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COLORADO <br /> FIELD DIRECTIVE RECLAMATION <br /> MINED LAND <br /> RECLAMATION DIVISION <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name Date <br /> 1'71/V e- 3 Gv L /3 Silt/ Zcl/h^-/<f7.71A l <br /> Contractor name Bid# <br /> C u nS T ZZ u <br /> Contractor address PO# <br /> Of r>o„-- C ail o S a d <br /> Req# <br /> Project Manager Field Directive# <br /> 12 . e/L- <br /> Use this form to authorize work changes due to changed conditions within the scope of the Purchase Order Contract. Field <br /> directives resulting in increased Contract 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 /> 7-4 e- Con.c/?-e-T e s G,y/3 L o c-q-?-e p A/S a w e 7z,�e_ <br /> Z 31L/ T-e 2/`-r e D 114-7- e C CIA L T-/2 F},S Fe/z2 /a-2 e/-t- 'r 7 /3 c <br /> ce C-'r ( ti / L,¢-cL /0/2-oIitOe.9 7-4 4-7 - <br /> W Ty,e S'T�eL = -/3 A2e 2errvve_o r/Zdrz 7� <br /> s L A-/,3 j 3) TL, L /j S /L F-A c.-L- /s /3 -ate D <br /> wi 711 e-Aiz77,-e %r�9 7�/t tit �S , co�/'914--C7-e /r, <br /> rN 5-1 (C) FV./T C/ f A--9-9-0 %v 13 (e�17 <br /> w r '`[Z ,Sv2/Lr, ,ND/A-(i Tc,/'O rr2H-/i4 y . <br /> 5-P(t7e..�T �S�GT) F�n. cc /`-r7 y rs� 2 /Zecre/J <br /> A-"F r-e 2 e )c c�v'J--7--/ e e T /-f/�e 4- s /ti <br /> 0 2 r)e/L 1-62 /"9 i n./."7! 7 L, e /V 0 7 e—r .a L <br /> /Z-oG /r /=.a // �eST/to !— -1-L? "e <br /> 1;>,e c, 7- /`r ih✓ii G e/L /`-7/I 17 //2 � c 7- -7-7-1 ,f-!� <br /> Si L T- re..r c-e T-/t/l e D _/D x /,!r— <br /> 6 X c-9 v.9-7-1 a . /ti o 2 7,)c 2 _ro /-i/ --//7/ <br /> 5-c-0tr--7c�T �R� S/�o/z7-J S�v�!/7 Tz, e � Qep <br /> /j'2 t 5 'e- <br /> Net change in Contract price Net change in Contract time <br /> $ p Days <br /> This document shall become an amen nt to the Contract. All Contract provisions shall apply. <br /> Approved by: Date: <br /> Project Manager $ <br /> Accepted by: f ;� Date: J, <br /> Contractor <br /> Mgiona- roiect Wnager Copy-Contractor 4 <br />