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DEVELOPERS OF AGRICULTURE
Certificate of Conveyances
Weld County Use by Special Review Application
Prepared for
Box M Ranch, LLC
CERTIFICATE OF CONVEYANCES
STATE OF COLORADO
COUNTY OF WELD
WELD COUNTY
DEPARTMENT OF PLANNING SERVICES
Land Title Order No.: Box M
The Land Title Guarantee Company TITLE INSURANCE or ABSTRACT COMPANY hereby
certifies that it has made a careful search of its records, and finds the following conveyances
affecting the real estate described herein since August 30, 1972, and the most recent deed recorded
prior to August 30, 1972.
Legal Description: Lot B of Recorded Exemption No. 1053-28-4-RE1462, recorded January 20,
1993 at Reception No. 2318744, being in the South Half of Section 28, Township 4 North, Range
64 West of the 6th P.M., County of Weld, State of Colorado.
CONVEYANCES (if none appear, so state):
Reception No. 1373307
Reception No. 1461253
Reception No. 2318744
Reception No. 3675334
Reception No. 3675576
This Certificate is made for the use and benefit of the Department of Planning Services of Weld
County, Colorado.
This Certificate is not to be construed as an Abstract of Title, nor an opinion of Title, nor a
guarantee Title, and the liability of Land Title Guarantee COMPANY, is hereby limited to the fee
paid for this Certificate.
It Witness Whereof, Land Title Guarantee COMPANY, has caused this certificate to be signed by
its proper officer this 30th day of August, 2018 at 5:00 o'clock P.M.
LAND TITLE GUARANTEE COMPANY
Heidi Crue, Title Examiner
By:
$r?ili( 6f'e.� N e Rocorded JAP) 7 9 1gfi2� of } '�. m.V ?li i�/aic7VReceprban Na I �i�f 3307. — sPgRtR Rwarder,
Made tries 27th day of January la the
year of our Lord one thousand nine hundred and Sixty—two between
ALBERT HOLMAN and ELIZABETH HOLMAN
of the
first part, and
of the
County of Weld
and State of Caloted% of the
LESLIE W. THOMPSON and MYRTLE A. THOMPSON
Candy of Weld and State of Colorado, of the
second Wart:
WDINZSSETH: That the said part ie a of the first port, for and in consideration of the sum al
Other valuable considerations and One Hundred ($100.00) DOLLARS,
to the aaid pert.eS of the first part in hand paid by the 'said parties of the second pert, the receipt whereof la
hereby confessed and acknowledged, ha Ve granted, bargained, sold and conveyed, and by these present@ do
grant, bargain, oil, Convey and confirm unto the laid parties of the second part, to pus riot le tenancy in common
but in joint tenancy, the survivor of them, their mini and the Reim and assigns of inch survivor forever, all the fol-
lowing described lot or parcel of land, 'hate, lying and being In the ---+
-County of Weld and State of Colorado, to'wltt
The South Half (Si) of Section Twenty-eight (28), Township Four (4+)
North, Range Sixty-four (6i) West of the 6th P.M., together with all
water, water, rights and water stock, including, but not by way of
limitation, 13.17 'shares of the capital stock of The Farmers Reser-
voir and Irrigation Company and lb, shares of the capital stock of
The Warner Lateral Company, RESERVING AND EXCEPTING however, unto
the Grantors herein an undivided one—half interest in and to all the
oil, gas and other minerals in and under said property, together with
the right of ingress and egress to prospect far and remove the same.
TOGETHER wills all and singular the hereditarite too and appurtenances thereunto belonging, or In soy pica
appertaining, and the reversion and lane, remainder and remainders, rents, imams and profits Ih.rott; and
all the cow, right, title, icier -rat, claim and dm,,and whatuerer of the Bald part ins of the first part, ehWr in
law or equity, of, in and to the above bargained premises, the heredltamenes and appurtenances.
