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<br />~i <br /> <br />i~ <br />' [ hereby certify that I carved a copy of the for25oing <br />N~f[CE OF PRJPOSeO aMOU'aT OF CIVIL PE~~eLiv on the operator <br />tnerein described by ______(a)= personal service upon the <br />operator or its representative at ___________~,__________ <br />_ ____ ___________. Colorado on ___________~. <br />19~_, or __X__(b) by depositing a true copy thereof first <br />class postage prepaid in the United ;tares mails a± Denver, <br />ColoradoJu~d3resed to 80a operator at the address above, on <br />---------- Y -----, 19_--' <br /> <br />Signature <br />__EB~D_B~.~AI~I11~B~~l~m.~~.i4[L.~Pgci~list ------- <br />Name Printed <br />-- Check applicable method of service. <br />flE9!lE.S?_FQR_~4~E3Ey~E ... <br />The operator above described hereby requests an assess- <br />ment or settlement conference as permitted by C.R.S. 34-33-123(S). <br />Operator <br />~.. <br />By----------- <br />(Signature) <br />Date <br />CNR/L%lODOS/1CE <br />. 19 <br />.,~ <br />... <br />