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Home My WebLink About950186.tiff_ .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. RESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO CONO-SERVICES, INC., DBA CONOCO NO. 06394 - EXPIRES APRIL 5, 1996 WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, Cono-Services, Inc., dba Conoco No. 06394, presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a County Retail License for the sale of fermented malt beverages, containing not more than 3.2% of alcohol by weight, in sealed containers not for consumption at the place where sold, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II., C., said applicant has paid the sum of$57.50 to the County of Weld for the renewal of the existing license, and WHEREAS, said applicant has exhibited a State License for the sale of 3.2% fermented malt beverages, in sealed containers not for consumption at the place where sold, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 3851 HIGHWAY 119, LONGMONT, COLORADO 80501 NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of Weld County, Colorado, having examined said application and the other qualifications of the applicant, does hereby grant License Number 95-02 to said applicant to sell 3.2% fermented malt beverages in sealed containers not for consumption at the place where sold, only at retail at said location; and the Board does hereby authorize and direct the issuance of said license by the Chairman of the Board of County Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which license shall be in effect until April 5, 1996, providing that said place where the licensee is authorized to sell 3.2% fermented malt beverages in sealed containers not for consumption at the place where sold, shall be conducted in strict conformity to all of the laws of the State of Colorado and the rules and regulations relating thereto, heretofore passed by the Board of County Commissioners of Weld County, Colorado, and any violations thereof shall be cause for revocation of the license. 950186 LC0031 ;Le (n/w-*,-r✓) SO T RENEW 3.2% BEER LICENSE - CONOCO NO. 06394 PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 18th day of January, A.D., 1995. BOARD OF COUNTY COMMISSIONERS \IXELD COUNTY, COL RA / /L�� L ATTEST' 7i ,`/ (1:1'4 1 Dale K. Hall, Chairman Weld County Clerk to the Board FXC:I ISFf IIATF r)F SI(;NIN(; (AYF) • BY. r Barb ra J. Kirkmeyero-Tem e 42-/�f-f�-li'e -"( "( f' L 4( Deputy Clerk to the Board f ° /eoorge E�Baxter O D AS TO FO ( v0��s�z r ,9� prNL/c.0 Constance L. Harbert ounty Attorne • W. yt V ,/ ,f) ; .2�7 950186 LC0031 - -T THIS LICENSE MUST BE POSTED IN PUBLIC VIEW OR 84p2 i Ip1921 STATE OF COLORADO • • DEPARTMENT OF REVENUE • Liquor Enforcement Division 1375 Sherman Street Denver.C.:.craco 80261 • CCNO-SERVICES :NC CCNCCO NCC6394 3851 HWY 119 i LONGMONT CO 80501 I ALCOHOLIC BEVERAGE LICENSE Liability Intormatlon Account Number County City Indust. Type Liability Data LICENSE EXPIRES AT MIDNIGHT 21-35816-0067 03 206 5541 C 040690 APR 05, 1996 Type Name and Description of Lrcens• Fee I • I 2122 3.2 PERCENT BEER RETAIL $ 50.00 I LICENSE (OFF PREMISES) i • 2190 1 COUNTY 85 PERCENT OAP FEE $ 42.50 i TOTAL FEEIS) $ 92.50 This license is issued subject to the laws of the State of Colorado and especially under the provision of Title 12. Articles 46 or 47. CRS 1973. as amended. This license is nontransferable and shall be conspicuously posted in the place above described This license is only valid through the expiration date shown above. Questions concerning this license should be addressed to the Department of Revenue. Liquor Enforcement Division, 1375 Sherman Street Denver.CO 80261. testimony whereof.I have hereunto set my hand. & MET lielta4 de FEB 0 2 1995 Division Director • Executive Dire for :;. t.: ., $(;!., 950186 w T P 387 471 667 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT-FOR INTERNATIONAL MAIL (See Reverse) Sent to CONO-SERVICES, INC. DBA, CONOCO NO. 06394 3851HWY 119 LONGMONT, CO 80501 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered N a Return Receipt showing to whom. Date. and Address of Delivery u j TOTAL Postage and Fees S Postmark or Date cd 0. a • 0. . . : : $` 950186 . i. .4 • -.a a`...; c 5" . •,:: 'A•c... .2.