TO HAVE AND TO HOLD the mid premises above bargained end described, with appurtenances, unto thn
acid p.reic. of lfrt second part, thi survivor of hhem, their aeafgry and the heirs and aesiena of auth survivor for-
ever- And the said part leant the first part, fartheict p,eS,LL9iitAresreuEnn, and admtelatratorq do
covenant, grant, bargain and agree to end with the said parties of the second part, the survivor of them, their
assigns and the heirs and assigns of such survivor, that at the time of the ensettling and delivering of than presects,
they are well seised of the premises above conveyed, al of good. sure, perfect, absolute and indefeasible estate
of inheritance, In law, in fee simple, and ha ve good right, full power and lawful authority to grant, bargain,
Neil and canny, the title in manner A nd form arerctald, and that the tamer are fret and clear from all (saner and
tithe grants, heresy's,rates Ih:e#, tear a, tovese Cats and i Cumbranc of horsy, kind or nature clever:
Subject to 2 taxes, due and payable in 1963, which said taxes the
Grantees herein assume and agree to ay- also subject to rights of
way for ditch puroses as contained n heeds recorded in Book 603 at
Page 53, and nook 8, Page 131, Wed County Records; also subject
to Oil and Gas Lease recorded in Book 11E32, Page 629, Weld County
Records;
and the above bargained premises is the quiet and peaceable p ion of the said parties of the second part, the
survivor of Wens, their atoigno and the heirs end amigos of such servla-0r, 'walnut all and every person at pentane
lawfully shaming or to claim the whole or any part thereof, the said pert lee. of the tent part shall and will
WARRANT AND FOREVER DEFEND.
IN WETNESS WHEREOF, the laid partieaf the first part have hereunto set the inane S and
seas the day and year first above written.
Signed. Sealed end Delivered in the Presence al
{j t (' }Pic]Ft e. l• -•d • '.r. . (SEAL)(A t�ertp� ofcisn).
rzf% (SEAT.}
(Elizabeth Holman)
(SEAL)
STATE OF COLORADO.I sr The foregoing instrument was acknowledged before me Ihfa_—�th , day of
Coney of -Weld. Jf
°ankle,ry _—..__„ 1464 by 4131 C—_Ntairnsn and
Elizabeth Holman.
Menem My Hand wed Official S ..-
My Commiedon Exedras _-
WARRANTY DEED —To Inn
0
ley, Colorado.
SKLD, Inc. LG 5KL13209 WE 1373307-1962.001
Notary. ?nbllo.
4.
lid�
- I IlaeariaL +r r.titaa MK.
g x.e,wkr, Pie 146'1 5 S 181" stighnl , Nees*.
r n. ..ri
;_ _ I'
SIN gliff241 Modeller lido 11►th kid a --April in tN
year of ear Lord: ase charmed erne bombed soda ixty-fSve. hiWet'
LESLIE W. THOMPSON and MYRTLE A. THOMPSON
of Iljt County ol Weld , and stale or Colorado, of are met port, and
MYRTLE A. THOMPSON ••
due--Cask/ or Weld , end State of Colorado, of the reeond puts
WITNESSETH, no the mid part ins of the Oral part, ter and in noneldetatton of the arm of
Other valuable considerations and Ten -DOLLARS,
In the odd pare ins of the first part in bond paid by the old part y of the aeco,td part, the receipt whereof in
berate: cordoned and acknowledges, ha Ye granted, harpaiurd, weld and conveyed, and by therr presents do
xrer r, bmraaln, ,dt convey and confirm note the mild nerdy of the reeocd pert her hare sad tacking,
former, all shy loltaselne described lot or parcel of land, elevate, lying and lasing In the County of Weld
ud Slate nr Coloada lawn: The South Half (5h) of Section Twenty-eight (20),
in Township Four (4) North, Range Sixty-four (66) West of the 6th
P.14., together with all water, water rights and water stock, in-
cluding, but not by way of limitation, 13,47 shares of the capital
stook of The Farmers Reservoir and Irrigation Company and 14 shares
of the capital stock of The Warner Lateral Company. -
a _
TOGETHER with all and angular the huedllamehlo meld appurlcllanera Ihcreualu helalgini. or in any -
.wire appertaining, and 11w revar.Inn and rcernbatr, remainder and remainder', ram, hone,' awl l.r.dite thrn•ol; and
all Me teat., rigla, ripe, intere.t, claim and demand whctaccyer of au raid parties of the (Woe part either in Liw
or equity, iii, In rod to III., iihnve Lanollled in mkt'. with the hereditament,' nod apyurlrlranavr.
