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. . COLORADO DIVISION OF <br />CHANGE ORDER MINERALS AND GEOLOGY <br />1313 Sherman SL, RM 215 <br />Denver, C.O 80203-2273 <br />(303) 866-3567 <br />CL <br />Pmjertrwne !C~ rL~~S / ~J, / <br />Dace ~ !/ - I <br />p~ <br />ContracLrnarre ~Qc~~i~AU CJlL~ /~/~ SjNG' Rid A' ~y /Lr/yiLs ~Zl <br />Contrx0oraddress ~ ~ ~I ,o O_~ ~ ~x ~ - CQl9 <br /> <br />.Pro)eclMarrager ~ _ / N~ rUy <br />U Charge OrderC i/ <br />'7 <br />Order:(IndudgthecosVtime d)ustrnenltoreach ange) ~/ <br />owitgchangestueh by made 0o thePur <br />FzGrN ~ ~/pllirLr~~ O /k'~ F / t? /190cCMrn'G iCOOQ JJ ~- <br />z riot/7 ~-~ la~~ ~'eR="t~~o lra~rii%~ H~',~ ~ ~oc9_r~v~ <br />djtL>~/TZ /~G ,60% cS'/ (o i~/~ ~uciU~S <br />00 <br />y ~~^'i / ~ ~ ~'(aov <br /> <br />Justibcafion <br />~-ur ~ fv ~ d/R-G ~~ /1r.¢rLfitie7 ~ 7 ~..r./~ /~j~If.SS~~ ro/~ <br />~~~/C ~~/IC6+,~-+~x-J <br /> <br /> <br /> <br />Change to purchase order price: <br />Original Purchase Order Price: ~Z~/ ~5 ~ SZ <br />Current Purchase Order Price adjusted by previous Change Orders: ~j ~ 1~ ~SZ. ,S Z <br />The Purchase Order Price due to this Change Order will be increa d/decreased b . ~G /, vr~ _ U (7 <br />The new Purchase Order Price including this Change Order will be: ~ ZZ ~ ~,~ Z 5 Z <br />Change to purchase order time: <br />The Purchase Order time will be increased/decreased by: <br />~) <br />v <br />/ <br />The date for completion of all work will be: ~ , eJ , Q y <br />Recom bY: ~~ ~/J i <br />~/l/ ,MLRD Project Manager <br />Acrepled y: <br />COnlraCtOf <br />Approved by: , <br />MLRD Program Supervisor <br />