GENERAL37728

• Permit No: C1981016
• IBM Index Class Name: General Documents
• Doc Date: 11/6/1995
• Doc Name: PURCHASE ORDER
• Permit Index Doc Type: RECLAMATION PROJECTS
• Media Type: D
• Archive: No

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-l,t~aNG~ ORDER
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R~~~!UF~ COLORADO DIVISION OF
MINERALS AND GEOLOGY
1313 Sherman St.RM 215
Denver. CO 80203-22T3
[phone]
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Contractorname ~, -
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Project Manager `
~rl~r~ ~ti Change Orderp j
The following changes are hereby made to Purchase Order: (Indude the cosVtime adjustment for each change)

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Change to purchase order price:
Original Purchase Order Price:
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Current Purchase Order Price adjusted by previous Change Orders: S! Z~~I 1 ~~~
The Purchase Order Price due to this Change Order will be increased/decreased by "1 ~T. C~1
The new Purchase Order Price including this Change Order will be:
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jChange to purchase order time:
The Purchase Order time will be increased/decreased by: r1 \
The date far completion of all work will be: /,(
Recommended by: ^'
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Accepted by:
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,Contractor
Approvedby: Oat®
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, MLRD Program Supervisor