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iii ~uiii~~u~uiu <br />999 COLORADO MINED LAND <br />CHANGE ORDER RECtAMAnoN OmsroN <br />1313 Sherman SL, RM 215 <br />Denver, CO 8020&2273 <br />(303) 866-3567 <br />Pro;ad name F, C . - D r hc~n I t - ~md t~ ro ~~cf °~'~ l ~ q ~r3 <br />Contredor name L ~ I/e C r &d pin! -CO.Rc -M~NF3 - <br />ConVactor address D ~ POp ~,_ ~t7y <br />vv <br />ll~oCl~ilzZQl / Rte" .~I~A _ y _dos <br />Project lAarrager Change OrderO <br />The lollovring changes are hereby made a Purchase Order: (Indude the cosVtime adjustment for each diange) <br />i 0 ~/u ~ naT t QaaDU~ ~ <br />~L1 I,{JA~S wDin IY1G(--//)0..f n <br />~iC( 'Q,i~Q fD Q ~h ~: ID ~ <br />~QO /~Cti~ l~/ /1~,~ 77ttLn 77t,~ 712 //t'.S ~~fh <br />Justification D 7Gci 2P~KL~t ~i >t' . I Ol ~ Wlt-S sLLUtt <br />cc+td s of p 0. <br />1 6t1~ S of dour n dire .,1~-> I`7u d~'czina ' <br />Tlu rn ~ ~-~ S /~d 1` <br />(,(,Eif71'1 G~ c/ 7tU ~ <br />~. <br />Gc-+17OrYt~ t~/S72[,rc~Gt -e2tc~li~~ <br />Change to purchase order price: ~ rda ~! <br />Original Purchase Order Price: <br />Current Purchase Order Price adjusted by previous Change Orders: /,/02 <br />The Purchase Order Price due to this Change Order will be increased/decreastsd by: N <br />The new Purchase Order Price including this Change Order will be: a /D~ <br />7 <br />Change to purchase order time: <br />The Purchase Order time will be increased/decreased by: <br />ter- a ,.! <br />C~ <br />The date for completion o1 all work will be: ~y~~ <br />~~7WV ~l ~yy. <br />Recommended - /1 <br />S l///(!//1u~1 ,MLRD Project Manager <br />Accepted by: <br />,Contractor <br />Approved by: <br />MLRD Program Supervisor <br />