EFTA Document EFTA01350228

3 gis 01 CO O NES, LLC 6100 RED HOOK QUARTER, 83 ST. THOMAS 00802 PAY TO ORDER OF THE New York State Insurance Fund One Thousand One Hundred Forty-Seven and 92/100 The State Insurance Fund Workers' Compensation P. O. Box 5238 New York, NY 10008-5238 MEMO DEUTSCHE BANK TRUST COMPANY AMERICAS NEW YORK, NEW YORK 10154 1-103/210 1265 12/28/2016 $ "1,147.92 I °LIARS t Ei 9 8 >- Z 2 (...9 9 co )- Z 0, ci LL D CC -J < < P Z Z LLI 0 0 Z Z OO 0 C.) EFTA01350228