Article 7-107 Road Assessment

Ursa Operating Company Speakman A Booster Compressor OA Project No. 015-3104

Denver Colorado Springs Phoenix Anniston Atlanta Niceville Parsons Pueblo Sacramento Washington, D.C.

2435 Research Parkway, Suite 300 Colorado Springs, Colorado 80920 Phone: 719.575.0100 Fax: 719.575.0208 matrixdesigngroup.com

February 9, 2016 Scott Aibner, P.L.S. River Valley Survey, Inc. 110 E. 3rd Street Suite 213 Rifle, Colorado 81650 Ph: 970-379-7846 RE: Speakman A Pad Compressor Station Roadway Dear Scott,

Per our discussion on the phone, it was explained that it is the intention to install a portable booster compressor (on skid pads) on the existing Speakman A Injection Well Pad. No roadway improvements are proposed with this installation. Per previous roadway standard documentation with the well injection application, prepared by Olsson and Associates, the existing roadways met the requirements of Garfield County. Changes or alterations to the roadway that may become necessary should be reviewed against the General Engineering Standards and Practices section of the Garfield County Land Use Code, Road and Bridge Standard Design Requirements, and be certified by a Professional Engineer. Please feel free to contact me directly if you have any questions.

Best Regards,

Gregory G. Shaner, PE Senior Associate of Development Services

Daybreak Road at intersection with Stone Quarry Road (CR 300)

Daybreak Road looking north toward intersection with Stone Quarry Road (CR 300)

February 26, 2014

Mr. Scott Aibner

River Valley Survey

email: sa ibner@comcast.net

CRUX cl.vl.L s""gl.111..eei-l.""g § t:.evet.op~e""t

COll\,SL<.ltA""ts

RE: Speakman A Pan - Access Roadway Assessment Compliance Letter

Dear Scott:

The CRUX Consulting Group, Inc. has completed a roadway access compliance review for the

Speakman A Pad proposed small injection well Garfield County Administrative Review land use

permit. This review was conducted to evaluate the roadway assessment prepared by Olsson

and Associates with regards to general engineering standards and practices of Section 7-107 of

the Garfield County Land Use Code. From the review we have performed, the existing Daybreak

Drive and Speakman A Pad accesses meet the standards and criteria of the respective

comparable standards of Garfield County. Dedicated legal access has been provided and the

development of the roadways provides safe and adequate access for the land use request.

Construction of the roadways was performed with materials and general design standards of

Garfield County, and Daybreak Drive has been super elevated to mitigate terra in impacts

conventional design might have imposed. If you have any questions please do not hesitate to

call me directly at 970.319.9744,

CRUx Consulting Group 110 E. 3'd Street Suit e 204 I Rifle, Colorado 816SO

970.319.9744 (o/c)

Bill To:

Garfield County

Road and Bridge Department P.O. Box426

Rifle, CO 81650

Phone-(970)625-8601 Fax- (970)625-8627

Invoice

Driveway Permit Number: GRB07-D-122

Invoice Date: 11/8/2007

Encana Oil and Gas(USA), Inc.

2717 CR 215 Suite 100 Parachute , CO 81635

$75.00 per Driveway Permit.

Driveway Permit Fee: $75.00

Total Due: $75.00

Thank You!

( ,.

Garfield,__. County

Application for Driveway Permit

Person Obtaini11g Permit: E11ca11a Oil and Gas(USA), Inc. Applicatio11 Date: 111812007 County Road Number: 300 District: Silt

Permit Number: GRB07-D-122 Termination Date: 121812007 Inspector: Jake Mall

hereby requests permission and authority from the Board of County Commissioners to construct a driveway approach (es) on the right-of-way off of County Road. 300, .5 mile West of Thunderburg Trail, located on the South side of road for the purpose of obtaining access to property.

Applicant submits herewith for the consideration and approval of the Board of County Commissioners, a sketch of the proposed installation showing all the necessary specification detail including:

1. Frontage oflot along road. 2. Distance from centerline of road to property line. 3. Number of driveways requested 4. Width of proposed driveways and angle of approach. 5. Distance from driveway to road intersection, if any. 6. Size and shape of area separating driveways if more than one approach. 7. Setback distance ofbuilding(s) and other structure .improvements. 8. No unloading of equipment on county road, any damage caused to county road will be repaired at subdivision

expense. 9. Responsible for two years from the date of completion.