•.,„“ •4 •C.. 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" . .-• . . • . , 44' I 4 , • - • . , •, ', , , ' ' • • ' • 2 ' ' , 2 k , 2 %1 , 1 %7,)i 2 i ',- tic ,2( I 1'1 , I It' 'if;e AI' 1 • a' • 1\1,: ...i ki ,(4 x, i x 4 lei. rci I, '''' L. 14--\."."' .."` ;fr. - I I DR 8400(8/89) Colo.Dept.of Revenue Liquor or 3.2 Beer License Liquor Enforcement Division • 1375 Sherman Street License Number: License Type: Denver,Colorado 80261 Renewal Application - 866-3741 - Liability Information: Business Location: • • Current License Expires: z pc-40)12 An/ von YOUR PROMPT ATTENTION IS REQUIRED.FAILURE TO COMPLETE THIS FORM ACCURATELY • SIGN THE FORM AND PROMPTLY MAY RESULT IN YOUR LICENSE NOT BEING RENEWED. • ENCLOSE TOTAL AMOUNT DUE • • FILL OUT THIS FORM COMPLETELY AND CHECK APPROPRIATE BOX BELOW. • SUBMIT FORM TO LOCAL(CITY/COUNTY) ❑ This renewal reflects no changes from last application. LICENSING AUTHORITY FOR APPROVAL • Li There are changes from last application.(Report changes on form DR 8176-"Report of • CHECK WITH LOCAL AUTHORITY FOR AMOUNT Changes-Liquor and 3.2 Beer Licenses"and attach that form to this renewal application.) OF LOCAL FEES. OATH by APPLICANT I declare under penalty of perjury in the second degree that this application and all attachments are true,correct,and complete to the best of my knowledge. Authorized Signature: Date: r §usiness Phone: Title of Signer(I1 corporation)- - Sales Tax No. ATTACHED DR 8401 MUST BE COMPLETED(ALL 3 Cons) SUBMIT THE STATE COPY AND LOCAL(CITY/COUNTY)AUTHORITY COPY TO YOUR LOCAL(CITY/COUNTY)LICENSING AUTHORITY NO LATER THAN 45 DAYS BEFORE YOUR LICENSE EXPIRES. EXCEPTION: Wholesaler,manufacturer,importer,and public transportation system license renewals do not need Local Licensing Authority approval and must be returned directly to the Colorado Department of Revenue no later than 30 days prior to license expiration. REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY The foregoing application has been examined and the premises, business conducted and character of the applicant are satisfac- tory, and we do hereby report that such license, if granted,will comply with the provisions of Title 12, Articles 46 and 47, C.R.S. • THEREFORE THIS APPLICATION IS APPROVED. • Local Licensing Authority for: ❑ TOWN/CITY ❑ COUNTY Signature: -. Title • Attest Date Do NOT DETACH•Do NOT DETACH•Do NOT DETACH•Do NOT DETACH•Do NOT DETACH•Do NOT DETACH•Do NOT DETACH•Do NOT DETACH• Do NOT DETACH -BUSINESS LOCATION: r 0 C O . NAME: USE LICENSE NUMBER _ LIABILITY INFORMATION RENEWED LICENSE XI FOR ALL REFERENCE COUNTY CITY INDUST. TYPE LIAB.DATE EXPIRES AFTER O 33 W fJ CASH FUND STATE FEE CITY 85%OAP CO 85%OAP m TYPE OF LICENSE ISSUED — - - - - - -•m 66.01 (9) 41-9 (9) 45.9 (9) 37.1 (9) 49-1 (9) 13 r m z ' (D m m z Make check payable to: TOTAL AMOUNT DUE 0- • M COLORADO DEPARTMENT OF REVENUE EXTENDED HOURS—Applies only to Hotel and Restaurant,Beer and Wine,Club,Tavern, Extended hours? R and Arts licenses.If desired,check"yes"and enclose Total Amount Due PLUS$170.00. Yes E No r 950186 LC00 a1 DR 8401 (07/94) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1375 SHERMAN STREET ATTACHMENT TO LIQUOR OR DENVER CO 80261 (303)866-3741 3.2 BEER LICENSE RENEWAL APPLICATION This page must be completed and attached to your signed renewal application form. Failure to include this page with the application