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I - - <br />UNITED STATE P_Q, TTAlr.SF.,RJf{C1 . <br />.: Sr dw:oF f 5,.;4. x4 <br />???? i .,, . •?.,,,?„ I>rsttJlas,?,71)fhft? <br />tage$,"eeo Pi <br />D <br />}? err171t t?1(f Qn? Q <br />F*Sender.: Please print your name, address, and ZIP+ In this box • <br />STATE OF COLORADO <br />DEPARTMENT OF NATURAL RESOURCES <br />1 DIVISION OF RECLAMATION, MINING 8r SAFETY <br />1313 SHERMAN STREET, SUITE 215 <br />DENVER, CO 80203-2243 ? <br />Spec. 9 Py? G5 <br />File - Iq'84-io,8 <br />- 'Jill Iddij T11 <br />_ <br />Certified Mail Provides: Spec. Postal <br /> <br />¦ A mailing receipt File # <br />¦ A unique identifier for your mailpiece <br /> <br />M ? <br />MAILT. RECEIPT <br />(Domestic 'Provided) <br />¦ A record of delivery kept by the Postal Service for tw ye m <br />Important Reminders. <br />¦ Certified Mail ma <br />ONLY <br />M Postage; •° <br />C <br />y <br />be combined with First-Class Mail®or Priority Maile. <br />¦ Certified Mail is not available for any class of international mail. <br />¦ NO INS ertified F $0.44 tt <br />Fee: <br />Return Rec <br />i <br />8 <br />X2 <br />URANCE COVERAGE IS PROVIDED with Certified <br />valuables, please consider Insured or Registered Mail <br />MCI For e <br />0 <br />. <br />pt Fee: <br />$2.30 <br />. <br />¦ For an additional fee, a Retum Receipt maybe requested to provide proof of <br />delivery. To obtain Retum Receipt service, please complete and attach a Retur <br />Receipt (PS Form 3811) to th <br />ti O <br /> <br />M Total Postage & Fe <br />e3: <br />(Endorsement n $5 <br />; <br />n <br />e ar <br />cle 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 USP <br />required <br />Postmark on your C <br />if ?w - <br />Restricted Delivery Fee <br />E <br />d <br />R ;54 <br />. <br />ert <br />ied Mail recei t is <br />P O n <br />orsement <br />equired) <br />( <br />¦ For an additional fee, delivery may be restricted to the addressee or <br />addressee's authorized aggent. Advise the clerk or mark the mailpiece with the <br />endorsement RestrictedDeiivery~ m <br />nJ <br />M <br />Total Post e & Fees <br />¦ If a postmark on the Certified Mail receipt is desired; pleaase re <br />cleat the post office for postmarking, If is postmark lease Cert fled Mail <br />receipt is not needed, detach and affix lab <br />l <br />i a7 Sent To X <br />Washington International Insta a <br />?freet <br />C <br /> <br />e <br />w <br />th postage and mail. <br />IMPORTANT: Save this recei <br />t a <br />d 0 <br /> <br />r` <br />Qe, <br />,l <br />ompany <br />orPO6 <br />475 N. Martingale Road, Suite 850 <br /> <br />p <br />n <br />present it when making an Inquiry. <br />Form 3600, August 2006 (Reverse) PSN 7530-02-000-9047 ,a <br />?;ry sip Schaumburg, IllinoisJ60173 <br />ORMS-1313 Sherman, Rm 215, Denver, CO 80203 2006 PS 3800. August see Reverse for Insir <br />ti <br /> uc <br />ons <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 />A* <br />Washington International Insurance Company <br />475 N. Martingale Road, Suite 850 <br />Schaumburg, IllinoisJ60173 <br />2. Article Number <br />(Transfer from service iabeo <br />7008 3230 0002 7253-3634 <br />ra rarrin acs 1 1, February 2004 •t estic Return Receipt <br />A. Signature <br />X ? Agent <br /> ? Addressee <br />B. Received A?? T !. C. ate of Delivery <br />D. Is delivery address di a eTW item 17 ? Yes <br />If YES, enter delivery address below: ? No <br />J. Service Type <br />? Certified Mail 0 Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />? Yes <br />?e25s5•e??na?tsa }