General Provisions

1) The applicant represents all parties in interest, and affirms that the driveway approach (es) is to be constructed by him for the bona fide purpose of securing access to his property and not for the purpose of doing business or servicing vehicles on the road right of way.

2) The applicant shall furnish all labor and materials, perform all work, and pay all costs in connection with the construction of the driveway(s). All work shall be completed within thirty (30) days of the pe1mit date.

3) The type of construction shall be as designated and/or approved by the Board of County Commissioners or their representative and all materials used shall be of satisfactory quality and subject to inspection and approval of the Board of County Commissioners or their representative.

4) The traveling public shall be protected during the installation with proper warning signs and signals and the Board of County Commissioners and their duly appointed agents and employee shall be held harmless against any action for personal injury or property damage sustained by any reason of the exercise of the Permit.

5) The Applicant shall assume responsibility for the removal or clearance of snow, ice, or sleet upon any portion of the driveway approach (es) even though deposited on the driveway(s) in the course of the County snow removal operations.

6) In the.event it becomes necessaiy to remove any right-of-way fence, the posts on either side of the entrance shall , be surely braced before the fence is cut to prevent any slacking of the remaining fence and all posts and wire

removed shall be turned over to the District Road Supervisor of the Board of County Commissioners.

7) No revisions or additions shall be made to the driveway(s) or its appurtenances on the right-of-way without written permission of the Board of County Commissioners.

8) Provisions and specifications outlined herein shall apply on all roads under the jurisdiction of the Board of County Commissioners of Garfield County, Colorado, and the Specifications, set forth on the attached hereof and incorporated herein as conditions hereof.

9) Final inspection of driveway will be required upon completion and must be approved by person issuing permit or representative of person issuing permit.

The inspection and sign off must be done prior to any CO from the Building and Planning Department being issued.

10) Contractor agrees to all Provisions in Exhibit A.

Special Conditions: 1. Driveway Width- lOOft 2. Culvert required? True Size: 24" by lOOft 3. Asphalt or concrete pad required? True Size of pad: lOOft wide x 20ft long x 4in thick 4. Gravel portion required? True Length: 80' temp 5. Trees, brush and/or fence need to be removed for visibility? True 6. Distance and Direction:lOOft east and west 7. Certified Traffic Control Required? False 8. Work zone signs required? True 9. Stop sign required at entrance to County Rd

In signing this application and upon receiving authorization and permission to install the driveway approach (es) described herein the Applicant signifies that he has read, understands and accepts the foregoing provisions and conditions·. and agrees to construct the driveway(s) in accordance with the accompanying specification plan reviewed and approved

by the Board of County Commissioners.

Signed: ~~~~~~~~~~~~~~~~~~~

Encana Oil and Gas(USA), Inc. Address:

Telephone Number: ~~~~~~~~~~~~~~

Permit granted 11/8/2007, subject to the provisions, specifications and conditions stipulated herein.

For Board of County Commissioners' of Garfield County, Colorado:

A:}•lWJ Representative of Garfield County Road and Bridge Signature

Specifications

I. A driveway approach is understood to be that portion of the county road right-of way between the pavement edge and the property line that is designed and used for the interchange of traffic between the roadway and abutting property.

2. At any intersection, a driveway shall be restricted for a sufficient distance from the intersection to preserve the nmmal and safe movement of traffic. (It is recommended for rural residence entrances that a minimum intersection clearance of 50 feet be provided and for rural commercial entrances a minimum of I 00 feet be provided.)

3. All entrances and exits shall be so located and constructed that vehicles approaching or using them will be able to obtain adequate sight distance in both directions along the county road in order to maneuver safely and without interfering with county road traffic.

4. The Applicant shall not be pe1mitted to erect any sign or display material, either fixed or movable, on or extending over any pmtion of the county road right-of-way.

