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C- <br /> COLORADO MINED LAND <br /> FIELD DIRECTIVE RECLAMATION DIVISION <br /> 1313 Sherman St.,RM 215 <br /> Denver,CO 80203-2273 <br /> (303)866-3567 <br /> Project name Date <br /> Contractor name <br /> Contractor address �/+� PO# <br /> (�Oo fvC �cT� G / LlZ <br /> G C G lv �6 Req# <br /> Project Manager �—, Field Directive# <br /> l 2 e e <br /> Use this form to authorize work changes due to changed conditions within the scope of the Purchase Order Contract. Field <br /> directives resulting in increased Contract 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 /> U e X c7�//�llzc<✓ /�'l��vG'' /Ou3D <br /> , S��-1/ e- Z Z ` , 19-5 /`z 5 U/Z--lp <br /> r rc C /1 --S-r- C,� <br /> G <br /> A- e Ce 5-,-n 6e e 77,e- J7clz S �0177 <br /> lS 4 ( 1(-4 /-7 tr rn (� ��- ) ems e— <br /> i )77 C 1-•.-4 , c� � �c C�rr� t P 11-2, <br /> e-l,2' C_r-7 U <br /> l7 <br /> C R t e c e-Sf �� /5 l -17--5- <br /> C c s c 7.7C.✓ /a-e Tr cal Tz e r <br /> Net change in Contract price Net change in Contract time <br /> $ -*---- Days <br /> This document sha me an amendment to the Contract. All Contract provisions shall apply. <br /> Approved by: Date: <br /> ` Project Manager <br /> Accepted by: <br /> _ / Date: ^�r <br /> Contractor <br /> naiona- rol ct ManaapV Conv-Contmrtor <br />