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COLORADO MINED LAND <br /> FIELD DIRECTIVE RECLAMATION DIVISION <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name Date <br /> Contractor name <br /> L 1-5 t�'/�, 5 11 f e j < < < L -ram t�� ad# r i� - 4 vc <br /> Contractor address PO# <br /> r''2 RGq# <br /> Project Manag J 4 C `1 a 4!t- Feld Directive# <br /> Use this form to authorize work changes due to changed conditions within the scope of the Purchase Order Contract. Field <br /> directives resulting in increased Contract 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 /> S /Ae 117 /1-7 /►-c 'r c' <br /> -7 /iS ¢ w /fir <br /> Ge t 5 /7.7/ht� /7 .. <br /> /?r <br /> I ` <br /> Net change in Contract price } Net change in Contract time <br /> Days <br /> This document shall become an prne offent to the Contract. All Contract provisions shall apply. <br /> Approved by: <br /> Date: <br /> ✓ ! w Project Manager C,,> —,%2-Accepted by- �� Date <br />