5. Generally, no more than one approach shall be allowed any parcel or property the frontage of which is less than one hundred (100) feet. Additional entrances or exits for parcels having a frontage in excess of one hundred 100) feet shall be permitted only after showing of actual convenience and necessity.

6. All driveways shall be so located that the flared portion adjacent to the traveled way will not encroach upon adjoining property.

7. No commercial driveway shall have a width greater than thiity (30) feet measured at right angles to the centerline of the driveway except as increased by pe1missible radii. No noncommercial driveway shall have a width greater than twenty (20) feet measured at right angles to the centerline of the driveway, except as increased by permissible radii.

8. The axis of an approach to the road may be at a tight angle to the centerline of the county road and of any angle between ninety (90) degrees and sixty (60) degrees but shall not be less than sixty (60) degrees. Adjustment will be made according to the type of traffic to be served and other physical conditions.

9. The construction of parking or servicing areas on the county road right-of-way is specifically prohibited. Commercial establishments for customer vehicles should provide off-the-road parking facilities.

I 0. The grade of entrance and exit shall slope downward and away from the road surface at the same rate as the nmmal shoulder slope and for a distance equal to the width of the shoulder but in no case less than twenty (20) feet from the pavement edge. Approach grades are restricted to not more than ten percent (I 0%).

I!. All driveways and approaches shall be so constructed that they shall not interfere with the drainage system of the street or county road. The Applicant will be required to provide, at his own expense, drainage structures at entrances and exits, which will become an integral pait of the existing drainage system. The Board of County Commissioners or their representative, prior to installation, must approve the dimensions and types of all drainage structures.

Note: This 11ermit shall be made available at the site where and when work is being clone. A work sketch or drawing of the proposed clriveway(s) must accompany application. No permit will be issued without drawing,

blueprint, or sketch.

BOARD OF COUNTY COMMISSIONERS OF GARFIELD COUNTY CERTIFICATION AND AFFIDAVIT

REGARDING ILLEGAL ALIENS The Contractor, whose name and signature appears below, certifies and agrees as follows'

1. The Contractor shall comply with the provisions of C.R.S. 8-17.5-101 et seq. The Contractor shall not knowingly employ or contract with an illegal alien to perform work for the Board of County Commissioners of Garfield County, Colorado ("BOCC"} or enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien.

2. The Contractor represents, warrants, and agrees that it has verified that it does not employ any illegal aliens; that it has participated or attempted to participate in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security; and otherwise shall comply with the requirements of C.R.S. 8-17.5-102(2) (b).

3. The Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If the Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101 et seq., the .BOCC may terminate work for breach and the Contractor shall be liable for actual and consequential damages to the State.

4. If the Contractor is a sole proprietor, the undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one) '

I am a United States citizen, or

I am a Permanent Resident Of the United States, or

I am lawfully present in the United States pursuant to Federal law.

I understand that this sworn statement is required by law because I am a sole proprietor entering into a contract to perform work for the BOCC. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to starting work for the BOCC. I further acknowledge that I will comply with the requirements of C.R.S. 24-76.5-101 et seq. and will produce the required form of identification prior to starting work.

I acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under C.R.S. 18-8-503.

CERTIFIED and AGREED to this ~- day of 200

CONTRACTOR,

(Contractor Full Legal Name) FEIN or Social Security Number

By' Signature of Authorized Rep Title

Permit Number: GRB07-D-122 Exhibit A

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11/05/2007 15:06 6256627 ROAD AND BRIDGE

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3. City: Carbondale 81623 0 Glenwood Springs 81601 D

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New Castle 81647 D Silt 81652 0 Rifle 81650 D Parachute 8163' gJ Other

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5. County Rd. No: I 3Qp ~ -~J 6. Nearest fntersection or address: ThltllJ'{;,· b(u !i z;,;._; I I( b~~:)

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7. Distance: from Int. or address: Q • 5 1?71 _ --~-=i 8. Direction from Int. or address: N 0 E 0 S D w IZl 9. Side of road: N D E 0 S [ZJ wO 10. Width of driveway: 30-foor D 40-foot D IOO-foot !2J

