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EMERGENCY CHANGE ORDER <br />COLORADO DIVISION OF <br />COLORADO RECLAMATION, MINING <br />DIVISION OF &SAFETY <br />RECLAMATION 1313 Sherman St. Rm. 215 <br />MINING Denver, CO 80203 2273 <br />1� <br />SAFETY (303) 866 -3567 <br />Project Name: <br />Date: <br />T <br />Contract r a e: r a t <br />Bid #: KA - <br />Contract <br />CM <br />W ddr o <br />Agreement #: <br />Project Manager. Change Order #: <br />�Q <br />Use this form to authorize work changed due 4 changed 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 />()UK OV C1- dc&,,t W OW tb_t W(,& Y� <br />, <br />CU� f� � � i hq <br />g <br />fa U Qv\ o� : <br />Net Change igAgreement Price: Net Change in Agreement Time: <br />This document shall become an amendment to the Agreement. All Agree ent rovisions shall apply. <br />Approved by: , DRMS Proj 1 <br />n <br />Manager <br />Date: ? J j1�jC <br />Accepted by: Contractor <br />Date: 31 1,3 I o c <br />AS Of 01/08/09 <br />