TO IIr1YE: AND TO IIO1.1) the acid premiers above bargained tool deerrllwil, auI Ir eplolrernauecl, WHO
hit told pirl y tar the treed ,art, her brie. and eyries, forever. Aral Ihr old purl ies of the lint
part, mrthemselvo a, 155 hh rr�, eaccutury and mdwiWllralrrre, do covenant, grant. hirNalu al d corer
to and vrth the gold part y al the seroud part, ha r helm arid oe.lgnv, All ii dui limn of the en•
waling and delivery of theca proem they areuell 'wised ui ,ire premire, ;drove conveyed, as of gaud, cure, pa,
feel, ahnulate cud indefeasible rotate of fnberiraecr, in law, lie lee simple, and ha Yegood rhea. roll power mid lawlnl
authority to grarll, hargrdn, aril end convey the same In manner and form aroremild. eel that the mime ere her
and clear from all former and ,oiler graem barAlm. saki, Ileum Kam amaru,etit, and Iricunihraner, ni N•hafevrr
kin+lure never; $t.tbject to mfnartll re' ervationa Of record; also eubjnc'
to taxes for 1965, rand prior years, and to a Deed of 'trust recorded
nn . Innygry ;7n, 1962, Ir. .:alp 153d1 '.6' 239, 'curls .Vuut.y nVcurue,
which said taxes and Dead of Troia (;rantee herein anounen and agrees
mid gm above psrnria., in d„- ry,ii.l ai.l hsperaldr i'ta.rnl§u „1 Olt gild pat y ..f rbe .revnrl earh 6u pay•
hers and ■uigur. saris nn .ell and ern). perms, ”e per rot'. fan -folly rislmiop tar ie rlar,n lei,: uhn1.• 'it may pall
Ihercnr, 11w Saki parties of the llrnl Tian shall sad will WARRANT ANl) FOREVER i)Eirl??f1).
IN WITN1iSti Wit ENEOE, T1w raid part les nl the (Ira part ha ye h.ruino met thefrlendlaurl
anal3 IHr day mid vier II•I ahoy' written,
Slgnrd, Seals,I owl nrlirmvd h. the finger of
i # t i, e y- t e ".../a tar,
II''�Yrtin A. l'homftion)
Leslie
N. '�� mYfnn)
1r
r .vo
..mans... 1ll,ra�F`ru uO'lla, Tile forgoing lmlrmi,rht men uchunalydp,d before me gar lit Lrl day of
1'\ive % ru \F." P"' kreyr•tle A.. 'lhomrmon_,.... IapaurE midU April 1165 , lip Lcalic W. 1'ho
eoliy.n.k.d Ad Official Seal,
tlF �
fly b.+Xi.E eepire. February. ,..,.96l'l.--..
WARRANTY ORRIS •lleVn' 1'rh,rrrh•, l.rertuy, Colontau
WWh1tr Puhllc.
