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III I II I II I II IIII III COLORADO MINED LAND <br /> <br />RECLAMATION DIVISION <br />CHANGE ORDER 999 <br />1313 Sherman St., RM 215 <br />Denver, CO 1302032273 <br />(303)866-3567 <br />Project name C ~ ~ _ - ~ ~` t7 ! <br />r 'F' T Date ' <br />~ <br /> <br />Contractor name , <br />ad;r - ~-M~NB S <br />Conbactor address ~ <br />O <br />~X `I PO it <br />_ <br />y7~~ <br />, p~~/ <br />~i-~ <br />TN-t.~1J~ C~ la /~' <br />/ -~y~~- <br />R~#i'K- - -l.lJ~~ <br />Project Manager Change OrderO <br />The following changes are hereby made to the rchase Order: (InGude fhe cost <br />ment for <br />ea <br />Ch Gtanga) <br />/ <br />ti <br />m <br />e a <br />dj <br />u <br />st <br />~ <br />N <br />Q <br />- <br />} <br />- <br />~ <br />~ <br />~ <br />p <br />~ <br />l N.vr `J WI 1 ~ (J / <br /><< ~ , ~ 11 I 1 u ~ <br /> <br /> <br />Jusdficatlon _j_, q~ ~, /~ ~ ~ ,, ~,/~ ,, ~/ <br />C I I V r r t1X 1IiLX.LXJLL/1 <br />~ ~ d ~ Zo zz <br />~ 2 <br /> <br /> <br />Change to purchase order price: <br />Original Purchase Order Price: c~'O5.J / ~ , <br />Current Purchase Order Price adjusted by previous Change Orders: ~' /O~7 J q <br />The Purchase Order Price due to this Change Order will be increased/decreased by: ~ ~ 3 ~ ` ~-~ <br />The new Purchase Order Price including this Change Order will be: ~ I ~n ~ ~ . ~l <br />~j J v <br />Change to purchase order time: <br />The Purchase Order time will be increased/decreased by: <br />~- <br />The date for completion of all work will be: n ~~ f <br />lI <br />Recommended by: <br />MLRD Project Manager <br />Accepted by: <br />Contractor <br />Approved by: <br />MLRD Program Supervisor <br />