2016-03-15_REPORT - M1979142

• Permit No: M1979142
• IBM Index Class Name: REPORT
• Doc Date: 3/15/2016
• Doc Name: Annual Fee - ITA
• From: CDOT
• To: DRMS
• Annual Report Year: 2016
• Email Name: ACY
• Media Type: D
• Archive: No

Internal Transaction Agreement(ITA) Page 1 of 1
Internal Transaction Agreement(ITA) Dept: HAAA Ver.: 1 Function: New Phase: Final
Modified by d little, 03/15/2016 /
Header 1111 1g I
— General Information
Document Name: Initiator:
ANNUAL FEES n )Provider!Seller V
WEST OF MAYBELL PIT V
Record Date: Delivery Date:
Additional information:
Document Description: ANNUAL FEES FEBRUARY 2016
WEST OF MAYBELL PIT
M1979-142
Actual Amount:
$791 00
— 1st Party Information
Vendor Customer: Vendor Contact ID:
Legal Name: Principal Contact:
Address Code: Phone:
Alias/DBA: Phone Extension:
Address Line 1: Fax Number:
Address Line 2: Fax Extension:
City: Email Address:
State: Web Address http://:
Zip:
Country:
County:
— Extended Description
Extended Description:
GIGI JOHNSON
303-866-3567 EXT 8149
— Document Information
Created By:
m.merkulov
Created On:
03/15/2016
Modified By:
d little
Modified On:
03/15/2016
https://codpa.hostams.com:1443/webapp/PRDFINIXI/advantage/Advantage/document to print.html 6/10/2016