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COLORADO DIVISION OF <br /> FIELD DIRECTIVE MINERALS AND GEOLOGY <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> jedname e.� 7 ��,,/J c L rt 9 /lc ate <br /> Contractorname ` Bid# <br /> Contractoraddress S ? Agreement# <br /> Project Manager � Field Directive#, G�e- Cti .�f'� <br /> Use this form to authorize work changes due to changed conditions within the scope of the Agreement. Field directives resulting <br /> 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 $ Increase/Decrease <br /> sra C 91/A s l<c) c 4--)Ie o/y (/7/>`-e. 1) <br /> PaNDS /7 /Nr off- /Sine /Ito 5T��l�p! /t f=rrlL <br /> L /7 / f/,ec/�rl/> /grin /ZPasul,9t, l .,i /S //�• <br /> C'/ <'7!tie 1, ,r,„,ram t7 z Z C/7/ <br /> /�ia'*H AR✓-e O . <br /> v 5 e pa�t/L Iv r(12)-ri-r— A,,,� r <br /> tv /SLt'. %l jL.z -e /7/'e-P plies Coc. rno O^' 74- <br /> r <br /> fG La C 0 !i 117 <br /> /�►� C /i lac r^i/yam — <br /> �R e .w <br /> 0 W le A-s <br /> S /1 C o i�/� G/S �i A-E c e s S /I fY/? /?e c G <br /> 17,VA-0 S d/ b' O1Z 'pC/L c./ r,rT���-s � e ar r�` <br /> 7/19 <br /> Net change in Agreement price - Net change in Agreement time <br /> $ C' Days <br /> This document shall become an amendment to the Agreement. All Agreement provisions shall apply. <br /> Approved by: !�s ate: <br /> Project Manager <br /> Accepted by: Date: <br /> Contractor <br /> Inginal-Project Manager Copy-Contractor <br /> 4 <br />