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~ III IIIIIIIIIIIII III <br />Transamenea Transrica Premier Insurance Company <br />•~,,.~„~e.n.e•, a,n. ,n,r Ue,ana <br />Insurance Services <br />TRANSAMERICA PREMIER INSURANCE COMPANY <br />WESTEktN STATES BOND AGENCY <br />~ Stag of CDlorado ~ <br />Division of h!inera}l1s and G~o;ogy <br />1313 She C{rdl $t. , I'.nV ~ ~:iJ <br />Denver, CO 80203 <br />~ ~ <br />STATUS <br />37"08749 <br />BOND No.: <br />PRINCIPAL: Color <br />OBLIGEE: st°" <br />~ Western States Bond Agency <br />910 15th St. Suite 750 <br />Denver, Colorado 80202 <br />CONTRACTAMOUNT$ 35C•`'`•~' <br />DESCRIPTION: GEC/EAST Pit Coal2eclamaticu Proitct <br />The TRANSAMERICA PREMIER INSURANCE COMPANY is the Surety on the above 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 />'rl~ster: States Bond A~,ency, Inc. <br />Bono Deparrmenl ~ _ <br />IF THE CONTRACT HAS BEEN COMPLETED: <br />1. What was the completion date? Date of Acceptance? - <br />2. What was the final contract price? Has full amount been paid? <br />3. Was the work satisfactory? If no, explain <br />4.Have all labor and material bills been paid? If no, explain <br />IF THE CONTRACT HAS NOT BEEN COMPLETED: ~,~ ~~ <br />1. What percent of work has been completed to date? <br />2. Total amount paid to the Contractor to date: $ a9li; 6So7• ~7 <br />3. What is the amount of the retainage withheld? $ ~ /d `7d <br />4. Is the Contractor paying his labor and material bills? ~5 ~ r 0.n tic! ~rvllL[,rJ <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 />By: <br />(AUlhorixed Sipnalure) <br />Address: <br />City, State <br />ado Wr.st Leasinr, <br />oi-Coloiailci ---" <br />(Tills) <br />.Zip <br />U rs understood that the mfo.mn•ron rnntained hwnm is lu.ni~hed as a matter o1 munesv for <br />the ¢pnM1tleniial use of the s.. .~ • ..e•a'y an exp25sion of opi^~on I[ .5 also agread <br />that m lumKhmg {ns mlbrma6Cf., no g~aranry or war2nry of accuracy or correuoess rs <br />made entl n0 re5pOn51bill[y 4 a55Omed a5 a re6ull of fel2nCe by the 5u:ery. Whether 5JU <br />inlormalwn Is Wrnronsd by Ihi GwrlYr IX Dy M atChri84IX enQinaer a5 {hC agen{ BI <br />Ole owrwr <br />Date: <br />