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THE FACE OF • •` GRADUALLY AND EVENLY FROMDARK TO LIGHT AND HAS MICROPRINTING
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<br /> RCTI R/T C3&117788a' 6�}
<br /> i
<br /> ' I
<br /> Amount
<br /> Pay SEVEN HUNDRED.NINETY-ONE USD AND 00/ 100 g** •** ** *791.00
<br /> ! VOID 90 days after date of check
<br /> he to COLORADO DIV OF RECLAMATION,
<br /> order of MINING & SAFETY I
<br /> 1313 SHERMAN ST., ROOM 215
<br /> 1
<br /> DENVER CO 80203
<br /> UNITED STATES
<br /> Authorized ignature
<br /> I �
<br /> I '
<br /> I
<br /> Vendor No Date 06/28/2018 Check No
<br /> Purchase Order Invoice Invoice Invoice Discount Net
<br /> Mine Number Date Number Amount Amount Amount
<br /> 05/23/2018 M1982036 791.00 0.00 791.00
<br /> Detach before
<br /> 46 depositing. Totals $791.00 $0.00 $791.00
<br /> No acknowledgment
<br /> required.
<br />
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