REP14132

COLORADO MINED LAND
FIELD DIRECTIVE RECLAMATION DIVISION
1313 Sherman St., RM 215
Denver, CO 80203 -2273
(303) 8663567
Project name
OVE Y=7 Cpl -fit ( l7 ioL��dU (
Date C) 8 ✓2-
Contractor name
2CG Cc: J" IC — feo '_j
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Contractor address
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Pox C.- f 3
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Req >< RK(1- 3tr i�(c
Project Manager • �
Field Directive Y
Use this form to authorize work changes due to changed conditions within the scope of the Purchase Order Contract. Field
directives resulting in increased Contract price or Completion time must be approved by a formal Change Order within 14 days.
The following changes are authorized at the direction of the PROJECT MANAGER:
ITEM No.
DESCRIPTION OF CHANGES
$ Increase/Decrease
3
/xC 3 i5(-5- 570 � rguiv1 4; 0 � (12c) 4
+ $ 4 goo cP°
M F - Err? AI,. 355,
4
Q� OF f�DOr� run, A�- , ri-A ;,•�' G
{ - (N� -uS4O rN
�I-�
�o (C G � 6 660 (N iEOar WrJ/kG 5
yam, x+/354
363
CHAM lie FRcv) C L.rLea--t- w I G> Zw ;z: 7 6�eA (7 clM1
366
Dwucr 'kscy-
J 2 ` 8 1 8.00
Am 2 -�a( Pj f 2 183. 00
3 72
OeDpo.3cy PJF 16. 0(>
36.00
3 73
RDp ,Icy fbF 84 -00
8q.00
31S
At,D S.Zc.f fUF 384.06
3H4lob
362
ADp .2 cy Pu F 24 -00
24.00
35f ADD
580 54 f4- x,-44 - to *3
8,760-00
Net change in
+-
Contract price
$ Tc Qc�wGrs otv
Net change in Contract time
+30 Days
This document shall become an amendment to the Contract. All Contract provisions shall apply.
Approved by:
-it 7 fll -O �d C• �, � Project Manager
Date:
Accepted by:
Date:
Contractor
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