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20]30]833 <br /> Notice: <br /> Causing this document to be delivered to the Secretary of State for tiling shall constitute the affirmation or <br /> acknowledgment of each individual causing such delivery,under penalties of perjury, that such document is <br /> such individual's act and deed, or that such individual in good faith believes such document is the act and deed <br /> of the person on whose behalf such individual is causing such document to be delivered for filing, taken in <br /> conformity with the requirements of part 3 of article 90 of title 7,C.R.S. and, if applicable,the constituent <br /> documents and the organic statutes, and that such individual in good faith believes the facts stated in such <br /> document are true and such document complies with the requirements of that Part,the constituent documents, <br /> and the organic statutes. <br /> This perjury notice applies to each individual who causes this document to be delivered to the Secretary of <br /> State,whether or not such individual is identified in this document as one who has caused it to be delivered. <br /> 6. The true name and mailing address of the individual causing this document to be delivered for filing are <br /> Wallen Kip Michael <br /> (Lust) 1b,rst) (Middle) (Saba) <br /> 1900 Wazee Street Suite 300 <br /> (Street number and name or Post Oise But information) <br /> Denver CO 80202 <br /> Ka t) pare) (ZIP/Postal Code) <br /> United States <br /> (Province—rfappluuht) tConntnf <br /> (II-applicable,adopt the following statement by marking the bon and include an attachment) <br /> This document contains the true name and mailing address of one or more additional individuals <br /> causing the document to be delivered for filing. <br /> Disclaimer: <br /> This form/cover sheet,and any related instructions.are not intended to provide legal,business or tax advice, <br /> and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy <br /> minimum legal requirements as of its revision date, compliance with applicable law, as the same may be <br /> amended from time to time, remains the responsibility of the user of this forin/cover sheet. Questions should <br /> be addressed to the user's legal, business or tax advisor(s). <br /> COMB CONY LLC Page 2 of 2 Rev 12/012012 <br />