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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 /> Contractor Name Bid# <br /> Contractor Address Agreement# <br /> Project Manager Change Order# <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 chan es are authorized at the direction of the PROJECT MANAGER: <br /> ITEM No. DESCRIPTION OF CHANGES $ Increase/Decrease <br /> Net change in Agreement price$ FNet change in Agreement time DAYS <br /> This document shall become an amendment 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 />