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5 <br />O © ? <br />S) �j �C <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Thomas O'Rourke <br />O'Rourke Excavating, Inc. <br />2489 C R 15 <br />South Fork, CO 81154 <br />X [3 Agent <br />❑ Addressee <br />B. RRee eived by (Printed Namej C. Date of Delivery <br />D. Is delive address different,frL item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />8 Certified Mail ❑ Priority Mail Express`" <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7 014 0150 0000 913 8 9844 <br />(Transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />Postal <br />CERTIFIED MAIL,. • • <br />only; (Domestic Mail <br />w <br />Er <br />ro <br />M Postage: Z <br />rr Certified Fee: $3.30 <br />w <br />Return Receipt Fee: $2.70 <br />C3 <br />E3 (En' Total Postage & Fees: , $6.90 <br />Re: r <br />[:3 (Endorsement Required) _JI <br />u, <br />r 9 Total Postage & Fees <br />O <br />-I- Sent To Thomas O'Rourke <br />ri , Inc. <br />o Sfrreet,Apt.No..; O'Rourke Excavating. <br />or PO Box No. --- - - - - -- <br />Ciry staie,ziP+ 2489 CR 15 <br />South Fork, CO 81154 <br />