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No. 09 ~ . OG <br />f <br />161690-620500 <br />~ VENDOR NO, 16000017$6 <br />DETACH BEFORE CASHING <br />TOTAL <br /> <br /> <br /> ' MINED LAND RECLAMATION DIVISA N~ 0 0 4 8 6 3 <br /> 1313 Sherman Street Room 423 <br /> ~~~,~~. _, 1' G <br />Denver, CO 80103 <br />O S <br /> DATE ~ IB <br />(303) 866-3567 <br />. <br /> 0(~ (~.~ <br />RECEIVED FROM ~Dl"r\O~y2.0 1 \1 Ml/YlE1 L-!~ <br /> CD <br />~ ~~ <br /> THE SUM OF1 ~ .,~/eA cc.+N ~} ~„O~F /on DOLLARS $ <br />~ Q~ <br /> <br /> FOR \1N1/1'1 K.~ 1~1_~'~d `J V/~~V 1 MOCK <br /> <br /> AMOUNT DF ACCOUNT, , .... $ /~p /~ 1' <br />~ <br />~ ~o <br />f <br /> Ull <br />u <br />AMOUNT PAID ................ $ ~~••/// <br /> BALANCE DUE ........ ......$ BY~~O~15~L1 <br /> <br />