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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2012004 <br /> Superior Oilfield Services Co., LTD Receipt#: 21403 <br /> Jack Miller Date: 05/02/2016 <br /> 1011 11 th Ave. <br /> Permit: M2012004 <br /> Greeley CO 806310000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check#1095 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />