Laserfiche WebLink
CALHAN I FALCQId I ELLICOiT <br />Check <br />:C <br />P,Q, Sns <br />9;) <br />• Cali�un, OQ >;1#iUB., <br />Cashi®rs Chi <br />7i9 <br />{ ) 37-2727 • {719] 445.3fi5{1 • (719).683-3999 =� Og <br />aww.ynurfsh.ciun / /2019 <br />RW,,e-­"' Remitter: HiLlto Gra�ei <br />Pay tat Colorado Department of Mining p <br />POW0182-35BIi021 <br />Pay <br />ExacU even Thousand Two Hundred Eighty Dollars And Zero Cents <br />r ¢ <br />[V CO <br />C%.j cl Cotarado Department of Mining <br />CV I� a <br />r <br />Amount: $11,280.00 <br />Z SIGNATURES EQUIRED IF OVER $1000 <br />�a .;, AUTHORIZED SIGNATURE <br />