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r� <br /> COLORADO MINED LAND <br /> FIELD DIRECTIVE RECLAMATION DIVISION <br /> 1313 Sherman St.,RM 215 1 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name Date <br /> G�9 L ni t— � ��f (G <br /> Contractor name <br /> a �` G Bid# <br /> Contractor address PO# <br /> '4 c l Req# <br /> Project Manager Feld Directive# <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- <br /> Z- -7 -e 11"2/1-e 5 <br /> a' (2-e— C cti-s 772-c 7- /7 Z T-c <br /> e 2 s7 5 tee ��2 S 7 5- /= T <br /> i <br /> we 7-4 G � � t � � , �� 4 <br /> t <br /> /9' t-C Ce G 771 a V e <br /> r-c- <br /> �+ <br /> St1-2 e-2 Tv <br /> Net change in Contract price Net change in Contract time <br /> $ 7 � B � Days <br /> This document shall become an amendment to the Contract. All Contract provisions shall apply. <br /> Approved by: Date <br /> Project Manager lG <br /> Accepted by: i / Date <br /> Contractor <br /> IQtona- r ert naaer comcentrartnr <br />