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COLORADO MINED LAND <br /> FIELD DIRECTIVE RECLAMATION DIVISION <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name Date <br /> ( � ems'i-✓ G✓n5'�-t- • �,3 G_ ( - �S� <br /> Contractor name —� Bid# <br /> Contractor address PO# <br /> Req# <br /> Project Manager Field 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/Decrease <br /> Q <br /> et change in Contr t price Net change in Contract time <br /> 86 B _ Days <br /> This document shall become an amendment to the Contract.All Contract provisions shall apply. <br /> Approved by: Date: <br /> Project Manager <br /> Accepted by: ^ Date: <br /> Contractor <br /> ngion - roject manager copy—contractor <br /> 4 <br />