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''EQUIPMENT RENTAL RECORD COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name <br /> ° •�' i ! y Date <br /> Contractorname � — /� f/ /' 7— L' c �V- Bid#F�`_`„ _ •, f �" , <br /> Contractor address _ <br /> /2 +41c, s l 3 4 Req# <br /> Project Manager <br /> Date Begin AM End AM Begin PM End PM Regularhours Biditemnumber Inspector's Contractor or operators signature <br /> initials <br /> 3 3 ;z i 2 3v sl 34� c� 5' iz 1 <br /> Y <br /> �1 <br /> I certify that all time recorded hereon was spent productively under the terms and conditions of the contract <br /> and is proper for payment. <br /> contractor _. Project Manager <br />