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COLORADO DIVISION OF <br />FIELD DIRECTIVE MINERALS AND GEOLOGY <br />1313 Sherman St, RM 215 <br />Denver, CO 80203-2273 <br />( )866-3 7 <br />Project name r7 _ ~ `~ I ( S ~ <br />~~U <br />~C'~ ale <br />Contractor name <br />~.,s--F-- t <br />Y ~ Bid# ~ . <br />Contractoraddress <br />~Q, <br />V Agreement# <br />c <br />Project Manager FieldDirecuve# <br />Use this form to authorize work changes due to changed conditions within the scope of the Agreement. Field directives resulting <br />in increased Agreement price or Completion time must be approved by a formal Change Order within 14 days. <br />The following changes are authorized at the direction of the PROJECT MANAGER: <br />ITEM No. DESCRIPTION OF CHANGES $ Increase/Decrease <br /> <br /> ~~c,~---Y~~ ~ ~ l s ~~ ,~ ~,r~~4- ~~dp'~n ~ <br /> D~-~ ~`~ <br />L <br />~ <br />~a ~ PrdD L~ PCZ-- `7 ~ D t~ C~1~(Jt3 <br /> A <br />_ <br />L <br />~~ t~c~ ~' ~~ ~`a~ ~ l`~~ ~ ~- <br /> <br /> <br /> k SP~~..u-SKY GINS-re~~'~ ~ `~~J ~r~l <br />2~ ~t~~ ~~~~e ~~~~~~~~ P~ ~~ NC <br /> ~,~ ~-~~~~ ~~ ~g $~ ~~ ~~ <br /> <br />Net change in Agreement price <br />$ Net change in Agreement time <br />Days <br />This document shrill become an amendment to the Agreement. All Agreement provlslons shall apply. <br />Approved by: - <br />Project Manage ate: <br />~ 2~1 <br />Accepted by: ` - Date: <br />~~ <br />Contractor <br /> <br />~ngma-rrotea manager copy-convacror <br />