Exhibit 5, State of Delaware Secretary of State Certificates, Blue Flame Medical LLC (Document 130-5)

Summary

Exhibit 5, Document 130-5, filed May 6, 2021 in Case 1:20-cv-00658-LMB-IDD. It contains an IRS notice (SS-4) about an EIN, covering electronic deposit of employment taxes through the Electronic Federal Tax Payment System, authorized e-file providers and reminders to keep the notice, and stating that the name control associated with the EIN is BLUE. It also contains two State of Delaware Secretary of State certificates dated March 23, 2020 for Blue Flame Medical LLC: a Certificate of Formation naming Patrick Brickhouse as the authorized person and stating a perpetual duration, and a certificate stating that the company is duly formed and in good standing. Pages carry the stamp CONFIDENTIAL.

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Full text

EXHIBIT 5

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CONFIDENTIAL
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(IRS USE ONLY)
575A
03-24-2020 BLUE B 9999999999 SS-4
If you are required to deposit for employment taxes (Forms 941, 943, 940, 944, 945,
CT-1, or 1042), excise taxes (Form 720), or income taxes (Form 1120), you will receive a
Welcome Package shortly, which includes instructions for making your deposits
electronically through the Electronic Federal Tax Payment System (EFTPS). A Personal
Identification Number (PIN) for EFTPS will also be sent to you under separate cover.
Please activate the PIN once you receive it, even if you have requested the services of a
tax professional or representative. For more information about EFTPS, refer to
Publication 966, Electronic Choices to Pay All Your Federal Taxes. If you need to
make a deposit immediately, you will need to make arrangements with your Financial
Institution to complete a wire transfer.
The IRS is committed to helping all taxpayers comply with their tax filing
obligations. If you need help completing your returns or meeting your tax obligations,
Authorized e-file Providers, such as Reporting Agents (payroll service providers) are
available to assist you. Visit the IRS Web site at www.irs.gov for a list of companies
that offer IRS e-file for business products and services. The list provides addresses,
telephone numbers, and links to their Web sites.
To obtain tax forms and publications, including those referenced in this notice,
visit our Web site at www.irs.gov. If you do not have access to the Internet, call
1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office.
IMPORTANT REMINDERS:
Keep a copy of this notice in your permanent records. This notice is issued only
one time and the IRS will not be able to generate a duplicate copy for you. You
may give a copy of this document to anyone asking for proof of your EIN.
Use this EIN and your name exactly as they appear at the top of this notice on all
your federal tax forms.
Refer to this EIN on your tax-related correspondence and documents.
If you have questions about your EIN, you can call us at the phone number or write to
us at the address shown at the top of this notice. If you write, please tear off the stub
at the bottom of this notice and send it along with your letter. If you do not need to
write us, do not complete and return the stub.
Your name control associated with this EIN is BLUE. You will need to provide this
information, along with your EIN, if you file your returns electronically.
Thank you for your cooperation.
CONFIDENTIAL
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7911342 8100
SR# 20202308492
Authentication: 202637934
Date: 03-23-20
Delaware
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
COPY OF THE CERTIFICATE OF FORMATION OF "BLUE FLAME MEDICAL
LLC" , FILED IN THIS OFFICE ON THE TWENTY—THIRD DAY OF MARCH,
A.D. 2020, AT 12 : 15 O'CLOCK P.M.
Page 1
You may verify this certificate online at corp.delaware.gov/authver.shtml
CONFIDENTIAL
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STATE of DELAWARE
LIMITED LIABILITY COMPANY
CERTIFICATE of FORMATION
FIRST
Name
The name of the limited liability company is:
Blue Flame Medical LLC
SECOND
Registered Agent
The address of its registered office in the State of Delaware is
8 The Green, Suite A in the City of Dover. Zip code 19901.
The name of its registered agent at such address is
A Registered Agent, Inc.
THIRD
Duration
The duration of the limited liability company shall be perpetual.
FOURTH
Purpose
The purpose for which the company is organized is to conduct any
and all lawful business for which Limited Liability Companies can
be organized pursuant to Delaware statute.
In Witness Whereof, the undersigned have executed this
Certificate of Formation this 2 3 rd  day of March, 2020.
By:

Authorized Person
Name: Patrick Brickhouse
State of Delaware
Secretary of State
Division of Corporations
Delivered 12:15 PM 03/23/2020
FILED 12:15 PM 03/23/2020
SR 20202307821 - FileNumber 7911342
CONFIDENTIAL
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SR# 20202308492
You may verify this certificate online at corp.delaware.gov/authver.shtml
7911342 8300
Authentication: 202637935
Date: 03-23-20
Delaware
Page 1
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "BLUE FLAME MEDICAL LLC" IS DULY FORMED
UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND
HAS A LEGAL EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SHOW, AS
OF THE TWENTY—THIRD DAY OF MARCH, A.D. 2020.
AND I DO HEREBY FURTHER CERTIFY THAT THE SAID "BLUE FLAME
MEDICAL LLC" WAS FORMED ON THE TWENTY—THIRD DAY OF MARCH, A.D.
2020.
AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL TAXES HAVE BEEN
ASSESSED TO DATE.
CONFIDENTIAL
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