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HomeMy WebLinkAboutNCG180242_Ownership Change Form_20180208IT ,,....��d Division of Energy, Mineral &Land Resources FOR AGENCY USE ONLY Date Received Land Quality Section/Stormwater Permitting Year Month Da NC®ENR National Pollutant Discharge Elimination System U. u'a PERMIT NAME/OWNERSHIP CHANGE FORM I. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage N I C I S 10 11 1 8 1 0 1 0 0 N I C I G 11 1 8 10 12 14 1 2 II. Permit status prior to requested change. a. Permit issued to (company name): Kohler Company b. Person legally responsible for permit: First MI Last r ulyIr - C-► dock LH S RECEIVED Title 444 Highland Drive FEB Q 8 2018 Permit Holder Mailing Address Kohler 5 044 DENR-LAND QUALITY City State Zip ip STORM111ATER PERMITTING ( 920) 457-4441 ( ) Phone Fa.� c. Facility name (discharge): Baker Furniture d. Facility address: 1 Baker Way Address Connelly Springs, NC 28612 City State Zip e. Facility contact person: Will L. Stange ( 828 ) 397-1255 First / MI /Last Phone III. Please provide the following for the requested change (revised permit). - a. Request for change is a result of ® Change in ownership of the facility ® Name change of the facility or owner If other please explain: b. Permit issued to (company name): Baker Interiors Furniture Company c. Person legally responsible for permit: Kevin E. Ward First MI Last COO Title 1105 22nd Street SE Permit Holder Mailing Address Hickory NC 28602 City State Zip ) 624-7000 kward@Bakerinteriorsgroup.com _(828 Phone E-mail Address d. Facility name (discharge): Baker Interiors Furniture Company e. Facility address: 1 Baker Way Address Connelly Springs, NC 28612 City State Zip f. Facility contact person: Will L. Stange First Ml Inst wstange@Bakerinteriorsgroup.com ( 828 ) 397-1255 E-mail Address Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) 12012 Revised Jan. 27. 2014 n NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Will L. Stange First Ml Last Project Safety Specialist Title 1 Baker Way Mailing Address Connelly Springs, NC 28612 City State Zip wstange@Bakerinteriorsgroup.com ( 828 ) 397-1255 E -Mail Address Phone E-mail Address V Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ® Yes ❑ No (please explain) VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: ❑ This completed application is required for both name change and/or ownership change requests. ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. ...................................................................................................................... The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package -will be returned as incomplete. Signature f Date APPLICANT CERTIFICATION I, � attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. ( I � 131 I IV Signature bate PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27, 2014 STOCK POWER FOR VALUE RECEIVED, the undersigned, Kohler Co. ("Seller"), hereby sells, assigns, and transfers unto S son Investment Holding Co., Thirty -Five Thousand (35,0) shares of Common Stock, no par alue, of KOHLER INTERIORS GROUP, LTD,, a Dela are corporation (the "Corporation"), standing in the name of Seller on the books of the Corporation, represented by Certificate No. 24, and herewith irrevocably constitutes and appoints attorney to transfer such stock on the books of the Corporation with full power of substitution in the premises. Dated effective as of tib, as of the 1 day of , 2017. KO7ER CO. Name: James M. (Buddy) Robinson IV Title: Sr. Vice President — General Counsel, Corporate Secretary and Business Development 7� 08 2018 1 140 Pa a n MIL -27597590-1 'tj>K DER THE LAWS Gn PVFlIp Nf, Ii�O NV DWI4NT a M. N, JACKBDN CNIC�GG PAYCT/V P6TIGINO JT 1334 I V OF THE STATE OF DELAWARE ThisCclificsTha at Kohler Co, ,!l���,®�r��7�i, Thirty -Five Thousand (36,000) SHARES OF CAPITAL STOCK OF KOHLER INTERIORS GROUP, LTi). KP/tlr,Ga!Peafr�'1f/rl(����l.G au;ONk,a�rc/et��eafrr��r�; 21st �i �� February �'.�. 