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J/ <br />USPS <br />w, w r xw a Pcrmlt- No' G-10 <br />• Sender: Please print your name, address, and ZIP+4 in this box • <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 Spec <br />File m -199 - m2 <br />llt,fril„rririlir,aril„?irlrriritirri„llr,ll,rritittlriti <br />Certified Mail Provides: <br />¦ A mailing receipt 5p2C. QDA. c S <br />¦ A unique identifier for your mailr An <br />¦ A record of delivery kept by the JO ryit'; l r Oa <br />Important Reminders: &4_wUU A- .2 - c3 - L <br />¦ Certified Mail may ONLY be combirleld with First-Class Mailo or Priority Mail. <br />¦ Certified Mail is not available for any class of international mail. <br />¦ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For <br />valuables, please consider Insured or Registered Mail. <br />¦ For an additional fee, a Return Receipt may be requested to provide proof of <br />delivery. To obtain Return Receipt service, please complete and attach a Return <br />Receipt (PS Fonn 3811) to the article and add applicable postage to cover the <br />fee. Endorse mailpiece "Retum Receipt Requested". To receive a fee waiver for <br />a duplicate return receipt, a US So postmark on your Certified Mail receipt is <br />required. <br />¦ For an additional fee, delivery may be restricted to the addressee or <br />addressee's authorized agent. Advise the clerk or mark the mailpiece with the <br />endorsement "Restricted Delivery". <br />¦ If a postmark on the Certified Mail receipt is desired, please present the arti- <br />cle at the post office for postmarking. If a postmark on the Certified Mail <br />receipt is not needed, detach and affix label with postage and mail. <br />IMPORTANT: Save this receipt and present it when making an inquiry. <br />PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 <br />DRMS-1313 Sherman, Rm 215. Denver, CO 80203 <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 mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Washington International Insurance Company <br />A Suite 850 <br />U.S. Postal Service r. <br />ii CERTIFIED MAILT. RECEIPT <br />cc' (Domestic (M e For delivery information visit our website at rt ! F ;., <br />ru <br />17- Posmnai tc, ? $0.44 <br />Postage: $2.80 <br />C3 Certified ec ° $2.30 <br />3 (End Return R glipt r <br />Res <br />C3 (End( $5.54 <br />M Total Postage-&- <br />n j Tota --- I w <br />M <br />CID Sent u <br />o uireer;' Washington International Insurance Company - <br />t,- o,PO 475 N. Martingale Road, Suite 850 <br />cry, Schaumburg, Illinois 60173 <br />SECTION COMPLETE THIS ON DELIVERY <br />A. Signature <br />? Agent <br />X ? Addressee <br />` <br />B. Received byff Name) C. Date of Delivery <br />HV i CRU <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />475 N. Martingale Roa 3. Service Type <br />Schaumburg, Illinois 60173 ? Certified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number 7008 3230 2002 7252 6308 <br />(Transfer from service label) <br />t625s5•e2•tt <br />` PS Form 3811, February 2004 Domestic Return Receipt <br />UNITEDT yyy First-Class Mail <br />k...,+6`+. <br />Postage & Fees Paid <br />.01 <br />