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f11 _~ 1 1 T ~ ~ r•. ~_.• ~ i- r i .. _ <br />.3 ~s ar.ernar, .a., nid c!o <br />Denver. CC 30203-2273 <br />(303) 866-3567 I <br />i ?roieci name y.i_t '.~ F=tu:c - ~ ~ ' ~; C ~ <br />{ - ~ _~ Date '~ 1(~ r ,~ . ~ ~.,>%' <br />icy `~J , <br />Jontractor name .~.r ~ ~ } <br />~~` .~ =t' \~_ t< ~,.~ ~ D ur _ Iv - c ;2~ ru &d # ~ ^~n <br />c t;; - cr\ .!v ~ _ ,_ <br />ConVactor address PO # <br /> <br />project Manager <br />i IChange Order n i <br />'he fgllowing changes are hereby made to the, Purchas <br />eOrder (InGude tlle.cost/time.adjystment}or 9acb. changeJ_ .,,._, -,..., ,,,,..„....... -._..._......_... _... <br />A <br />I ?~ r (ti.:~.} ,-~ .-t- ~ V,•. yL1 ~1 `% '~T~l~ y~y~ 9 1~%' iA9p,~ TrN ~ _ _ <br />1 l l `• C ~ 1 :.~.JNr y L ~w .~.-_Z.IlIL f'~ rC ll (T'~17 ~ l lUN/'tL <br />l~c(:1(L:~AielJ~ ~ ~\`.%Cilt~(L TC ._C>~~~1. ~ (~ <br />! t`L 1~.. <br />n l tiiSTCCt-t-F~ <br />7CL~1 D~ l~l=. Ai i(.r OCrtZrcfij UvII..NJIY~Sf~~'T ~~ \ ~'/L ~L~Ls~ ~G~1.T ~~ <br />,} <br />2 ~" -p ZCC~ ~a -E~ To `t~1z- ~t'Qf`.G <br />Justification <br />~% \H '. ~ ,..15 ~ 3~E.~ %~ -~pCC lniT~.~ tvlU7 \ I~1C~.=Dc't~ [ N -tZT~ <br />~`IU~IN~r~ SC.c3Q~ c~~ w~jR^C~. S`i: Pt-l`l/'cC~{~,9 ~tC=~-O C~t2ECZtLIcS <br />t~~VS I :3~Gt2 <br /> <br />Change to purchase order price: <br />Original Purchase Order Price: ~ ,., , <br />L~1 Vlil1 'l.:C <br />Current Purchase Order Price adjusted by previous Change Orders: _~~~~~ <br />The Purchase Order Price due to this Change Order will be increased/decreased by: ~ ~ , ~~j <br />The new Purchase Order Price including this Change Order will be: Y Z`k , ~S~ . ~i~ <br />Change to purchase order time: <br />The Purchase Order time will be increased/decreased by: l ~~' i <br />The date for completion of all work wilt be: ~~~~~ ~~ ~~ ~ , <br />Recommended by:~ r-~, ~ ~ / <br />~~ -~-~'~ \~`~ ~F-~„C-,I-~~~~- ,MLRD Project Manager <br />Accepted by: ~"~ _, <br />,Contractor <br />• ~~G <br />Approved by: <br />MLRD Program Supervisor <br />