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t <br /> CHANGE ORDER COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> WHEREAS,authority exists in the Law and Funds have been budgeted,appropriated and otherwise made available and a 1313 Sherman St.,RM 215 <br /> sufficient uncommitted balance thereof remains available for encumbering and subsequent payment of this contract under Denver,CO 80203-2273 <br /> Encumbrance Number in Fund Number Apr_,and GBL (303)866-3567 <br /> Project name Date <br /> Contractor name Bid# <br /> Contractoraddress Agreement# <br /> e <br /> VendorlD# <br /> Project Manager s e G.vetrf/2 Change Order# <br /> The following changes are hereby made to the Agreement:(include the cost/time adjustment for each change) <br /> -r &7 lc <br /> 74 <br /> & w CS$ 1W L! 1, /t-e— <br /> eK c t,Qti- vL"A,0 t/I/-7-c /L e1lc 4 le & A- <br /> 12i e"+.-C.�—� Ce-- �ci l �7!'v/i`r V�`� 4-e i 4 /Z L- e9 ✓� <br /> t ! r ' >12-J i A-4-r,— � L 2 3 r� e-P <br /> Justification <br /> C -?5 L.' /L •v G— <br /> erA- !y C- 17/e Y7, G44 ,,e, L ter ! �' <Z- r•� <br /> r cG c� <br /> Change to Agreement price: <br /> Original Agreement Price: <br /> Current Agreement Price adjusted by previous Change Orders: <br /> 7� 7 <br /> The Agreement Price due to this Change Order will be increased/deeFeaered by: Z, 7 79 po <br /> The new Agreement Price including this Change Order will be: 51 <br /> Change to Agreement time: <br /> The Agreement time will be increased/decreased by: <br /> 0 <br /> The date for completion of all work will be: (� <br /> Recommended by: / <br /> —�' DMG Project Manager Principle Representative <br /> Accepted by: <br /> for the Division of Purchasing, <br /> Contractor State Building Programs <br /> Approved by: <br /> DMG Prooram Suoervisor ,for the Controller <br />