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' ~l <br />t <br /> <br />! iiere~y certify tnat I sarved a copy of the fore9oinq <br />'+JiICE OF PaJPOScO aMOJ'lT ;,F CIVIL PE"InCTY on the operator <br />tnrrain Jescri~au by ______(~)~~ U9r5onal 5•'_rvice upon tha <br />operatur or its r?;,rzsentativ? at ________________________ <br />__________=_~. .-_______r CUIJr d~~O On <br />19___, ur ,~_(u )~; Dy d?pOSi ti n~~ d Crue Copy thtryOf first <br />C1d5S pOSt]y~ ;~r2pdiU in the 'JnitEd SCdteS 'nai15 9t veneer, <br />Coloracn, ,duras~d to tr.. o~ar]tor at Lh~ aJdress abova, on <br />_ 17 c ~---~L---------' I a l6C'l , <br />___________________ _1.-.__-______________ <br />$yy1 ~~)ndtur2 <br />U~O~~~'r~ G ~~C1 CY IZ' <br />wame ?rintzu <br />-- Cn?ck applicablz method of service. <br /> <br />The Opel dtOr abOV2 ~eSCrib~d hBreby r9^yue5t5 an a55e55- <br />,nant Or settlamznt confarenc~ as permitted by G.R.S. 34-33-123(°). <br />------------------- <br />7perator <br />~y--------------- <br />(Si,jnatUr2) <br />Date --------------------' 1~---- <br /> <br />