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COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> EMERGENdY CHANGE ORDER 1313 Sherman St. Rm.215 <br /> Denver, CO 80203 2273 <br /> 303 866-3567 <br /> Project Name Date <br /> C� ,a c yRSin. /�` e S(✓ S / r/i��ITco•�. /'U - v f <br /> Contractor Name Bid# <br /> Contractor Address Agree me t# <br /> Project Manager Change Order# <br /> /L-- <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 followinq chap es are authorized at the direction of the PROJECT MANAGER: <br /> ITEM No. d <br /> DESCRIPTION OF CHANGES $ Increase <br /> 7 <br /> l ! /1vv( t) e 5L 32- Ltv•-AS Ad cfrT!ox4't- <br /> f� P 1-4-8vti Tv /'/1c C=/; <'7 c.y'cc,. c,.;ti T710/ <br /> !/ti c T c /2 <br /> v <br /> A d cliTtvA-A f �c, e/Z ivcIt i Tv <br /> yr G-R�r!'z / (/7�Rv�t C vr� S nl .iC % Sty%►C <br /> �v�9i7I t�l D L <br /> + � <br /> Net char in Agreement rice$ 3 / Net chan22 in Agreement time + A— DAYS <br /> This document shall become an dment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: Date: <br /> Project Manager (� <br /> Accepted by: Date: <br /> Contractor <br /> Original:Project Manager Copy:Contractor <br /> Revised 7/02 <br />