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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 Date <br /> Contractor name Bid# <br /> Co ntracto r address Agreement# <br /> Project Manager Field Directive# <br /> O <br /> Use this form to authorize work Chan es 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 /> /> <br /> r C T <br /> ,tic / iv <br /> f � S <br /> Net change in Agreement price / Net change in Agreement time <br /> $ z 2 , �6 a- C y`'nX Days <br /> This document shall become an amendment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: / Date <br /> Project Manager & , S <br /> Accepted by: Date: <br /> , y <br /> z�'c Contractor <br /> rigina-Project Matiag6rCopy- on for 4 <br />