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. III IIIIIIIIIIIIIIII • <br />ggg ~ COLORADO MINED LAND <br />FIELD DIRECTIVE RECLAMAnON DIVISION <br />7313 Shemtan SL, RM 215 <br />Denier, CO 80203-22T3 <br />(303) 866-3567 <br />Project name ~, . G~-si F'~.~ DeOB G - iy - .9~ <br />Contactor name ~~~~~ GUF-~1 .(.rr-S/~G nW• <br />Contracwr address POtl <br /> Req 0 <br />Protect Marager ~ ~~ Field Directive M ~ ~ <br />Use this form to authorize work changes due to changed conditions within the scope of the Purchase Order Contrail. Field <br />t~eilives resuRing in increased Contract price or Completion time must be approved by a formal Change Order within 14 days. <br />he following changes are authorized at the direction of the PROJECT MANAGER: <br />ITEM No. DESCRIPTION OF CHANGES $ Increase/Decrease <br /> <br />~ l / l <br />FMK C~i~/~~Fic~-lo~/ iltl= Fl=i"'/~/CcF-O G/>n-c/%-T~ <br /> <br /> f~°~~j~/l°C~N <br />~~/~ ~~ V .~~~i <br />~ <br />~~; <br />~~~ Tifr <br /> / <br />~ <br />~ <br />n <br />VIYLv / /t\ (//-S/'1 /i~iil A-S `fry--t)N l/l~ /lfY <br />/ <br /> ~'v~< <br />wi-~~~ DING ~/f~-~ . <br />i <br /> <br /> ~' <br /> <br /> /.~ <br /> ~~ <br />/ <br /> / <br /> <br /> ~--' <br />Net dtange in Contact price <br />~ Net change in Contract time <br />~ <br />$ Days <br />This document shall become an amendment to the Contract. All Contract provisions shall apply. <br />Approved by: I~ <br />~- ~i` /` ~~'? <br />P Date: <br />~ <br />'~ ~~~`~ <br />, <br />roject Manager J <br />Accepted by: Date: ~ ~ (, <br />~ z <br />Contrailor <br /> <br />agio -matt er o - ontractoi <br />