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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2006039 <br />Chevron Shale Oil Company, a division of Chi <br />Michael Haub <br />100 Chevron Road <br />Suite 102 <br />Rangely CO 816480000 <br />Receipt #: <br />25645 <br />Date: <br />12/01/2017 <br />Permit: <br />M2006039 <br />Check #0024231141 4300-MAFO Minerals Annual Fees $323.00 <br />User: sdt <br />Payer: Chevron <br />DUE 12/8/17 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />