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<br />COLORADO DCC FINANCING STATEMENT <br />Filing Fee: $15 <br />Follow Instructions (front and back) Carefully <br /> <br />A. NAME & PHONE OF CONTACT (optional) <br />Steve Biondo 303-894-2574 <br /> <br />B. SEND ACKNOWLEDGMENT TO: (Name and Address) <br /> <br />COLORADO WATER CONSERVATION <br />BOARD <br />ATTN: WATER SUPPLY PLANNING & <br />FINANCE <br />1313 SHERMAN STREET, ROOM 721 <br />DENVER, COLOARDO 80203 <br /> <br />'-"-""1"" '1,' ,",;,.., lifO- t:: <br />.lUW4i.! L,Jo' _~ <br /> <br />(' <br />"".. <br /> <br />$ 15.00 <br />r'~E"" .-'I'''f~'''{' A '1'~.fl <br />;Jl,Kt. ! nrO <br />1 t - 22- 2t302 <br /> <br />(iF STATE <br />15:37:-33 <br /> <br />ABOVE SPACE FOR FILING OFFICE USE ONLY <br /> <br />1. DEBTOR'S EXACT FULL LEGAL NAME.. insert only ~ debtor name (1 a or 1 b) - do not abbreviate or oombine names <br /> <br />1a. ORGANIZATION'S NAME <br />OR LAKE HENRY RESERVOIR COMPANY (THE) <br /> <br />1b. INDIVIDUAL'S LAST NAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />1e. MAILING ADDRESS <br />331 MAIN STREET <br /> <br />CITY <br />ORDWAY <br /> <br />STATE <br />CO <br /> <br />POSTAL CODE <br />81063 <br /> <br />COUNTRY <br />USA <br /> <br /> <br />1 e. TYPE OF ORGANIZATION <br /> <br />if. JURISDICTION OF ORGANIZATION <br /> <br />19. ORGANIZATIONAL 10#, if any <br /> <br />ONe <br /> <br />co <br /> <br />C019871117874 o NONE <br /> <br />2. ADDITIONAL DEBTOR'S EXACT FULL LEGAL NAME - insert only ~ debtor name (2a or 2b) .. do not abbreviate or combine names <br />2a, ORGANIZATION'S NAME <br /> <br />OR <br /> <br />2b. INDIVIDUAL'S LAST NAME <br /> <br />FIRST NAME <br /> <br />MIDDLE NAME <br /> <br />SUFFIX <br /> <br />2e. MAILING ADDRESS <br /> <br />CITY <br /> <br />STATE POSTAL CODE <br /> <br />COUNTRY <br /> <br /> <br />ADD'L INFO RE <br />ORGANIZATION <br />DEBTOR <br /> <br />3. SECURED PARTY'S NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR SIP).. insert only one secured party name (3a or 3b) <br /> <br />2e. TYPE OF ORGANIZATION <br /> <br />21. JURISDICTION OF ORGANIZATION <br /> <br />2g. ORGANIZATIONAL 10 #, if any <br /> <br />o NONE <br /> <br /> - <br /> 3a. ORGANIZATION'S NAME <br />OR STATE OF COLORADO - COLORADO WATER CONSERVATION BOARD <br /> 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX <br />3e, MAILING ADDRESS CITY STATE I POSTAL CODE COUNTRY <br /> 1313 SHERMAN STREET, ROOM 721 DENVER CO 80203 USA <br /> <br />4. This FINANCING STATEMENT covers the following collateral: <br /> <br />SECURED PARTY'S REVENUES PLEDGED TO REPAY LOAN OF $490,000.00 IN ACCORDANCE <br />WITH LOAN CONTRACT NO. C150098 AND PROMISSORY NOTE DATED NOVEMBER 1, 2002. <br /> <br /> <br />o BAILEElBAlLOR 0 SELLERlBUYER 0 AG LIEN 0 NON-UCC FILING <br /> <br />7. Check to REQUEST SEARCH REPORT(S) on Debtor(s) (Optional) <br />o All Debtors 0 Debtor 1 c:J Debtor 2 <br /> <br />8. OPTIONAL FILER REFERENCE DATA <br />LOAN CONTRACT NO. C150098 <br /> <br />NATIONAL UCC FINANCING STATEMENT (FORM UCC1) - COLORADO (REV 11/15/2001) <br />