may result in your license not being renewed. Trade Na a of Establishment State License Number C'cr-)ceo *(3(03 `lJ/ e91- gee 71a- Ole 7 1.Operating Manager Home Address Date of Birth 01«vrIon Prai-i-'er301 -7 mini) St, (AAildsor co 60550 ( / 2. Do you have legal possession of the premises for hich this application for license is made? Yes No Are the.premises owned or rented: ()Lone r If rented,expiration date of lease: ❑ 3. Has there been any change in financial interest(new notes,loans,owners,etc.)since the last annual application?If yes,explain in Yes No detail and attach a listing of all liquor businesses in which these new lenders or owners,(other than licensed financial institutions)are ❑ materially interested. 4. Since the date of filing of the last annual application,has the applicant,or any of its agents,owners,managers,principals,or lenders Yes No _ (other than licensed financial institutions)„been convictedof acrime?.lf yes,attach a detailed.explanation. .. 5. Since the date of filing of the last annual application,has the applicant,or any-of its agents,owners,managers,principals,or lenders (other than licensed financial institutions),been denied an alcoholic beverage license,had an alcoholic beverage license suspended or Yes/ No revoked,or had interest in any entity that had an alcoholic beverage license denied,suspended or revoked?IIf yes,attach a detailed 11(l Elexplanation. See n -joonvnen 1ha T 7 t 6. Does the applicant,or any of its agents,.owners,managers,principals,or lenders(other than licensed financial institutions),have a Yes No direct or indirect interest in any other Colorado liquor license(include loans to or from any licensee,or interest in a�loo1__anttooanny Ir7V—r�T/ licensee)?If yes,attach a detailed explanation. sr r !n tfceinm e r1T .1J� 7. Sole owners or husband-wife partnerships answer this question.Since the date of filing of the last annual license application: Has ownership changed in whole or in part,from a sole owner to any other person,partnership,corporation,or limited liability Yes No company other than the licensee listed on your state liquor license?If yes,this license must be transferred to the new owner and may not be renewed.Contact your Local Authority immediately. 8. Partnership applicants must answer this question.Since the date of filing of the last annual license application: Yes No (a) Are there,or have there been any general partners added to,or deleted from the partnership?If yes,this license must be transferred to the new partnership and may not be renewed.Contact your Local Authority immediately. (b) Are there,or have there been any limited partners with a 10%or more interest,added or-deleted from the partnership?If yes,this license must be transferred to the new partnership and may not be renewed.Contact your Local Authority immediately. 9. Corporate applicants must answer this question.Since the date of filing of the last annual license application: Yes No (a) Are there,or have there been any officers or directors added to,or deleted from the corporation? If yes,complete and attach DR 8177 and submit to your Local Authority immediately. (b) ArG More-,or have there beerrany'stockhotder5 wit11-10%Or-mateof-the rsth stdck'adoed to,or delleted fro n'fhe tttpdrattbn'T ` _ _. •- -' If yes,complete and attach DR 8177 and submit to your Local Authority immediately. ��J� (c) Date of filing last annual corporate report with the Colorado Secretary of State: 1 10. Limited Liability Company applicants must answer this question.Since the date of filing of the last annual license application: Yes No (a) Are there,or have there been any managing members added to,or deleted from the company?If yes,complete and attach DR 8405 and submit to your Local Authority immediately. II (b) Are there,or have there been any members