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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 c Bid# <br /> Contractor address 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 /> J Atr- 7 5)e'­- e , '—C ,^' G`/` I?-/`' - ter- - C //-t^,/ —eL <br /> 5/ irk t l /7 = C' t <br /> TR <br /> 7 /• Tye <br /> C <br /> /A L s (�i}rr t l' r '�-c 'r?Y/) rL' 14 <br /> Net change in Agreement price Net change in Agreement time <br /> $ -_-_"- '--- Days <br /> This document shall become an amendment to the Agree nt. All Agreement provisions shall apply. <br /> Approved by: � -- - ate: <br /> Project Manager <br /> Accepted by: Date: <br /> Contractor �� u C' � <br /> ngina- roject Manager Copy-Contractor 4 <br />