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<br />PLEASE DETACH THIS REMITTANCE BEFORE DEPOSITING CHECK <br />ast 'd den AI B1 Monitoring Report <br />VENWR r PAYEE NAME NUMBER YYD~p Nr NUMBER T <br />t <br /> <br />GE ACCOUNT <br />DISTRIBUTION fnDE DISTRIBUTION AMOUNT <br />INVOICE <br />NUMBER DR (BLANK) <br />CRI-) NERAL <br />LEDGER .ae Yuwea•R cosr itEY <br />GROSS <br /> NUMBER <br />eounweYr <br />VYpER <br />Ywwr cooE <br />AMOUNT RETAINAGE DISCOUNT <br /> <br /> <br /> <br /> <br /> <br /> <br />REQUESTED BY: PS/MH-lg <br />DATE PREPARED: <br />MO. DAY YR. <br />PAYMENT TO THE ACCOUNT OF <br />FLATIRON MATERIALS COMPANY <br />P.O. BOX 504 • FORT COLLINS, COLORADO 80.522 <br />