LPPD000464

• Contract/PO #: C150173
• Contractor Name: Upper Surface Creek Domestic Water Users Association
• Contract Type: Loan
• Water District: 0
• County: Delta
• Loan Projects - Doc Type: Contract Documents

COLORADO UCC FINANCING STATEMENT
Filing Fee: $15
Follow Instructions (front and back) Carefully
NAME 8 PHONE OF CONTACT (optional)
Steve Biondo 303
SEND ACKNOWLEDGMENT TO: (Name and Address)
� COLORADO WATER CONSERVATION
BOARD
ATTN: WATER SUPPLY PLANNING &
FINANCE
1313 SHERMAN STREET, ROOM 721
� DENVER, COLOARDO 80203
� .d.._..___._ __ . _
ABOVE SPACE FOR FILING OFFICE USE O NLY
]
1. DEBTOR'S EXACT FULL LEGAL NAME - insert only orie debtor name (1 a or 1 b) - do not abbreviate or combine names
ta. ORGANIZATION'S NAME
oR UPPER SURFACE CREEK WATER USERS ASSOCIATION
1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX
1c. MAILINGADDRESS CITY STATE POS7AL CODE COUNTRY
P.O. BOX 70 CEDAREDGE co 81413 uSA
ADD'L INFO RE te. TYPE OF ORGANVATION 1f. JURISDICTION OF ORGANIZATION 1g. ORGANIZATIONAL ID#, if any
DE TOR T��N D N C CO C019871130243 � NONE
2. ADDI710NAL DEB70R'S EXACT FULL LEGAL NAME - insert only Qng debtor name (2a or 2b) - do not abbreviate w combine names
2a. ORGANIZATION'S NAME
OR
INDIVIDUAL'S LAST NAME
2c. MAILING ADDRESS
INFO RE 12e. TYPE OF ORGANIZATION
NAME
JURISDICTION OF ORGANIZATION
NAME
STATE IPOSTALCODE
ORGANIZATIONAL ID #, if any
� NONE
3. SECURED PARNS NAME (or NAME of TOTAL ASSIGNEE of ASSIGNOR S/P) - insert only one secured party name (3a or 3b)
3a. ORGANIZATION'S NAME
OR STATE OF COLORADO - COLORADO WATER CONSERVATION BOARD
3b. INDIVIDUAL'S LAST NAME FIRST NAME
NAME
3c. MAILING ADDRESS CITY STATE POSTAL CODE COUNTRY
1313 SHERMAN STREET, ROOM 721 DENVER CO 80203 USA
4. This FINANCING STATEMENT covers the following collateral:
SECURED PARTY'S REVENUES PLEDGED TO REPAY LOAN OF $163,802.00 IN ACCORDANCE
WITH LOAN CONTRACT NO. C150173 AND PROMISSORY NOTE DATED MAY 1, 2004.
5. ALTERNATIVE DESIGNATION (rfapplica6le): ❑ LESSEEILESSOR ❑ CONSIGNEEICONSIGNOR ❑ BAILEElBAILOR � SELLER/BUYER ❑ AG LIEN ❑ NON-UCC FILING
6, This FINANCING STATEMENT is to be filed (for record) in the REAL 7. Check to REQUEST SEARCH REPORT(S) on Debtor(s) (Optional)
ESTATE RECORDS ❑ All Debtors ❑ Debtor 1 � Debtw 2
8. OPTIONAL FILER REFERENCE DATA
LOAN CONTRACT NO. C150173
NATIONAL UCC FINANCWG STATEMENT (FORM UCCt) - COLORADO (REV 11/15/2001)