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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 /> Gv�-I ��►s/� '�I w e S(v c S !I�/ l ��T�v t v — �—v <br /> Contractor Name Bid# <br /> Contractor Address Agreement# <br /> Project Manager Change Order# 3 <br /> Ee ti <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 followin chap es are authorized at the direction of the PROJECT MANAGER: <br /> ITEM No. DESCRIPTION OF CHANGES $Increases" <br /> a J e c r A a P..A ,4-4-4 15 iF 5 <br /> N!/n,e 3 rllek - Z. s <br /> r? tNe t c✓es S <br /> f FIL 1�1 in-e AC1t1'4C—` <br /> A 4 d r n c w-fi c A [-Re-Y L-e ra .5-C '!-n /F 7 <br /> 17tA S',/'eei -7r..�f ' <br /> [Z Sw, rci,113l+er <br /> ^?_ h-,4 a r i .i/►t A C/t a q-4-e = 1 'et s- <br /> 3 /v iAt of C/it a ve li d-- 12 e­W- r,rre_ i s f L,C A c, <br /> A i,c/U4st a/— (y : Y® ., rAvt-r l3jp <br /> p �s <br /> SCAn�i7 S l,t4V/i�G = s Cl <br /> Net change in Agreement Price$ TNet char a in A reement time DAYS <br /> This document shall become an Amendment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: Date: <br /> Project Manager /V _6 <br /> Accepted by: Date: <br /> Contractor c— >—6 <br /> Original:Project Manager Copy:Contractor <br /> Revised 7/02 <br />