/,(S'rt1%G*%
SKID, Inc. LG SKL13209 WE 1461253-1965.001
►n
SKID, Inc. SI4,13209 WE 2318744-1993.001
°Reco►ded in Weld County, CO Doc Id: 3675334
02/10/2010 02:33 P Receipt#: 7454569
Page: 1 of 1 Total Fee: $6.00
Steve Moreno, Clerk and Recorder
ERSONAL REPRE 1YE'S DEED F I BUTION
THIS DEED is dated February 9, 20O, and Is made between Art Guttetsen,
the "Grantor," as Personal Representative of the estate of Myrtle A, Thomason,
deceased, and Arthur Roy Quttersen, Arthur Roy Guttersen es custodian For Grace
ch_mdler_0unsrsen under the_"Coloradoj)nifemi Transfers to Minors A, t" and.
William Parker Gatemen, as joint tenants with right of survivorship (whether one,
or more than one), the "Grantee" whose legal address is 17506 WC&57. gersev,
CO 80644 of the County of Weld, State of Colorado.
WHEREAS, the decedent died on the date of November 17, 2O8 and the Grantor was duly appointed Personal
Representative of saki estate by the Weld County Probate Court in and for the County of Weld. and State of Colorado, Probate
No. 2008 PR 444, on the date of August 6, 200. and is now qualified and acting in said capacity.
NOW THEREFORE, pursuant to the powers conferred upon the Grantor by the Colorado Probate Code, Grantor does hereby
convey, assign, transfer and release unto Grantee (In joint tenancy), as the person entitled to distribution, the following described
real property situate in the County of W. State of Colorado:
The South Half (M) of Section Twenty-eight (28), in Township Four (4) North, Range Sixty-four
(64) West of the 6Th P.M., together with all mineral rights, water, water rights and water week,
including, but not by way of limitation, 17.05 shares of the capital stook of The Farmers Reservoir and
Irrigation Company.
Also known as Lots A and B, Recorded Exemption No. 1.053.28-4-i(E1462, according to the map thereof
recorded January 20, 1993 at Reception No. 2318744, being the South Half of Section 28, Township 4 North,
large 64 West of the 6t' P.M., County of Weld, State of Colorado.
Assessor's schedule or parcel numbers: 105328400021, 105328400022 and 105328000002
With all appurtenances.
IN WITNESS WHEREOF, the Grantor has executed this deed on the date set forth above.
Art Outtersen
STATE OF COLORADO
County of +mod
)
) ss.
Personal Representative of the Estate of
Myrtle A. Thomsen, Deceased
The foregoing instrument was acknowledged before me this 9d' day of February, 2010., by Art .Guttejseq as Personal
Representative of the Estate of Merle A. Thomson.
Witness my hand and official seal. U
My commission expires;
DALE LEIGH DOWNING
NOTARY PUBLIC
STATE OF COLORADO
stun, Inc. LG 5KL13209 WE 3675334-2010.001
eRecorded in Weld County, CO Doc Id: 3675576
02/11/2010 12:14 P Receipt#: 7454799
Page: 1 of 2 Total Fee: $11.00
Steve Moreno, Clerk and Recorder
OUITCIABI DEED
THIS DEED Is dated. Febmaty 9.2010. and is made between Arthur Roy
UuUersott. rihur R y Gutterscn _as cuat[ti�thrh for Grace [handler f'rthttersen
under the "Col oradn 1?nit'un* Transfers. ktigheers Act" and Wham Fier
Qulters (whether one, or more than one), the "Grantor," of the County of
Maki end State of Colorado and Du M Ranch. L7.C, the "Grantee," whose
legal address is 173.a.Ronket.SDAIliele of the County of Ike; Lid and
State of Colorado.
WITNESS, that the Grantor, for and in consideration of the sure of TIM DOLLARS, custa ), the receipt and
sufficiency of which is hereby acknowledged, does hereby remise, release, sell and QUITCLAIM unto the Grantee,
and the Grantee's heirs and assigns, forever. all the right, title,rhtereet, claim and demand which the Grantor has in
and to the real property, together with any improvements thereon. located in the County of Egj4 and State of
Colorado, described as fbliows:
The South Half of Section Twenty-eighl (28), in Township pour (4) North, Range Sixty-four
(64) West of the P.M, together with all mineral rights, water, water rights and water stock,
including, but not by way of limitation, 17.05 shares of the capital stock of The Farmers Reservoir and
Irrigation Company.
