Laserfiche WebLink
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 /> C a - 4 -� <br /> Contractor Name Bid# <br /> Contractor Address Agreement# <br /> L � - - <br /> Ca 1/4- /r? �, Z� <br /> Project Manager Change Order# �y <br /> Use this form to authorize work changes due to Chan ed 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 followin chan es are authorized at the direction of the PROJECT MANAGER: <br /> ITEM No. DESCRIPTION OF CHANGES $ Increase/Decrease <br /> 7'rt t-r-s - S v o <br /> S 4A-✓AS .= 6,,v <br /> /`7 i ! c,.S S T T-n e'e-s o S 4,4 <br /> /`7 i 3 -rA- 1-s = '6'6 v S [..4 <br /> /`7//bC 3 LuwL2 `►� �c,s - `tav <br /> /�-1 � ^� _e S r2tc-j — 3d S 4 <br /> ti d C C C„t14-1 <br /> L? 5�i/t c r f 771.►� .c,, a 7-T/�f �/1�/�r/177 M�' <br /> l"v n,v r-,Ae A_ or �,. '7 7-�c s s r4- <br /> Av G-e.- c),t./2G/L- <br /> 31— <br /> Q•uv <br /> /-1 ( A e— ( („r G 57' Zu[J <br /> v ere k- 400 <br /> l/L 2 v U <br /> Net change in Agreement price$ Net change in Agreement time DAYS <br /> This document shall become an amendment tot Agreement. All Agreement provisions shall apply. <br /> Approved by: Date: <br /> Project Manager —S—o <br /> Accepted by: Date: rr <br /> Contractor t d T <br /> Original:Project Man&g4r Copy:Contractor <br /> Revised 7/02 <br />