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UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> LISPS <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 Spec TN <br /> C s CanL;-L accept File kvi►q 8yq,� <br /> �t'tltlt�t�i��ttttls��►ititt1►111111i1�ts�lll�lt�il�ti�lltl��tijli� <br /> COMPLETE <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. X Patrick O'Donnell ❑Agent <br /> ■ Print your name and address on the reverse ❑Addressee <br /> s that we can return the card t you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the <br /> e mailpiece, <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, 3. Service Type <br /> P O Box 73909 ❑Certified Mail® ❑Priority Mail ExpressW' <br /> Cedar Rapids, IA 52407 ❑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 label) 7 014 2120 0001 7 8 8 5 6620 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />