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¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Western Mobile Northern, Inc. <br />dba Lafarge-Northern <br />11409 Business Park Cir #200 <br />Longmont, CO 80504 <br />A. <br />? Agent <br />B.41eived by (PAnteTName) C. Date of Delivery- <br />1 ? -oZ7 <br />D. Is delivery address different from item 1? ? Yes 1 <br />If YES, enter delivery address below: ? No i <br />i <br />I <br />i <br />3. Service Type <br />K Certified Mail ? Express Mail i <br />? Registered Return Receipt for Merchandise i <br />? Insured Mail C.O.D. i <br />4. Restricted Delivery? (Extra Feel ? Yes <br /> 2. Article Number <br />(Transfer from service labeo <br />7008 1830 <br />0003 6839 1865 <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540 <br /> U.S. Postal ServiceThl U.S. Postal Service,,, <br /> CERTIFIED MAILV, RECEIPT CERTIFIED - ECEIPT <br />?r1 <br />(Domestic Only; Coverage Provided) <br />I •? <br />(DOMestic Mail Only; No insuranc <br />e coverage , <br />CO r <br />,q r-1 <br /> <br />j <br />? Ocj <br />if <br />rr ' <br />' <br />CO <br />Postage <br />$ CC) <br /> <br />0 <br />Postage <br />$ ,y? <br />t <br />?11 - - ^ <br />w?S <br />(11 Certified Fee 2 80 ? G <br /> <br />Postmark <br />e rrt Certified Fee O \ <br /> <br />? <br />C3 Return Receipt Fee <br />(Endorsement Required) <br />2 <br />3 <br />r. Here Return Receipt Fee <br />(Endorsement Required) <br />Z <br />30 tmark <br />are <br /> , <br />r O , <br /> <br />r3 Restricted Delivery Fee <br />(Endorsement Required) <br />C3 Restricted Delivery Fee <br />(Endorsement Required) <br />M <br />cc <br />Total Pr...-- M <br /> <br />Total PO•' - ^ ^- <br />5 . i' <br />Q <br /> <br />d 1`. <br />A --- r-q <br />c0 <br />C3 ent o <br />Western Mobile Northern, Inc. co <br />C3 T-55175- <br />Gino and Cheryl A. <br />• <br />Tori <br />o Sir'eei, A dba Lafarge-Northern E3 <br />[l- Sfieef,A <br />a 4704 O Street <br />or PO Be <br />, <br /> or PO B. <br />city sia 11409 Business Park Ctr #200 -° , <br />C;ry' Siih Greeley, CO 80634 <br /> Longmont, CO 80504 pi".9 WWI <br />¦ Complete items 1, 2, and 3. Also. complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to the back of the maliplece, <br />or on the front If space permits. <br />1. Article Addressed to: <br />Gino and Cheryl A. Tori <br />4704 O Street <br />Greeley, CO 80634 <br />A., S grf r <br />? Agent <br />? Addressee <br />i <br />B. eived by (Printed Name) C. Date of Delivery <br />D. Is deliveryaddress differs f dem 1? ? Yes <br />If YES, enter delivery ad s gyp{ rN No <br />9 <br />3. ServIce Type <br />Certified Mail z Mall <br />? Registered V R6? t roh <br />? Insured Mail ? . <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number 7008 1830 0003 6839 1766 <br />(Transfer from service /abeQ <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-o2-M-1540