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AND CONDITIONS OF THE COLORADO SELF-STORAGE LIEN ACT ( 38-21.5-101-105, C.R.S.) UPON OCCUPANT S DEFAULT, INCLUDING, BUT NOT LIMITED TO, THE NON-PAYMENT OF RENT Occupant s Name: Phone: Address: City: Zip: Alternated Address (optional): City: Alternate Phone: Zip: Emergency Phone: E-Mail Address: Vehicle Make #: License #: Annual Rental Rate: $120.00 per year, per space State Issued: Space Number: Description of Propert.

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