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C, <br />Transamerica <br />Insurance Services <br />Transamerica Premier Insurance Company <br />w~w....:,•.e.e u~... ,..•r G•a.n~ <br />TRANSAMERlCA PREMIER INSURANCE COMPANY <br />WESTERN STATES BOND AGENCY <br />~ State of Colorado ~ ~ Western States Bond Agency <br />Division o: I*_inerals aad !;eaiosy 910 15th St. Suite 750 <br />1313 Sherv~an St., Rr,oa 21: Denver, Colorado 80202 <br />Denver, CO 80203 <br />L J <br />STATUS <br />BOND NO.; 3738749 <br />PRINCIPAL: Coloracle West t,Efi51n{; <br />OBLIGEE: State ei Colorado CONTRACT AMOUNT $ 35C,~i7.3% <br />DESCRIPTION: cFc/EAST Pit Coal Reclamation Proiect <br />The TRANSAMERICA PREMIER fNSURANCE COMPANY is theSurety on iheabove Bond. We <br />will appreciate your cooperation in providing the information requested below. <br />Please return the form so we may have current status information on the captioned job. A <br />business reply envelope is enclosed for your convenience. Thank you for your assistance. <br />Sincerely, <br />[ItsCEr:: ScatES Bond Agency, Inc. [~ <br />Band Department D <br />IF THE CONTRACT HAS BEEN COMPLETED: <br />1. What was the completion date? <br />2. What was the final contract price? <br />3. Was the work satisfactory? Ii no, explain <br />• <br />Date of Acceptance? - <br />Has full amount been paid? <br />4.Have all labor and material bills been paid? If no, explain <br />IF THE CONTRACT HAS NOT BEEN COMPLETED: ~ y ~d <br />1. What percent of work has been completed to date? _ <br />2. Total amount paid to the Contractor to date: $ ~~~~~ QJ °z- ~7 <br />3. What is the amount of the retainage withheld? $ ~~ ~~ <br />4. Is the Contractor paying his labor and material bills? ~'~ ~ r CLn wY ~GV~2i-~J <br />5. What is the anticipated date of completion? <br />6. Is the work being accomplished and progressing satisfactorily? <br />If no, explain: <br />Firm <br />Rv <br />jAUtnorized Signature) (iiuel <br />Address: <br />h s understood fiat the mbrmn+on onn:a~ned he•eln s lurn,ched as a manor of rnunesy for <br />Me m~4denual use c! arc ;,. *:'Y': an e~o'z ~wor. of o; ~cnn n. s also a_raed <br />Inal ,n fumgnmg ma •n!SSrn.]LC •., no gad'anry Or vart2ni% GI aCCO'aCy or rprteChea ~5 <br />made eM rw iespon5~d~nry ii assumed as a result of reliance by trio su,ery. wnelner suU+ <br />mlormauon .c lurnrcneo by tM owner a by rn ucnnea a eng,naer as Ne anent el <br />Te owner <br />City, State _Zip Date: <br />