with 10%or more membership interest,added to,or deleted from the company? If yes,complete and attach DR 8405 and submit to your Local Authority immediately. I I ❑ (c) Date of filing last annual LLCO report with the Colorado Secretary of State: 11. Bed and Breakfast applicants must answer this question and certify compliance with 12-47-118.5 C.R.S.,to the state licensing authority by initialing the following listed questions: That it has no more than 20 sleeping rooms,and That it provides at least 1 meal per day at no charge other than for overnight lodging,and That it does not sell alcoholic beverages by the drink or in sealed containers,and That it shall not serve alcoholic beverages for more-than 4 hours in any one day,as follows: MONDAY HOURS TUESDAY HOURS WEDNESDAY HOURS THURSDAY HOURS FRIDAY HOURS SATURDAY HOURS SUNDAY HOURS From: m. From: m. From: m. From: m. From: m. From: m. From: m. To: m. To: m. To: m. To: m. To: m. To: m. To: m. rf 950186 DATE: JANUARY 11, 1995 TO: ROSEMARY LOPER, RECORDS FROM: OFFICE OF WELD COUNTY CLERK TO THE BOARD SUBJECT: LIQUOR LICENSE CHECKS Please run a records check on the following establishment. This information will be used by the Board of County Commissioners in considering renewal of liquor license. PLEASE RESPOND NO LATER THAN JANUARY 18, 1995. Thank you. ESTABLISHMENT: CONO SERVICES, INC., dba CONOCO#06394, 3851 HIGHWAY 119 LONGMONT, CO 80501 INCLUSIVE DATES: JANUARY 1994, through JANUARY 1995 BY: Shelly K. Miller, Deputy Call 356-4000, ext. 4226 WHEN COMPLETED, OR IF QUESTIONS. No violations on record. • BY:: ,4 ) VIOLATIONS: (PLEASE LIST ) BY: 950186 (sett MEMORANDUM WL`D C. TO: Board of County Commissioners January 12, 1995 COLORADO From: Keith A. Schuett, Current Planner II SUBJECT: Liquor license renewal LC - 31 — Conoco-Services, Inc. = o • dba Conoco #06394 _'� ' .� 3851 Highway 119 Longmont, Colorado 80501 `2 Part. East %, Southeast '/4, of Section, 3 Township 2 North, Range 68 West of the 6th P.14 Weld County, Colorado (131303000013) (SPR-7) The use is a permitted use in the C-3 Commercial Zone District of Weld County. M 4 “. 950186 CONO SERVICES INC P.O. Box 4784 - TR 3038, Houston, TX 77210-4784 73-1143039 STORE NO. ADDRESS CITY ZIP Colorado *06302 601 South Broadway Street Boulder 80303 *06307 14490 East 6th Avenue Aurora 80011 *06308 6724 W. Canyon Avenue Littleton 80123 *06309 12001 East Iliff Avenue Aurora 80014 *06310 11090 North Colorado Blvd. Denver 80233 *06311 5091 South Jellison Way Littleton 80123 *06312 15351 East Iliff Avenue Aurora 80013 *06313 1191 S. Buckley Aurora 80017 *06314 4490 Peoria St. Denver 80239 *06315 9175 Harlan St. Westminster 80030 *06317 11515 N. Highway 83 Parker 80134 *06318 8170 W. Both Ave. Arvada 80005 *06319 19001 E. Quincy Ave. Aurora 80016 *06320 16810 E. Quincy Ave. Aurora soots *06324 8073 S. Broadway Littleton 80120 *06325 5810 Omaha Blvd. Colorado Springs 80915 *06326 3434 W. Alameda Denver 80223 *06327 10210 E. Arapahoe Rd. Englewood 80111 *06328 4140 Date St. Colorado Springs 80917 *06329 279 S . Federal Blvd. Denver 80223 *06330 1705 W. Uintah St. Colorado Springs 80994 *06331 4310 Fountain Blvd. Colorado Springs 80909 *06332 2350 Hancock Expressway Colorado Springs 80910 *06333 502 Sheridan Blvd. Denver 80223 *06334 3210 Youngfield Wheatridge 80033 *06335 1501 Colorado Blvd. Denver 80220 *06336 14501 E. Colfax Avenue Aurora 80123 *06337 13690 E. Alameda Pkwy. Aurora 80012 *06338 7444 West Chatfield Littleton 80123 *06340 290 S . Havana Aurora 80012 *06341 1985 Kipling Street Lakewood 80215 *06342 4315 N. Academy Blvd. Denver 80917 *06344 1100 S . Havana Aurora 80012 *06350 7199 N. Federal Blvd. Westminster 80030 *06351 3550 Downing, Unit C Denver 80205 *06352 4200 N. E. County Line Rd. Erie 80316 *beer only rev 9/93 950186. I1 Cono-Services Inc. Violations which have resulted in suspensions of the license 12-84 JeffersonCounty Ten day suspension for sale to a minor. 