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EMERGENCY CHANGE ORDER <br />COLORADO DIVISION OF <br />' <br />RECLAMATION, MINING <br />& SAFETY <br />nPRECLA 1313 Sherman St. Rm. 215 <br />Denver, CO 8 0203 2273 <br />(303) 866 -3567 <br />Project Name <br />/Ia4 <br />Date: <br />7 a� <br />a <br />Contractor Na <br />_fro .. <br />Bid #: <br />!t — — <br />ContractorAd r � �` <br />S t <br />Agreement 4t <br />Project Manager: R C w � • <br />Change Order #: 5 <br />Use this form to authorize work changed due to dhanged conditions within the scope of the Agreement. Emergency Change Orders resulting in increased <br />Agreement 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 <br />DRMS PROJECT MANAGER. <br />Item No. <br />DESCRIPTION AND JUSTIFICATION OF CHANGES <br />$ Increase /Decrease <br />-� O-kv- t-u �. <br />4 1 o? (c� - R>r a c <br />� - �O Ica <br />0 -tee t S cn� v�c-� <br />,? <br />N (�A <br />a <br />i wo-IMKe- fi 6yi. ald,(; <br />'� <br />- - s � Qom- Gam✓ <br />a <br />Ge C, loo % Kff . <br />JAJ <br />Net Change in Agreement Price: Net Change in Agreement Time: <br />c( <br />This document shall become an amendment to the Agreement. All Agree ent provision s s II a <br />Approved by: , DRMS Project <br />1 <br />Date 3 31 <br />Manager <br />Accepted by: ,. G , Contractor <br />q <br />Date: 3 I <br />As of 01/08/09 <br />