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EMERGENCY CHANGE ORDER <br />COLORADO DIVISION OF <br />C O L O R A D O <br />DIVISION OF <br />RE MINING <br />& SAFETY <br />RECLAMATION <br />MINING <br />1313 Sherman St. Rm. 215 <br />Denver, CO 80203 2273 <br />SAFETY <br />(303) 866 -3567 <br />i Project Na <br />Q, majAbayel <br />Date: <br />Contractor Name: <br />Bid #: <br />s <br />Contractor Address: I ZD <br />Agreement #: <br />Project Manager. <br />Change Order #: <br />Use this form to authorize work changed due to cha ged 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 />11,k a addA6 &vX %UD &*,ck c r <br />rD r Sl v.� . �,{ <br />�?-� ,�G.�.•� �O Uv0 �1 "�C.I �A�S � • E3�� � 'lC�e, �1 <br />Net Change in Agreement Price: V Net Change in Agreement Time: <br />This documen all bec me an amendment to the Agreement. All Agree ent rovisions shall apply. <br />Approved by: , DRMS Project <br />c Manager <br />Date' <br />3 <br />Accepted by: <br />, Contractor <br />Date: <br />As of 01/08/09 <br />