Also known as Lots A and B, Recorded Exemptice No. 1053-28-4-RE1462, according to the map
thereof recorded Jemmy 20, 1993 at Reception No. 2318744, being the South Half of Section 28,
Township 4 North, Range 64 Westaf the 6ie P.M., County of Weld, State of Colorado.
Assessor's schedule or parcel numbers: 105328400021,105328400022 and 145328004002
TO HAVE AND TO HOLD the same, together with all and singular the appurtenances and privileges
thereinto belonging, or in anywise thereunto appertauhmg, and all the estate, right, title, interest and claim
whatsoever of the Grantor, either in law or equity, to the only proper use, benefit and behoof of the Grantee, and the
Grantee's heirs and resigns, forever.
IN WITNESS WHEREOF, the Grantor has executed this deed on the date set forth above.
Arthur Roy Gutterseri
William Parker Gultereen
(ACKNOWLEDGEMENTS TO FOLLOW ON NEXT PAGE)
Arthur Roy Guitersea as custodian for Grace
Chandler Guttersee under the "Colorado
Unlfbrm Transfbr to Minors Act"
SKID, Inc. LG Sha.13209 ux 3675576-2010.001
eRecorded in Weld County, CO Doc Id: 3675576
02/11/2010 12:14 P Receipt#: 7454799
Page: 2 of 2 Total Fee: $11.00
Steve Moreno, Clerk and Recorder
STATE OF COLORADO
) ss.
County of WELD
The foregoing instrument was acknowledged before me this 2 day of E bruary. 2010, by Artbur Rcv .Ciu1t eisen mid
Arthuritemauttersauts t atudien for Gracc C. Gutter under the "Colorado Uniform Transfer to Minors Act",
Witness my hand end official seal.
My commission. e>cplres: _
STATE OF 7Z1.1.1
)sa-
Cuultiy of /41t4. -4,,f
f
it-
'Ate foregoing inatruntent was eclmowledged before me this i day of ebruary. 2010. by William Parker
Eiw to o t,
Witness my hand end ai't'wi-{.sear
My commission expires:
MICHAEL M0PRIS0N
Notary Public, State of Texas
rly.lrnuii-i+3rrE„A1itr'r'
August 24, 2073
S1 .D, Inc. I.G SKL13209 wa 3675576-2010.002
Document must be filed electronically.
Paper documents will not be accepted.
Document processing fee
Fees & forms/cover sheets
are subject to change.
To access other information or print
copies of filed documents,
visit ww=w.soS.state.co.us and
select Business Center.
Colorado Secretary of State
Date and Time: 07/10/2009 10:25 AM
ID Number: 20091368028
$50.00 Document number: 20091368028
Amount Paid: $50.00
ABOVE SPACE FOR OFFICE USE ONLY
Articles of Organization
filed pursuant to § 7-80-203 and § 7-80-204 of the Colorado Revised Statutes (C.R.S.)
1. The domestic entity name of the limited liability company is
Box M Ranch, LLC
(The name of a limited liability company must contain the term or a bbreviation
"limited liability company", "ltd, liability company", "limited liability co.", "ltd.
liability co.", "limited", "l.l.c.", "Ilc", or "ltd.". See §7-90-601, C.R.S.)
(Caution: The use of certain terms or abbreviations are restricted by law. Read instructions for more information.)
2. The principal office address of the limited liability company's initial principal office is
23691 Highway 263
Street address
Mailing address
(leave blank if same as street address)
(Street number and name)
Greeley CO 80631
(City) (State) (ZIP/PostaI Code)
United States
(Province — if applicable) (Country)
(Street number and name or Post Office Box information)
(City)
(State)
(ZIPlPostaI Code)
(Province — if applicable) (Country)
3. The registered agent name and registered agent address of the limited liability company's initial registered
agent are
Name
(if an individual)
OR
(if an entity)
(Caution: Do not provide both an individual and an entity name.)
