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EQUIPMENT RENTAL RECORD MINE RASAND DIVISIONOF <br /> MINERALS AND GEOLOGY <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name ate <br /> C v�+c b'/is ice- w e se ,-� r c L � 7`�Lam— /e - y7 <br /> Contractor name Bid# <br /> D t i� v /�fT/► <br /> Contractor address PO# <br /> Sur ct K if <br /> / C 4 Q/?W Req# <br /> Project Manager <br /> C e n.in elt- <br /> Date BeginAM End AM Begin PM End PM Regularhours Bid item number Inspector's Contractor or operators signature <br /> initials <br /> /U a y F <br /> 3 Cl <br /> I certify that all time recorded hereon was spent productively under the terms and conditions of the contract <br /> and is proper for payment. <br /> ,ontractor Project Manager <br />