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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 ate <br /> Contractor name ^ ' Bid# <br /> S1p <br /> Contractor address / , Agreement# <br /> Project Manager Field Directive# <br /> y- 't <br /> Use this form to authorize work changes due 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 /> (7 C o j S C (7c --S i+ri 0 <br /> C' iT�,7>%eS � C- t r �/�� 57 /"✓r1t .P`4 � <br /> A-e c- <br /> rZ L:7\--t /n <br /> (j (A- c /)-zn-s ClJLi A,, 7e C „/�/!r r 1� <br /> Netchange in Agreement price Netchange in Agreementtime <br /> $ ------- Days <br /> This document shall become an amendment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: Date: <br /> Project Manager a r S Y <br /> Accepted by: Date: <br /> ✓ i -�� t Contractor <br /> rigina-Project Managbr copy,uijr or 4 <br />