Other: I reCC>> !ffe, Vork .... i)O '=] 11. Culvert requiJ'ed: Yes fZJ No 0 12. Size of culvert required: 12-inch 0 IS-inch D 18-inch D

Other: j ,/"/ ''

J3. Leiig1h o('culvert required: 30-foot 0 40-foot Oothe.j /tJO 1 j

14.~rconcretepadrequked: Yes 0 No j_J 15.Sizeofpad: 30-footwidaX10-footlongX4inchesthick:Yes [ J

40-foot wide X 10-foot long X 4-inchcs thick: Yes 0 !00-foot wide X 20-fool long X 4-inches thick: Yes cg)

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11/05/2007 15:06 6250627 ROAD AND BRIDGE PAGE 05

!6. Gravel po;tion required: Yet !?(! No []

17. Length of gravel porlion; 40°foot 0 ~0-foot[J 100-foot CTJo '/· l!y::?.)

18. Trees or brush removed for visibility: Yes IS"J No 0 19. Distance and direction from driveway to be removed:

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20, Driveway must be no more than 3 % slope away from County road,

21. Drive umst be cousbucted so no drainage accesses Cowity nmd from driveway,

22. Certified traffic control required: YesO No ~ 23. Work zone ~ignage only required: Yes~ No D (frur·/.:

24. Stop sign required at entrance to County Rd. Yes IZJ No D 25. lnspection of driveway will required upon completion and must be approved

by pel'llon issuing permit or representative of person issuing pennit.

26. Person Requesting Peml.it: 0 -1r" ..e. R<?_~(,i-r,. t>t.J.:(~l

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Nov 12 07 09:46a Bonnie Marshall 97:1-285-2691 p.2

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l l/00/2007 09; 29 t>i58627 ROAD ~ND BR! CJG~ PAGE 07

Apolicatlon for ~[!ve'Xav Permit

Perso11 Obtaining Permit: Enctma Oil am/ Gas(USA), Inc:. A.pplicat/611 Date: 111812007

Permit N1m1~"'' GRB07·D·lZ2 Torml11111ion Date: 121612(}()1

Co1mty Road Number: JOO District: Silt Inspector: Jrike Mall

hereby request• polTTli,iSion and authority hom tho Bowd of Counr:y CommiS1ioner~ to construct a driveway approach (es) on the right·Of·way or1· Df County Road. JOO •• ! mlle Weir of nrnn.<1erbur1 Trail, located on !ht ~side of rood for the purpo•• of o\>tainitjg •••• .. to property.

Applicant subiuitsherJwith for the con•idoration and approval of the Board of County Cou1m1ssion1Jr>, a sk<lch of the proposed installalion >howing nll the necessary specification delail inoluding:

l. Fr011tag• of lo along road. 2. Di$tllnCc from e<mto:rlin.e of road to property line. ~. Number of dti 1cways requnted 4. Wid:h of pr •sed driveways and anglo ofappr<>•ch. 5. Distance fro1n drive'\l.·ay to road inters~ctlQTI, if any. 6. Size •od ihapt of are• separating driveways if more than one approoch. 7. Setback C:ista." .e ofbuilding(s) and ot~er S)l'llclure.improvcments. 8. No unlo&ding f equip.men! on <OWlty rood, ony ffi>mage caused lo coW'lty ro•d wi i.; be re113ired at sul>dMsion

e1.pensi;. 9. Responsible for two yoars from the dat.o of comple!lo\\,

l) Th• applicant fepreseots all parties in intere•t, aml affinns that the dtiveway approoch (••i u to be cor.suucted by him for tho boj1a fide purpose of .ecuriog acce<S w bis property and not for the purpose of doing busine.ss or servicing vcb.ir'·l•• Q'n the road right of way.

2) lhe appli.)ant rail fumi•h ali lobor Md materials, perfonn all WO<k, and pOy aij costs in COnIJOCtion Wilblhe construction oj the driv..,.,.,y(s). All wor~ sh.JI be COllljlleted within thiny (30) days of the permit date.

