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~ o <br />COLORADO DIVISION OF <br />,EQUIPMENT RENTAL RE D MINERALS AND GEOLOGY <br />' • _ n ~ 1313 Sherman SL, RM 215 <br />C ~~~•~ Jr Denver, CO 80203.2273 <br />(303)866J567 <br />Project name Date <br />ConVaetorname Bbd C <br />Contracmraddress ~ PON <br /> Req # <br />ProleclManager <br />Date Begin AM End AM Begin PM End PM Regutarhorus Bid item number Inspectafs <br />initWs Contraetororoperators sgnature <br />_2 ~ -- r- - v ~n~ <br />~-~ ~~~ l~:r~ l2~~ ;;3c~ <br />~~ _ <br />a W r.Sv <br />,., <br /> <br />r <br />~ • <br />. _. <br /> <br />i <br />i ~. <br />n <br /> <br /> S o~ i.s ~ . <br />' <br />rV ~ ~Rr~ ~ ~r~ ~ O~/ ~fE <br /> n~~ ~ <br />j n,t <br />~ I <br /> i+ .. ~_ <br /> 9 A ~i ~-y, 4 e - <br /> <br /> <br /> <br /> <br /> <br />I certify that all time recorded hereon was spent productively under the terms and conditions of the contract <br />and is proper for payment. <br />:ontractor project Manager . <br />