3-90 Arvada Five day suspension for sale to a minor;four of which are held in abeyance for 12 months. 9-90 Thornton Two locations, ten days suspension each;five to be held in abeyance for one year,a fine in lieu of suspension of three days,and two days actual suspension. 3-91 Dept. of Rev. Store#06326 in Denver received a one day suspension for failure to conspicuously display the liquor license, a fine was paid in lieu of suspension. 6-91 Longmont Store#06356. Received a 10 day suspension for sale to a minor. Paid a fine in lieu of suspension. 7-91 Broomfield Store#06370 Received a 7 day suspension for sale to a minor, 4 days to be held in abeyance for one year and a fine was paid for the other three days. 12-92 Denver Store 06421,received 10 day suspensionfor sale to a minor, held in abeyance. 1-93 Denver Store#06333. Received 10 day suspension for sale to a minor 8-92, held in abeyance. 1-93,Fine paid for 10 day suspension,20 days to be held in abeyance,for sale to a minor. 2-93 Broomfield Store #06412. Received 7 day suspension for sale to a minor. Four days held in abeyance,fine paid in lieu of remaining three days suspension. 7-93 State Store#06430(Westminster).Received a 3 day suspension for improper posting of a minor warning sign. Fine paid and two days held in abeyance for one year. 8-93 Denver Stores #6351, 6418, and 6335. Received 10 days suspensionat each location for sale to a minor. Sevendays were held in abeyance for a period of one year and a fine was paid in lieu of remaining three days suspension. 10-93 Broomfield Received 21 day suspension for sale to a minor. Ten days held in abeyance,a fine was paid in lieu of suspension of four days and seven days suspension were served. 4-94 Boulder County Received 5 day suspension for sale to a minor. Two days held in abeyance and three days served. 5-94, second violation, 14 day suspension. 11-94 Broomfield Received 31 day suspension,24 to be servedand 7 held in abeyance. • 11-3-94 CONO SERVICES INC P.O. Box 4784 - TR 3038, Houston, TX 77210-4784 73-1143039 STORE NO. ADDRESS CITY ZIP Colorado (continued) *06354 3809 Mulberry *06355 12354 Weld County Rd. Bri htonins 80521 *06356 1801 Hover Rd. g 80501 Love *06357 1260 14th St. , S.W. Loveland 80537and 80537 *06358 5009 N. Garfield *06359 3495 Fox St. Lovelande 80537 Com *06360 4981 E. 64th Ave. mr 80216 *06362 1110 S. Pierce Lakewood City 80226 *06363 14531 E. Alameda Lakewood 80226 Aurora *06364 7444 West Chatfield e 80012 Little *06365 5600 Southton 80123 Simms, Unit A Littleton 80123 *06366 7130 County Line Rd. *06367 774 W. 120th Ave. Highland Ranch 80126 Northglenn*06368 80234 *06368 1095 First St. Berthoud 3375 28th St. 80513 Boulder *06370 1601 Hwy. 287 Broo 80020 *06372 . 1550 W. 88th Ave. Thontonld 80221 Lafayet*06373 802 S. Public Rd. n 80221 *06374 2350 E. 120th Ave. Lafayette 80026 15900 WestGoldenon 80401 *06375 *06376 44th Avenue Golden 80401 *06376 8113 W. 94th Ave. Westminster 80020 *06377 10815 W. Jewell Ave. Lakewood 80226 7960 Niwot Rd. Niwot 80544 *06380 230 Broadway Sterling 80751 *06381 92 Poudre Canyon, Hwy. 28 Bellvue *06382805103 Hwy. 287 & N. Overload Tr. Rd. LaPorte 80535 *06383 2803 W. 10th St. Greeley 80631 *06384 213 18th St. Greeley 80631 *06386 1611 W. Eisenhower Blvd. Loveland 80537 *06390 1105 South Havana Aurora 80012 *06391 2880 S. Circle Drive Colorado Springs 80906 *06393 520 Peterson Road Colorado Springs 80915 *06394 3851 Hwy. 119 *06395 Longmont 80501 6794 N. Academy Drive Colorado Springs 80918 *06396 680 E. 84th Avenue Thornton 80221 *06402 400 E. 104th Thornton 80229 *beer only rev 9/93 r <� 44 ` ` s' 950186 CONO SERVICES INC P.O. Box 4784 - TR 3038 , Houston, TX 77210-4784 73-1143039 STORE NO. ADDRESS CITY