3) the type of co.ostruotion •tall be .as deoignatcd 1111dlor approved by the Board of County Commissioners or their repr•sentative and all materials u,.,,J shall be of satisfac!ozy quality and s11bjeot to uupecuon and approval of the Board of Cotmty Conunissioncrs or Uieir representative.

4) The traveling publir. shall be protetted during the io¥tnllation with proper w;;rning signs and signals ond the 0ourd of Co1>11ty Co11troi•s10ners a;id their duly a11pointed agcnl3 and employee •hall be held barmless against any acrjan for per>onal mjury or property damage sus1wned by ~ny reason o{ ihe e>ercise of the Permit.

S) The Applicant shall ""''me r .. p<msibllity for the mooval or clearonr.e of •now, ice, or sleet upon •ny pN1ion of the driveway approach (es) even tl1ough depooitoo on tho driveW11y(s) in the course o(tlx County snow removal Of't;nations.

Nov 12 07 09:47a Bonnie Marshall

11!68/28?.7 0S: ,9 (;258627 '

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370-285-269~

R0.1D AND BRIDGE:

p.3

PAGE 08

6) In the event it ~ocome> ne<cssary to mnov• ony right-of-way fence, the p<>i!S ''" ei!hcr side of the entrance >lt•ll be surely bra~~dd before the knee i~ .cut to prevent any slacking of the ren1a1rri!\g fence snd all posts and wire removed shall e runied over to the DistriC1 Row! Supervisor or the Board of CoijOly Comntis•ionm.

?l N<> re\isions . additions s)lall be made IO the driveway(s) or its app\ll'len•nces on tilt right-of-way without miUen pcncis ion of the Boord ofO>\lllty Commissioners.

8) Provisiun• and spcoificarions outlined herein shall apply on all ro•ds under 1hejwisdiction of the Board of CoW\ty Cornmirnoner of Garfield County, Colorado, and the Specifications, set forth on the attached hereof •nd incorporated oin "'' conc!itions hereof.

9) FloAl lnspecti. ·• of driveway ""' be requlrod upon. completion and m1111t be approved by ~rson lssllillg permit or rep esentolive of peuou IHuiBg permit.

Th• i••pcrtion and vlg~ offmn•t be doae prlor to any CO rrotn the Bulldlug and Plaonlo.g D<portmtut b l.ng ls1ued.

10) Co11tractor a ee1 to all Pro•hJon.1 In l::chlbil A.

§!!:!sit! COldllfona: !. Drlvl!Way Wi1 • IOOfl Z, Culvert requ.i d? True Size: 24" b)· JDOft 3. A1plrnlt er co .crete pad required? True Size of p•d: lOOJI wide ¥ JOl'C long~ 4i11 thick 4. Gravd portio 1 required? True Lcqth: 80' t•Jnp 5. lrees, brush' f!.d/or fence need lo be roro.o .. d for •i1ibillty? Tr11e 6, Di,taace and. )irectlon: JOO Ct east and wnt 7. CerClOed Tra• fie Control RequJred? Falu 8. Work zome si~os re~u!red? 'l'nl• 9. Stop 1lg11 req-lred at emranu to County Rd

ln signins thi$ application and upon receiving authoriution and pmnission to install the driveway approach (es) . des<Tibe-0 herein the Awlicwit signifies that be bas read, 1n1d•rotands and a""epts the foregomg prov1sioru llM conditions" and agrees to consl?Uot tl1e drivewty(S) ifl accordance with the acc-Ompunying specification pla.o reviewed and approved

~: ""'-.. !J/ lhe Board of County Commissioners.

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Permit granted 1118/:ZOOZ. sul;ect \O th• l"•riolons, 1peelflca1lons 1111d condition• 11lpulated here.In.

for Board of County Commissi<lncrs' ofGarneld Cowity, Colo111do

___ .A}a~2 -Rcpl'~sentative of Garfield County Road and Bridge Signature

Nov 12 07 09:47a flonnla Marshall

ll/eB/2007 09:29 6259627 ROAD AND BRIDGE

~c11tfons

970-285-2691 p.4

PAGE 09

J. A drivew•Y approach is un<krstood to be that portion of the county road right-of way betwe•n the pavement edge and the property line that is designed and u•ed for the interobange of traffic be1ween the roadway and •b•llin1 property.

