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REP23196
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REP23196
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Entry Properties
Last modified
8/24/2016 11:55:41 PM
Creation date
11/27/2007 3:38:42 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1981256
IBM Index Class Name
Report
Doc Date
6/30/2003
Doc Name
Annual Fee Payment/Report
Permit Index Doc Type
Annual Fee / Report
Media Type
D
Archive
No
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CLAIM VOUCHER <br />Submitted by: <br />Yuma County Road & Bridge <br />1310 S Blake <br />Wray, CO 80758 <br />Date: 05/19/2003 <br />RECEIVEQ. <br />}UN 3 0 2003 <br />Division ~f Minerals and GeeloAY <br />Reference: Permit Fees <br />Order/Req : 050-053003 <br />Dept: <br />Date: 05/30/2003 <br />Pay TO: Div of Minerals & Geology <br />1313 Sherman St Rm 215 <br />Denver. CO 80203 <br />QUANTITIES <br />Ordered Recd Stock/ <br />Item No. <br />Description Unit <br />Price <br />Invoice Date <br />Recd <br />Account <br />Total <br />1.000 1.000 M-1981-250 annual fee Brand 688 .0000 M-1981-250 05/12/2003 02-704-6455 688 .00 <br />1.000 1.000 M-1981-254 annual fee Collette 281 .0000 M-1981-254 05/12/2003 02-704-6455 281 .00 <br /> <br />1.000 1.000 M-1981-256 annual fee Ekberg 688 .0000 M-1981-256 05/12/2003 02-704-6455 688 .00 <br />1.000 1.000 M-1981-258 annual fee Fadenrecht 281 .0000 M-1981-258 05/12/2003 02-704-6455 281 .00 <br />1.000 1.000 M-1981-260 annual fee Gelvin 281 .0000 M-1981-260 05/12/2003 02-704-6455 281 .00 <br />1.000 1.000 M-1981-176 annual fee Groves 688 .0000 M-1981-176 05/12/2003 02-704-6455 688 .00 <br />1.000 1.000 M-1983-061 annual fee Kurtzer 688 .0000 M-1983-061 05/12/2003 02-704-6455 688 .00 <br />1.000 1.000 M-1981-178 annual fee May 688 .0000 M-1981-178 05/12/2003 02-704-6455 688. 00 <br />1.000 1.000 M-1981-179 annual fee Mekelburg 688 .0000 M-1981-179 05/12/2003 02-704-6455 688. 00 <br />1.000 1.000 M-1981-263 annual fee Mullins 688 .0000 M-1981-263 05/12/2003 02-704-6455 688. 00 <br />1.000 1.000 M-1989-038 annual fee Oestman 688 .0000 M-1989-038 05/12/2003 02-704-6455 688. 00 <br />1.000 1.000 M-1981-267 annual fee Soehner 281 .0000 M-1981-267 05/12/2003 02-704-6455 281. 00 <br />Total: sszl;.oo <br />I DO HEREBY CERTIFY this claim voucher is a true and accurate accounting of goods and/or services received <br />pursuant to the referenced purchase order. <br />AUTHORIZED SIGNATURE: <br />
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