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<br />, CWCB Construction Fund Loan Application <br />Revised January 31, 1994 <br /> <br />2. Are any of the above liabilities "now in default, or been in default at any time in the past? <br />YES NO X . If "YES", please give detailed explanation: <br /> <br />3. Please provide a summary of all revenues received during the last two fiscal years by <br />category (such as service charges, tap fees, assessments, etc.): <br />See Appendix 5 <br /> <br />4. Please provide a brief narrative description of potential sources of funding (in addition <br /> <br />to the CWCB) which have been explored or which will be explored for the proposed <br /> <br />project (Examples would be Banks, U.S. Farmer's Home Administration, Colorado <br /> <br />Water Resources and Power Development Authority, etc.) <br />First Bank of Avon - Up to $200,000 medium term <br /> <br />GOCO <br /> <br />265,000 <br /> <br />(See Appendix 6) <br /> <br />5. What collateral will you be offering for this loan?: <br />Government/Agency Bond <br /> <br />Signature of Applicant: <br />Title: <br />Date: <br /> <br /> <br />" fJl2-8-/9 5 <br /> <br />5 <br />