2. At any in1erseclion, •driveway shall be restricted for a sufficient diolance from I.be inters•~tion to pre~e the DOmU1l and safe mov=ent of1raltic. (It i5 recommended for llllal residence entrances that a minimum intorseotion ciearance of SO fret be provided and for rural comme:rctal entnmcos a minimum of JOO feet be provided.}

3. AH entrances and cxilS shall be so located and constructed that vtluoles appro>oching or using them will be able to ol!lain adequa~ sight distance in both directions alons the county road in order to maneuver safely and without intarf'«ing with county road tni.ffic.

4. The Applicant shall not be pennin..d to orer.t any aign or di&play IJ\llleri•I, either fiKed or movable, on 01 extending ova any ponion of the county road !ight-01:way.

~. <renorally, no lrore than one approach sh.all be allowed anyparoel r:rr prope:rty the frontage ofwhLch is less than one h. undred (~!IOO) feet. Additional entrances ore.UIS for parcels having • frontage m 01tcess o( one hundred 100) feet shall be p rmitled only a~er showing of no.Ill al convenience and necessity.

6. All <!riveway$ ·hall be so Joeatcd that the llored por1ion edja;;ent to th< travelod way will not e11croach upon adjoming prop my.

7. No commerciai driveway shall have & v.idth grcotex than thirty (30) feet measured at right angl .. to the centerline of lbe driveway except as mcrrased by permissible radii. No noncommer~i•I dri,.,,way •hall have • widlh @1'eater 1ban tw0t1ty (Wj feet rnea>ured at right angles to the centerline o(lhe dri•·ew•y, exoopt es increosed by ·. pennissible xiu\ii.

8. The a:.;h ofan;approoch to the road may be •I• right angle to tho centerline or the counly road and of any •rigle between nmet)i (!lO) deit<•S and si><ly (60) degree.& lxlt shall nol l>e I••• than •ixty (60) degre ... Adju•tment wlll be made accorttmgto the type oftn1ffic to be served and other pbysi~al conditions.

9. The constructiin ofparkiog or •micing 1treas on the COl.lllty road right-ol:w•y is specifically prohibited. Commerdal ,tablishments for customer vehicle. should p!:ll\Ode off-the-road parldng facilities.

I 0. The grade of ltrance and exi~ shall slope downward and away from the road surface at the &amC rate ""the noimol •hould !f slope and for a distance <'quo! w the widlh of the shoulder but in no ••;e less Uwi twenty (20) feet from tho r•veme-11t edge. Approach grades Ne i:es!riclrd to not more than ten percent (10%).

11. All driV<'WllYS md approaches sh~ll be so constructed that th<:y shall not imerfere with the d111inoge 'ystem of !he street or count• road. 'The Applica?lt will be r«]uired to pwvide, at his own ei::pen••, drainage structures et entrances il!ld ·.tits, which will bec<>me on intognil part of the <)listing drainage syslem. The Board of CoUl'lty Comntission~r; or their repre$entative, pnor to in3tllllation, must app1ove the dimensions and types of all draillJl!!e structwes.

Noo: This permll •h•U be mQde available at tM sl!o wllero aud w•ea work I• belog dou. A work •ketch or drawJ1>g of the proposed drl•ewa)'(s} muS1 •ceompany apptiU!IOll.. No permit ..tll be Juued wilho•t drawing,

blueprint, or •ketch.

Nov 12 G? 09:50s . lonnie Marshall 970-285-2691

11/08/2007 09:~9 6258&27 ROAD ~D BRIDGE

.1

80AltD OF COOKTY COMMISSIONBRS OP GAl\FlBLD COUNTY CERTIFICATION AND AFFIDAVIT

REGARDING ILLEGAL ALIZNS The Contractor. followS":

~hose n.~me and signature appears below, oertitiea and ag;rees as

I 1. The Contxacto et.all comply with the .PX'OVieion& of C.R.$. f:l-l'l,5•101 et seq~ Tt:e contrac ac t1hall not kn.owingly employ o;r contract \rli~h an ille91Jl alien to perform work 01: the eoard of Co\.\r..ty CQmmissionere of Garfield County, Colorado { "BOCC"; "='r enter into ai contl.'ElCt. with a alJ))c.ontractor that. Xno;...iingl)' err.ploya or contr< ct& "'ith an illeigal alien.

