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CHANGE ORDER COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> Wl-LREAS,authority exists in the Law and Funds have been budgeted,appropriated and otherwise made available and a 1313 Sherman St.,RM 215 <br /> sufficient uncommitted balance th f remains available for encumbering and subse ue t payment of this contract under Denver,CO 80203-2273 <br /> in Fund Number A and GBL `—� (303)866 3567 <br /> Encumbrance Number pr 1 <br /> ject name C Date r ,� r✓titi� <br /> Contractor name _ Bid# 7�— <br /> v/ do �— <br /> Contractoraddress / Agreement# <br /> VendorlD# <br /> e e.�rtia� t-- Ca � , �/� •-� - <br /> ProjectManager Change Order# <br /> The following changes are hereby made to the Agreement:(Include the cost/time adjustment for each change) <br /> o VL r,- aS r!/ e C. '�04 <br /> v, <br /> Justification <br /> C 9SL p c e e / 6-- <br /> JDA <br /> R-r 72,e-- L T 2 <br /> Le <br /> Change to Agreement price: <br /> Original Agreement Price: 7 egg <br /> Current Agreement Price adjusted by previous Change Orders: s� <br /> 2- <br /> The Agreement Price due to this Change Order will be /decreased by: <br /> The new Agreement Price including this Change Order will be: y <br /> Change to Agreement time: <br /> The Agreement time will be increased/decreased by: ` <br /> The date for completion of all work will be: <br /> Recommended by: <br /> DMG Project Manager LZ Principle Representative <br /> .cce led by: <br /> X for the Division of Purchasing, <br /> Contractor ��,' -' State Building Programs <br /> Approved <br /> DMG Program Supervisor for the Controller <br /> 2 <br />