McNab Stewart
(Last) (First)
(Middle) (Suffix)
Street address
1600 Stout St., STE 1700
(Street number and name)
Denver Co 80202
(City) (State) (ZIP Code)
ARTORGLLC
Page I of 3 Rev. 02128/2008
Mailing address
(leave blank if same as street address) (Street number and name or Post Office Box information)
CO .
(City) (State) (ZIP Code)
(The following statement is adopted by marking the box.)
The person appointed as registered agent has consented to being so appointed.
4. The true name and mailing address of the person forming the limited liability company are
Name
(if an individual)
(Last) (First) (Middle) (Suffix)
OR
(if an entity) Art Guttersen, LLC
(Caution: Do not provide both an individual and an entity name.)
17506 Weld County Road 57
Mailing address
(Street number and name or Post Office Box information)
Kersey r�CgO 80644
(City) United)States (ZIP/Postal Code)
(Province — if applicable) (Country)
(If the following statement applies, adopt the statement by marking the box and include an attachment.)
❑ The limited liability company has one or more additional persons forming the limited liability
company and the name and mailing address of each such person are stated in an attachment.
5. The management of the limited liability company is vested in
(Mark the applicable box,)
one or more managers.
OR
n the members.
6. (The following statement is adopted by marking the box.)
There is at least one member of the limited liability company.
7. (If the following statement applies, adopt the statement by marking the box and include an attachment,)
❑ This document contains additional information as provided by law.
8. (Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has
significant legal consequences. Read instructions before entering a date.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document is/are
(uunlddlyyyy hour:minute anilpm)
ARTORGLLC
Page 2 of 3 Rev. 02128/2008
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the
person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity
with the requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic
statutes, and that the individual in good faith believes the facts stated in the document are true and the
document complies with the requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the Secretary of
State, whether or not such individual is named in the document as one who has caused it to be delivered.
9. The true name and mailing address of the individual causing the document to be delivered for filing are
McNab Stewart
(Last)
1600 Stout St., STE 1700F;rst) (Middle) (Suffix)
(Street number and name or Post Office Box information)
Denver CO 80202
(City)
(State) (ZIP/Postal Code)
t�rllted States
(Province — if applicable) (Country)
(If the following statement applies, adopt the statement by marking the box and include an attachment.)
❑ This document contains the true name and mailing address of one or more additional individuals
causing the document to be delivered for filing.
Disclaimer:
This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice,
and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy
minimum legal requirements as of its revision date, compliance with applicable law, as the same may be
amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should
be addressed to the user's legal, business or tax advisor(s).
ARTORGLLC
Page 3 of 3 Rev. 02128/2008
Document processing fee
if document is filed on paper
if document is filed electronically
Fees & forms/cover sheets
are subject to change.
To file electronically, access instructions
for this form/cover sheet and other
information or print copies of filed
documents, visit www.sos.state.co.us
and select Business Center.
Paper documents must be typewritten or machine printed.
$125.00
$ 25.00
Colorado Secretary of State
Date and Time: 09/07/2007 10:19 AM
Id Number: 20071411827
Document number: 20071411827
AHOVL SPACE FOR OFFICE USE ONLY
Articles of Organization
filed pursuant to 7-90-301, et seq. and ,;"/7-80-.204 of the Colorado Revised Statutes (C.R.S)
1. Entity name:
2. Use of Restricted Words (if any of these
terms arc contained in an entity name, true
name of an entity, trade name or trademark
stated in this document, mark the applicable
box):
3. Principal office street address:
4. Principal office mailing address
(if different from above):
Art Guttersen, LLC
(The name of a limited liability company must contain the term or abbreviation "limited
liability company", "ltd. liability compa ny", "limited liability co,", "ltd. liability co.",
"limited". "Ilc". "I.I.e.", or "ltd." §7-90-601, C.R.S.)
