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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 /> Project name <br /> (303)866-3567 <br /> "�� <br /> 7-C y � -c: ,7 _.� / j.- �f'O S i.G,L. ate <br /> Contractor name /) Bid# q <br /> Contractoraddress PO# <br /> ,/�-97 I-,)e C c' ' 1t�:� Req# <br /> Project Manager <br /> Date Begin AM End AM Begin PM End PM Regularhours Bid item number inspector's Contractor or operators signature <br /> initials <br /> -c 3 c C <br /> J u /y g ar7 - S Cl '3 A <br /> 1a iS $ n-; /7 <br /> r <br /> 11 '3, 3 /� <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 <br /> Project Manager <br />