authorization to execute Financial Warranty Documents on the Company's behalf is terminated.
Further, Affiant sayeth not.
STATE OF eD 10
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COUNTY OF _ )
The foref ^*nom i stru`m1enntt wLas�acknow ed before me this 10
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day o
as
of
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JOREE POLZINE
NOTARY PUBLIC
STATE OF COLORADO
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My Con
NOTARY ID #20064002052
MY Commission Expires April 6, 2018
RECEIVED
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APR 14 2015
Division of Reclamation,
Mining & Safety
RECEIVED
APR 24 ZCi4r°
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