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"A COLORADO MINED LAND <br /> HELD 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 Bid# <br /> Contractor address PO# <br /> Req# <br /> Project Manager s- Field Directive# <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 /> .2- <br /> �"�- /�tSsI/S!c Cc,L/--1,c >- G,.('2�r— /'�-c- <br /> O Docvr7 .•-T Ccd✓C e/LavCiv -- 7-4�- 17e�/� <br /> t%.. -7-4 d1, c 7- Tu r5 17're z- a '74, <br /> I? 2e, C?v�lz/G w C/ !3 e- / 1t)e ff e O 4- T Tz+ <br /> r?��s tOz 120 ,+p 9e re 4 As <br /> Dawn. TL.e <br /> o �,. T.S i/k v�Y' 777Z n -rp rr, 72.e 6F L' /,9C Cl 7Z z. <br /> l�r 7-c d, <br /> 7' Ale Ore vt- rZ.t �P��rRe � vc��v/yQ N pe pp/J e.v <br /> 1-11 4e T e Z �� >> C G NT7l lz-/2 <br /> z Y!��s/y e A- ��✓t p <br /> T 7`Z 1 /`/// t <br /> G1?C1-A.10 /rvz/ n-1 e2Fe s'faf'eS <br /> �>c/—M-7-C clGeG/tTrc^'S 77 ' f e x C 3Y.rTici✓ <br /> A-T •7-4 e e f5 7' e..,0 !ice �c �Yl> A. <br /> �e /Jc,Nf /1Ztc/t /21 �tekC�v✓} r74,0- <br /> / Z T 5 �- <br /> Net change in Contract price Net change in Contract time <br /> $ —" Days <br /> This document shall become an amendment to the Contract. All Contract provisions shall apply. <br /> l <br /> Approved by: - _ Date <br /> Project Manager ?6 <br /> Acce pted y• iDate <br /> Contractor <br /> na o - roiect naa .00v rt ;;rtnr <br />