Laserfiche WebLink
._ ~,~..~, b9: 3a CENTENNIAL INS ~ 8523759 <br />C~1/~- svRerr 9M <br />cNa SuREiv <br />le] S0. PHILLIPS 4VENUE <br />SI9UX FALLS, S.D. 57192 <br />Prlnclpai Information: <br />MATMIAS CDNCRETE, INC <br />P, 0. BOX 266 <br />MONTE VISTA, CO 81144 <br />N0.336 D02 <br />Transaction Report & lnvolce <br />~D: 000140536 ' <br />i <br />Agency Code: OS-00324 <br />CENTENNIAL AGENCY INC <br />P 0 BOX 8210 <br />PUEBLO CO 8!008 <br />7raneactlon Deecrlptlon: RENEHAL <br />Number: l4zlo7en7 <br />Witten By' CDMINENTAL CASUALTY CoxPANY <br />Desch Ddon g,U1D i GRA VEI REC LAI'UTIDN 110ND <br />Obliyea 3TATE Of COLORADD <br />AIMED LA10) RECLAMAT IDN DIV. <br />DEPT. OF NATURAL RESOURCES <br />1313 SNE 41uM STREET, RDON 21b <br />DEIN ER, CO X0203 <br />Effective Date: o4-zz•zooi <br />Espusuon Data: oc•zz•zoot <br />".u Rg ni ~Bn 8~ty: (19,400.00 <br />Penewal Method: INVOICE <br />Transaction Effective Date: 04/22/Z001 <br />nE PNP <br />O'9ANNDN PIT, PERMIT N0. N•60-201 <br />tC <br />JAN 2 9 2001 <br />Centenniallnsurance <br />PREnIUN <br />wrtv •w mer gmOV~ mrD AIW b uu a• o blllip/orvd'/Invooe <br />eNA SURErrgM tNVOice <br />=nE NO i EFFECTIVE GATE I ANNIVERSARY OaTE <br />~/r~~, <br />DAOCESS Da7E <br />Di-73-n1 <br />s217.00 <br />i <br />PFJlAITY <br />519,600.00 <br />DE FMP <br />:=aCiP>: MA~H1A~ LU Nt;Ktit, 1fVL <br />P. 0. BOX 266 MONTE VISTA, CO 81144 <br />sa sra-E CD ~ ' <br />,e seaiv-~oN SAND 8 GRAVEL CLAHA - `ANNON T, PERFI7 0. M-BO-201 <br />05-00324 I CHARGE 5217,00 <br />.~.-,a.~~,. <br />~EN•ENNI AL aGENCV INC <br />P 0 BOx 8210 <br />PUEBLO CO 81908 <br />