Conference/Public Meeting Agenda/Documents — Packet

Section 3.12 RESPONDENT PROPOSAL FORM THE RESPONDENT MUST READ THE FOLLOWING INSTRUCTIONS TO COMPLETE THIS PAGE. If doing business under a trade name or partnership, you must submit the proposal under the exact title of the trade name or the partnership; and the proposal must be signed by either the owner or a partner witnessed by a notary public. Ifa corporation, the proposal must be signed by the President or Vice President and witnessed by a Corporate Secretary and affix Corporate Seal. Other persons authorized by Corporate Resolution to execute agreements in it behalf may also sign the proposal documents (pages). Copy of a Resolution must accompany the proposal. The person who signs this form must also sign the Non-Collusion Affidavit. You cannot witness your signature. p, Lie NAME OF RESPONDENT | Cavern PL Ave, Sevsey y Cody WNT 09805 ADDRESS OF RESPONDENT Exsene Ciackowski. 2Di- 333-SQuY xX 1OZ PRINT NAME & TITLE TELEPHONE NUMBER OF CORPORATE SECREATRY 0 (edaleo leat CORPORATE SEAL Nicholas Ve Nné PRINT OR TYPE NAME AND TITLE WARNING: IF YOU FAIL TO FULLY, ACCURATELY AND COMPLETELY SUPPLY THE INFORMATION REQUESTED ON THIS PAGE, YOUR PROPOSAL MAY BE REJECTED. 47