GENERAL33121

• Permit No: C1981037
• IBM Index Class Name: General Documents
• Doc Date: 1/7/1994
• Doc Name: CHANGE ORDER
• Permit Index Doc Type: RECLAMATION PROJECTS
• Media Type: D
• Archive: No

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999 COLORADO MINED LAND
CHANGE ORDER RECLaManoN DfwsfoN
1313 Sherman SL, RM 215
Denver, CO 80203-2273
[phone]
Project name ,~'•~' , -a, ha,,., Af - ,R.D ~e Date f
Contractor name Bid # ' / ~.,
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Contractor address yt.,~ x
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Project Manager Change Order 1t Q
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by made to the Purchase Order: (Indude the cosvdme adjustment for each change)
The following changes are here
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Change to purchase order price:
Original Purchase Order Price: `~1' )/~ ~OSU ,
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Current Purchase Order Price adjusted by previous Change Orders:
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The Purchase Order Price due to this Change Order will be increased/decreased by:
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The new Purchase Order Price including this Change Order will be: ~ ~~ O~~ . rn
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Change to purchase order time:
The Purchase Order time will be increased/decreased by:
The date for completion of all work will be:
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Recommended by:
,MLRD Project Manager
Accepted by:
Contractor
Approved by: ~ i
MLRD Program Supervisor
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