"bank" or "trust" or any derivative thereof
"credit union" "savings and loan"
"insurance", "casualty", "mutual", or "surety"
17506 Weld County Road 57
(Street name and number)
Kersey CO 80644
(City) (State) (Postal/Zip Code)
Weld United States
(Province — if applicable) (Country— if not US)
(Street name and number or Post Office Box information)
(City)
(State) (Postal/Zip Code)
(Province — if applicable) (Country— if not US)
5. Registered agent name (if an individual): Guttersen
OR (if a business organization):
Art
(Last) (First)
(Middle) (Suffix)
6. The person identified above as registered agent has consented to being so appointed.
7. Registered agent street address:
17506 Weld County Road 57
(Street name and number)
Kersey CO 80644
(City) (State) (Postat'Zip Code)
ARTORGLLC
Page 1 of3 Rev. 11/16/2005
8. Registered agent mailing address
(if different from above): (Street name and number or Post Office Box information)
(City) (State) (PostaI/Zip Code)
(Province — if applicable) (Country— if not US)
9. Name(s) and mailing address(es)
of person(s) forming the limited
liability company:
(if an individual) Guttersen
OR (if a business organization)
(if an individual)
OR (if a business organization)
(if an individual)
OR (if a business organization)
Art
(Last) (First)
(Middle) (Suffix)
17506 Weld County Road 57
(Street name and number or Post Office Box information)
Kersey CO 80644
Weld (City) Un(i[eU)States (PostaI/Zip Code)
(Province — if applicable) (Country— if not US)
(Last) (First)
(Middle) (Suffix)
(Street name and number or Post Office Box information)
(City) (State) (PostaI/Zip Code)
United States
(Province — if applicable) (Country— if not US)
(Last) (First) (Middle) (Suffix)
(Street name and number or Post Office Box information)
(City) tat ) (PostaI/Zip Code)
Un(i ec� States
(Province — if applicable) (Country— if not US)
(If more than three persons are forming the limited liability company, mark this box ❑ and include an attachment stating the true
names and mailing addresses of a]] additional persons forming the limited liability company)
10. The management of the limited liability company is vested in managers
OR is vested in the members
11. There is at least one member of the limited liability company.
ARTORGLLC
Page 2 of 3 Rev. l 1116/2005
12. (Optional) Delayed effective date:
(nuu?dd?yyyy)
13. Additional information may be included pursuant to other organic statutes such as title 12, C.R.S. If
applicable, mark this box ❑ and include an attachment stating the additional information.
Notice:
Causing this document to be delivered to the secretary of state for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, tinder penalties of perjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the
person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity
with the requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic
statutes, and that the individual in good faith believes the facts stated in the document are true and the
document complies with the requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the secretary of
state, whether or not such individual is named in the document as one who has caused it to be delivered.
14. Name(s) and address(es) of the
individual(s) causing the document
to be delivered for filing:
Guttersen Art
(Last) (First)
17506 Weld County Road 57
(Middle) (Suffix)
(Street name and number or Post Office Box information)
Kersey CO 80644
Weld (City) Urfttl9) States (Postal/Zip Code)
(Province — if applicable) (Country— if not US)
(The document need not state the true name and address of more than one individual. However, if you wish to state the name and address
of any additional individuals causing the document to he delivered for filing, mark this box ❑ and include an attachment stating the
name and address of such individuals.)
Disclaimer:
This form, and any related instructions, are not intended to provide legal, business or tax advice, and are
offered as a public service without representation or warranty. While this form is believed to satisfy minimum
legal requirements as of its revision date, compliance with applicable law, as the same may be amended from
time to time, remains the responsibility of the user of this form. Questions should be addressed to the user's
attorney.
ARTORGLLC
Page 3 of 3 Rev. II/16/2005
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