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CHANGE ORDER COLORADO DIVISION OF <br /> MINERALS AND GEOLOGY <br /> WHEREAS,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 thereof remains available forencumbering and subsequent payment of this contract under Denver.CO 80203-2273 <br /> Encumbrance Number inFundNumber_ Apr ,andGBL (303)866-3567 <br /> ject name � Date <br /> •� ac -30 - <br /> Contractornarn V Bid# <br /> oAv —3 <br /> Contractoraddress Agreement# <br /> D � C /2G C� <br /> VendorlD# <br /> Project Manager Change Order# <br /> The following changes are hereby made to theAgreement:(Include the cost/time adjustment for each change) <br /> 11 cr 6 tic A futi-ft- acv <br /> e C 2� S l is 5- ce <br /> 3 _ c <br /> e- c c, e X Ce SS � �, "u <br /> Justification <br /> p G 5"F-rt c le.ti-T O N O P G L'N A,e c e-SS <br /> 0 t C, T& e r«5s-t 12,,t. e w e <br /> 5 r S a 'e /hp e 4 PS T r i`r c/7 3 /-c- <br /> Pss1,45 Ie So O e < <C /9/b ' ,�✓ <br /> 1/2 <br /> Change to Agreement price: <br /> Original Agreement Price: <br /> A�- <br /> G d <br /> Current Agreement Price adjusted by previous Change Orders: st. <br /> ! d <br /> The Agreement Price due to this Change Order will be increased�s d by: <br /> The new Agreement Price including this Change Order will be: sr G <br /> Change to Agreement time: <br /> The Agreement time will be increased/decreaeedby: <br /> / ,- cl <br /> The date for completion of all work will be: <br /> Recommended by: <br /> DMG Project Principle Representative <br /> ccepted <br /> for the Division of Purchasing, <br /> Contractor State Building Programs <br /> Appr ed by: <br /> DMG Program Supervisor for the Controller <br /> 9 NJ y <br />