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r-. <br /> <br />~ COLORADO DIVISION OF <br />EQUIPMENT RENTAL REC D MINERALS AND GEOLOGY <br />1313 Sherman St, RM 215 <br />Denver, CO 80203-2273 <br />Tp - c2 S i3~[ L Oo 2'N A (303)866-3567 <br />Project rams ate <br />Cofltrae0ornanw Bid # <br />Contraeloraddress ~ PO # <br /> Req # <br />ProjecllAanagar <br />Date Begin AM End AM Begin PM End PM Re u r Rid item number nsPectors <br />ini1a15 Contractororoperetors signature <br />~'~./e <br />9 qy <br />7: ov <br />/.Z~vo <br />/Z: ~o <br />S:.~v <br />;,,1~ ~. ,,j RS ri <br />af+' j r <br />~~ <br />-7"/.ve <br />/o q <br />7%OD <br />/,Z: ov <br />12: 3r3 <br />~' 3a l <br />r,K1d <br />~~ <br />r~j~~~r g;oa .a-~ r~(~ ~f . 3U o~~ s~ o <br />~''y ~~3o i~'~v ~.~ ~'ofl ~~z ~f <br /> ~~ <br />~.r~ G: ~~ iz:~ ra1.~ G.~ ~~ ~ ~. <br /> <br /> <br /> <br />d -z3 <br />~; 60 <br />>z:oo <br />12; 3d <br />y:3o -~ <br />/G w o-~ <br />~ Pte.--- <br /> <br />~ ~~ <br />6 ' ~ <br />1 J~3a <br />~ :pv <br />~ , oc~ ~r <br />L <br /> s -- ~ I N~~'S I Z i+~t (CcN~ `/';r•a ,-v i o-zS Fi~r~`- I <br /> i It"lS ' <br />~AC~G nC/ ~(tt<i i!_7 %~I Ci(~'~ J a ~JC ~ ~ <br />r ' ~ .~ ~ ~1 `~ <br />is <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. J <br />.ontractor Project Manager <br /> <br />s <br />~~ <br />