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COLORADO DIVISION OF <br /> FIELD DIRECTIVE MINERALS AND GEOLOGY <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name L ate <br /> Contractor name Bid# <br /> & - A,/ f t /5 (1- S c-: p v /— Sc / -' -�— <br /> Contractoraddress Agreement# <br /> Project Manager Field Directive# <br /> Use this form to authorize work changes due to changed conditions within the scope of the Agreement. Field directives resulting <br /> in increased Agreement 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 /> x-q r— <br /> d ' <br /> ( ! <br /> /�Sri/--r /m �T c!✓.fiL �!l /�'�:;Y�/1 !:3'Z— A" T YJ✓i F17 v"Tt'S i <br /> lie <br /> y�/c TC /" - T"L 7-, <br /> 'rcl <br /> P,l< fc v-e �`'c r /'`• 7 <br /> rtci <br /> t" alc.-� jar b� rvt/?5t �...�/ + <br /> P r7 cc <br /> t�✓ c i f c f cat/� � .� �'_c,� 17 S �_ <br /> s rr, c,/t <br /> /7 l7 tr C/l�<t.e If C i,, r,�i� -7 <br /> P/r,Jac i / �✓�e l`— / <br /> Net change in Agreement price �r �/ _ Net change in Agreement time <br /> $ � '�/ TES <br /> C� Days <br /> This document shall become an amendment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: Date <br /> Project Manager _YJ <br /> Accepted by: Date: <br /> i <br /> Contractor <br /> rigina-Project Manager Copy-Contractor 4 <br />