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COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> EMERGENCY CHANGE ORDER 1313 Sherman St. Rm.215 <br /> Denver, CO 80203 2273 <br /> 303 866-3567 <br /> Project Name [ Date <br /> Ca'�( lJ�y�v �1N1- �r� f ��.��tll ��'I47r ,✓ fC1 - `' ,� - G, <br /> Contractor Name „ Bid# <br /> C 1l <br /> Contractor Address Agreement# <br /> —ii 7 /'!i A <br /> Project Manager ✓e- lk e- Change Order# 1 <br /> Use this form to authorize work changes due to changed conditions within the scope of the Agreement. Emergency Change <br /> Orders resulting 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 $ I <br /> C fl7&,wr Dz A 1-// xeo r <br /> ` CCC <br /> n 57-f t c.f l 140 (PA, <br /> tjr Se-0) -7 /n-e 3 �•� c. 4e2e-. z, <br /> �c s <br /> F T 13 <br /> r~tltic 9//' c reo . 16 4 -as <br /> '�J e 5, y` j f 7W 5 e /'!i 7z 14,1 - i7 L r4v 4, <br /> /VJ Cv5T C` 4irw ct Cam;,. FnIC i <br /> Net change in Agreement price$ Net change in Agreement time DAYS <br /> This document shall become an amend to the Agreement. All Agreement provisions shall apply. <br /> Approved by: Date: ,2 <br /> Project Manager l v <br /> Accepted by: Date: <br /> Contractor <br /> Original:Project Manager Copy:Contractor <br /> Revised 7/02 <br />