2. The Contracto:· repi=esents, warrants, and agreeo that'. it ha.a verified that ).t G.oei; not !!l'mpl .y an)r illegal Aliens.1 that it has participated or attempted t" perl:i.cipate :in t)1e Baaic Pilot Employment Verifir:a.tion Program administet-ed by the S¢cial Se.cur \:.y Aclmin:ietration and Oepftrt.ment of Homeland Security; •nd otherwi.ae shal.l <orllply wit.b the require~ents of c.R.s. B·l7.5-1C2(2) {b).

J. The- Contreitcto 9haJ.1 COl'f\PlY with all reasonable reque'Sta ma.d.e in the course Gf an inv~stlgat.on under C.R.S. 8-17.S~lo2 by the Colorado ~epa~tment of Labor and ~rployment. :t the Contractor fails to coMply witn eny require~ent of thiu provision or C.~ S. e.-·'1.7.5-101 flt seq., the BOCC may terminate work f9,; breach and tht.=! cOntr-act ·J· sllnl;L be liable for actual and conaoquentia.l damages to the State.

I 4. :r.f the Contra1·tor ta a sole prciprietor 1

a.ftirme under pE:1..a.lty Of 1?erjuxy under t-he lchE-ck one) :

the undersigned. hereby swaarB or laws of the State o! Colc4~do that

:r am a Unit~.ti StzLt.ee cit.izen. or

I a.m a Pil!Tm~nent Re5ideni: of the United Sta.tea, 01·

! am 1.aY1fully p-resenl: in the. Unit:ed States pursuant to Federal law.

I Unde~'tand ~h~t this sworn •tatem•nt im ~equired by law because t ani a aole proprietor enterir.g into a contra.ct to perfo.t'm work for the BOCC. L un~p.rgcand ~hat state l~~ ~equiree me to provide proof that. I a«i ~awt1.1.J.ly P'-·esent in tht': trniteel States. prio·r to staLting w9rk for t.~e JOO:.~C'. I ru:rther acknowledge that I will oomply wit"n the xeq·..ii::-~me1'1tv of c.R:.S. 24~76.5-101 et seqo. and will prod.•.ice the r.equired t1rm of ;..dentif"lcation prior to eta.rt.1.09 work.

' : a~know~edge th ·t m•king a f'albe, fierltiove, or:: fraudulent etatetr.ent or representation iJ chig sworn -affidavit. le punishable undez.· t.hu- ori'lf'.inal laws of Colorado as pe.t'.j ry .in the eecond dasrree under C.R.$, 18-8-503.

Cl!l'<1~Fl£0 and Al'' E~;v to chie _ day of _ 200_

{Contractor L"ull Legal Name)

By: Signature ot Authoiized Rep~~--~- Ti~le

i .Permit Number: GR807-D-l:l2

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£xhibi1A

Nov 12 07 09:51a 6onnie Marshall

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970·285·2691 p.6

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Nov 12 07 09:46a Bonnie ~larshall 970·285-2691

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FAX COVER

Date: November 11, 2007 N•Jmber of Pages lricluding This Cover $!" JI

To: Jake Mall - Garfield County f~oad and Bridge 625-8627- Fax#

From: Renata Busch I EnCana Oil & Gas

RE: I Signed Driveway Permits GRB0?-0-121 GR807-D-122

Jake -- Here are the two Driveway permits -- signatures applied and invoices coded.

Hard copies 'pf permits will be provided to Jake St. Clair. Jake is also aware that the Illegal Alien />age must be signed by contractor and faxed back to you.

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Thank you! I

Renata Busch Permit and ROW Coordinator South Piceance lei (970) 285-2825 fax: (970) 285-2691 cell: (970) 31;9-8890 renata.busctl@encan_a.com

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