2017 MIGHT & U N JACABG/T �'� ( CGflI'GnAdGH $taAAtyM e,U aos w BANGGIrN $IG¢U c"ICAGtlj 4kIt10tS 49FC6 oIv or I Delaware Page The First State I, JERMWY W. SrwC9, SECRETARY OF STATE OF THE S OF DELAWARE, DO HEREBY (CERTIFY THE ATTACHED IS A. TRUE AND CORRECT COPY OF THE CERTIFICATE OF ABOND NT OF "ME1LER INTERIOR'S GROUP, LTD.", CHANGING ITS NABM FROM "HOHLER INTERIORS GROUP, LTD." TO "BArM INTERIORS GROUP, LTD_", FILED IN THIS OFFICE ON THE; TWENTY—EIGHTH DAY OF FEBRUARY, : A. D. 2017, AT 12.03 O ' CLOCK A FILED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE NEW CASTLE COUNTY RECORDER OF DEEDS. 649524 8100 \�v SR# 20171384720 You may verify this certificate online at corp.delaware.gov/authver.shtmi \/-nA�(�: .Ja7rTl Yl, Bu119GR.SKMtuY of Sats Authentication: 202113357 Date: 02-28-17 � •�. ... � n� .� .. _��- -� ...r. ,_..-.- .. ....,rn F ._..� .. _ .. _. ... r. - ..-v�♦ � +iv a.,.- sxa_ a._. ._. �� r �.x-i a .. �- � _ - i r State of Delaware Secretary of State Division of Corporations Delivered 12:03 Elf 02128/1017 MED 12:03 Elf 02/29N17 CERTIFICAf I'E of AAMNDMENT SR 20171384720 - Re:Vomber 649524 TO THE CERTIFICATE gfINCORPORATION I of KOHLER INTERIORS GROUP, ETD. KOHLER INTERIORS GROUP, Lt, a corporation organized and existing under the General Corporation Law of the State of Dela are does hereby certify that: 1. The name -of the corporation is KOHLER INTERIORS GROUP, LTD. 2, The Certificate of Incorporation ofthe corporation is hereby amended by deleting the text of Article I in its entirety and replacing it with the following text: "ARTICLE I: The name of the Corporation. is BAKER INTERIORS GROUP, LTD." 3. The above amendment was duly adopted in accordance with the applicable provisions of Section 242 and 228 of the General Corporation Law of the State of Delaware. IN WITNESS WHEREOF, Kohler Interiors Group, LTD, has caused this Certificate to be signed by James M. (Buddy) Robinson IV, its Vice President and Secretary this 28°i day of February, 2017. J s M. {Buddy} Robinson . Vice President and Secretary NUL-27SO2462-1 k -- NORTH CAROLINA e Department of the Secretary of State 31 h r.� To all whom these presents shall elome, Greetings: 1, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify the following and hereto attached to be a true copy of ARTICLES OF AMENDMENT OF KOHLER INTERIORS FURNITURE COMPANY WHICH CHANGED ITS NAME TO BAKER INTERIORS FURNITURE COMPANY the original of which was- filed in this office on the 28th day of February, 2017. Scan to verify online. Documenthh 0201705900811 Verify this certificate online at hitp://www.sasne.gov/verification IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seat at the City of Raleigh, this 28th day of February, 2017. 0.0 Secretary of State SOSID: 0009377 Date Filed: 2/28/2017 2:39:00 PM Elaine F. Marshall North Carolina Secretary of State C2017 059 00811 ARTICLES oJAM ENDMENT TO THE ARTICLES ojINCORPORATION Of KOHLER INTERIORS FURNITURE COMPANY Pursuant to § 55-10-06 of the General Statutes of North Ca olina, the undersigned corporation hereby submits the following Articles of amendment for the purpose of amending its Articles Pf Incorporation: . 1! The name of the corporation is KOALER INTERIORS FURNITURE COMPANY. 2. The Articles of Incorporation are hereby amended by deleting the text of Item no.1 in its entirety and by substituting therefor the following Item no. 1: "I. The name ofthe Corporation is BAKER INTERIORS FURNITURE i COMPANY." 3. The amendme t -does not provide for an exchange, reclassification, or cancellationof issues shares. =--- - 4. The date of adoption of the amendment is February 28, 2017. •5. The amendment was approved by shareholder action, and such shareholder approval was obtained as required by Chapter 55 of the North Carolina General Statutes. 6. These articles will be effective as of February 28, 2017. This the 28m day of February, 2017. KOHLEA INTERIORS FURNITURE COMPANY Js M. (Buddy) Robinson IV Sr ice Preside ntyint and Secretary NUL-27505183-1 .