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<br />Water Supply Reserve Account - Grant Application Form <br />Form Revised April 2007 <br /> <br />Part A. - Description of the Applicant (Project Sponsor or Owner); <br /> <br />Mailing address: <br /> <br />I Goodman Point <br /> <br /> <br />12190 C. R. 16 <br />Cortez, CO 81321-8716 <br /> <br />Water Association <br /> <br />1. <br /> <br />Applicant Name(s): <br /> <br />Taxpayer 10#: 116-1770907 1 Email address: I JR.Berry@Hotmail.com <br />Phone Numbers: Business: I (970) 759-9562 I <br />Home: I (970) 565-3227 I <br />Fax: I I <br /> (970) 565-8797 <br /> <br />2. Person to contact regarding this application if different from above: <br /> <br />Name: <br /> <br />J .R. Berry <br /> <br />Position/Title <br /> <br />President, Goodman Point Water Association <br /> <br />3. Provide a brief description of your organization below: see "Description of Applicant" in Part 2 of Criteria and <br />Guidance for required information. <br />Goodman Point Water Association (GPW A) is a 501 C 12 non-profit corporation formed in 2006. It <br />comes under the eligibility category, "Private Incorporated ". We are organized under and by virtue <br />of, and in accordance with the provision of Articles 20 through 29 of the Colorado Non-Profit <br />Corporation Act (see attached Articles of Incorporation, By-Laws, Registration document with the <br />Colorado Secretary of State and IRS ruling on Goodman Point Water Association as a qualified 501 C <br />12 non-profit corporation. <br /> <br />GPW A was organized specifically to develop (or cause to be developed) a domestic water supply to <br />the residents of Goodman Point of Montezuma County, Colorado. We have a Board of Directors <br />consisting of three (President, Vice-President, and Secretary/Treasurer. We have no employees. <br />Refer to the project Summary Letter and Financial Attachments for the additional information <br />Requested here (project need, funding requested, problems & opportunities, why the project is <br />important to GPW A, etc) Also refer to the PER & ER for complete information regarding "Study <br />Area Description". <br /> <br />2 <br />