ZIP Colorado (continued) *06406 1090 S. Havana Aurora 80012 *06407 303 S. Colorado Blvd. Denver 80222 *06408 2110 S. Federal Denver 80219 *06409 14401 E. 6th Ave. Aurora 800-11 *06410 3000 28th St. Boulder 80301 *06411 600 S. Broadway Boulder 80301 *06412 525 U. S. Hwy. 287 Broomfield 80020 *06414 330 S. Academy Blvd. Colorado Springs 80907 *06415 507 Garden of the Gods Colorado Springs 80907 *06416 515 N. Murray Blvd. Colorado Springs 80915 *06417 911 S . Circle Drive Colorado Springs 80910 *06418 3495 S . Monaco Pkwy. Denver 80207 *06419 500 W. 120th Avenue North Glenn 80234 *06421 2100 S . Monaco Pkwy. Denver 80207 *06422 785 Colorado Blvd. Denver 80211 *06423 4785 Federal Blvd. Denver 80211 *06424 8900 E. Hampden Denver 80231 *06426 5096 5 . Yosemite Greenwood Village 80111 *06428 5898 S. Broadway Littleton 80121 *06429 160 W. 104th North Glenn 80234 *06430 7995 N. Federal Blvd. Westminister 80030 *06431 4750 Kipling Street Wheat Ridge 80034 *06432 12085 E. Colfax Ave. Aurora 80010 *06433 5500 E. Arapahoe Boulder 80303 *06434 1003 N. Academy Blvd. Colorado Springs 80909 *06436 3700 N. Freeway Pueblo 81008 *06440 1013 cENTRE sT. Ft. Collins 80525 *beer only rev 9/93 950186 (conoco) __, D CYC:;TI James G. Fuqua Conoco Inc. Marketing Manager-Retail 6855 S. Havana, Suite 610 Rockies Regional Business Unit '.7fn9®wood, Colorado 80112 (3031 649-4022 '^ Fax: (303) 649-4020 January 3, 1995 Weld County P.O. Box 758 Greeley, CO 80632 Dear County Clerk: Enclosed you will find the application for the renewal of the beer license for: Conoco #06394 and payment in the amount of $92.50/$57.50 for the licensing fees. Please return the 1995 licenses(s) to my attention at 6855 S. Havana, Suite 610, Englewood, CO 80112. If you have any questions regarding the information submitted, please contact my administrative assistant, Kim Wood at 303-649-4019. Sincerely, James G. Fuqua JGF/kw License 9501% Vendor Code: 008765R08 C 001 - CONOCO INC Check No.: 03419586 S Voucher Invoice Invoice 1099 Gross ADJ Adjustment Discount Net H Reference Date Number CD Amount CD Amount - Amount Amount VENDOR NAME: COLORADO DEPARTMENT OF REVENUE IN CASE OF QUESTIONS ABOUT THE FOLLOWING INVOICES, PLEASE CALL (3031 649-4075 S 12778010C36211004 19941221 ROC93513 92.50 .00 .00 92.50 • • • INQUIRIES ON ABOVE INVOICES SHOULD BE DIRECTED TO PHONE NO. LISTED ABOVE TO CHANGE VENDOR NAME OR ADDRESS ONLY -- PLEASE CALL (405) 767-4342 TOTAL NET AMOUNT 592.50 m m $ t 't' 1A .2 co co m 5 toi a, LTA yma « '> 5 w m W O w O 2 �Y 2'c ,� CC P 387 471 _5 9 o ff a ;, 5 Er c e RECEIPT FOR CERTIFIED MAIL c m u w w p y v NO INSURANCE COVERAGE PROVIDED m E . ` E U cc w 1~y NOT FOR INTERNATIONAL MAIL 3 y 1.71 R C ❑ ❑ ❑ N cc (SEE Reverse) o, < cc a 01\\` 0 cr 9-� (� CD I 3 ❑ ❑ E �O E. 'W .> 1^ y a F' COLORADO DEPT OF REVENUE w = tV — w o Z J v b To wf0 W LIQUOR ENFORCEMENT DIVISION < co STATE CAPITOL ANNEX o «O Q o d co , t o co 9a 0 1375 SHERMAN ST E m cc O w O < m DENVER CO 80203 « c ❑'w v as ❑ a m 0 o Oo i 1E 0 �0IL Q a W Certified Fee ' 0 - y 'E o m o E z 'I Special Delivery Fee mm P 2 ag `o_ 2 E c W (~71 Restricted Delivery Fee 'c o o "J H a ' H a Return Receipt showing m d j ?SO .o. 7 A to whom and Date Delivered w a6 2 O c • o a F W O V U, 'NI,- N�' O�= V 2 2 cn q Return Receipt showing to whom. m C E o 0 10' m Date,and Address of Delivery ERVICE o v m o o c CC • O Z c F o =BWP R c c a W yea v a`' AD. ' TOTAL Postage and Fees S WRONG wc « c pF" O $ 00p w .., 'o 'ES c L B=BA w w w c E d¢ v i O W IF-I £ v OV 7-222 S, m Postmark or Date E E E o 0 o E a ; 2 a Q.' O a rn . t vmaN>.,22n20 «« c«w en / 7 c d 0 Y E O W C W O Qit— c / ^/� — / 2 w v o `OO« em s c . ¢CaQ w' V v$i a: o CO IL. LL >OL a= m 1 O W W 0 10 CI (n 0EEEm2 '€, - O'Q n z m m D; a l W ` aUm ' u.W 65 UUa4a 5. d 0-1 u) .-i q VJ• • • -5 • 2 • -5 i Lei 6 K 950186 Hello