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UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> • Sender: Please print your name, address, and ZIP+4®in this box* <br /> State of Colorado <br /> Department of Natural Resources <br /> Division of Reclamation,Mining&Safety <br /> 1313 Sherman Street, Suite 215 <br /> Denver, CO 80203 G�t a✓�u L Spec i(A <br /> File m i qSD 143 <br /> I Jill 1li1111111 lit lit, <br /> COMPLETE • <br /> COMPLETE • ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete i A. Signature <br /> item 4 if Restricted Delivery is desired. Patrick Q' Agent <br /> ■ Print your name and address on the reverse X (,'Don rlr?11 <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, jiB Received by(Printed Name) C. Date o�Delivery <br /> or on the front if space permits. _ <br /> 1. Article Addressed to:_ D. Is delivery address different from item 1? ❑Yes <br /> If YES,enter delivery address below: ❑No <br /> Jennifer Williams <br /> United Fire & Casualty <br /> 118 2nd Ave. SE, <br /> P O Box 73909 <br /> Cedar Rapids, IA 52407 3. Service Type <br /> ®Certified Mail® p 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 <br /> (Transfer from service labeg 7 014 2120 0001 7885 6637 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />