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ggg COLORADO MINED LAND <br />CHANGE ORDER RECLAManoNDrvrsroN <br />1313 Sherman St., RM 215 <br />Denver, CO 802032273 <br />(303) 866-3567 <br />Project name , ~_ , ~ t„ ~„ „ ~ ,rlrt~ ~ <br />f ul~/f , -"t V Date 171 ~ /„ <br />V <br />W / <br />Contractor name Bid # to <br />_ <br />I\ <br />K, <br />Contractor address ~ ~~ <br />1 V PO # <br />Co 12 R~°# .4 ~~f <br />Project Manager ('~ <br />J ~ Change Order# ' <br />P ch Order: (Indude the cost/Gme adjustrnent for each change) <br />The following changes ere heretry m <br />a <br />de to <br />N <br />e <br />~ <br />^ <br />~ <br />,~ <br />n <br />Ll-~., <br />Lci~ tiu ! v / f'u <br /> <br />Justlficatlon <br /> <br />/U /G(( <br />>OJ~ m W"1~~"h ~.Kis S <br /> <br />Change to purchase order price: <br />Original Purchase Order Price: ~ ~~ ~~ <br />Current Purchase Order Price adjusted by previous Change Orders: sj, I~~ ~~ <br />7Y <br />The Purchase Order Price due to this Change Order will b increas ecreaied by: <br />O hr3 x 75 ~ a ash <br />f <br />The new Purchase Order Price including this Change Order will be: ~ / O ~J 9oa_ <br />/ <br />Change to purchase order time: <br />The Purchase Order time will b increased ecreased by: <br />The date for completion of all work will be: <br />Gov as, j993 <br />Recommend y:. <br />cJ ,MLRD Project Manager <br />Aceepled by: <br />Contractor <br />Approved by: <br />,MLRD Program Supervisor <br />