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Cediftied Mail Provides: spepia.e.„..._.sGs <br />A mailing receipt IC <br />s A unique identifier for your maiipiecer I le ft. M — iqel (Q_ bbl <br />■ A record of delivery kept by the Postal Service for two years <br />Important Reminders: <br />o Certified Mail may ONLY be combined with First -Class Mail® or Priority Maii®. <br />® Certified Mail is not available for any class of international mail. <br />o 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 Form 3811) to the article and add applicable postage to cover the <br />fee. Endorse mailpiece "Return Receipt Requested ". To receive a fee waiver for <br />a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is <br />required. <br />o 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 />Safeco Insurance Company of America <br />14123 Denver West Parkway <br />Golden, C0180401 <br />_ 2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />UNITED STATES POSTAL SERVICE <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 <br />etrvratta.,,i - g - 11 <br />Spec , _gw . , <br />File in • 1RZtp -6ST <br />r4 <br />a <br />m <br />m <br />O <br />A. Signature <br />X 2tf <br />For$delive", mfiirmatcoray sitrour w b ite at www .usgroinr, <br />mr.. �es� "ter . 9€' r- y,p.�+ry.. ^i:'9c8 �.. a - .• >,:. <br />omesticxMat Only No Insurance Coverage Provided) <br />Re <br />(Endors, <br />Restric <br />(Endorse <br />Total Postage & Fees <br />PS Form 3800. August 2006 <br />See Revel se for ns n <br />Sent To <br />Street, Apt. No.;1 <br />or PO Box No <br />City, State, ZIP <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />709 282p -- <br />0003 5701 4804 <br />Domestic Retum Receipt <br />Postage: <br />Certified Fee: <br />Return Receipt <br />Total Po <br />Agent <br />Addressee <br />3. Service Type - <br />❑ Certified Mail ❑ / Eicpress Mail <br />❑ Registered ❑ Retum Receipt for Merchandise ' <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />85 -02 -M -1540 <br />stage <br />SENDER: COMPLETE THIS SECTION <br />COMPLETE THIS SECTION ON DELIVERY <br />B. Received by ( Printed Name) <br />t_0 <br />C0 <br />LO <br />to of Delivefy <br />` 1 / 1 ( <br />0 0 <br />S TA 0.44= <br />Feet <br />U9 -8 ?0 <br />5:59 <br />Fee '" <br />First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />Safeco Insurance Company of America - -- <br />14123 Denver West Parkway <br />Golden, 001180401 <br />