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<br />CWCB Construction Fund Loan Application <br /> <br />1. List any existing liability or indebtedness that exceeds one thousand dollars. For example, bank <br />loans, government agency loans, bond issues, accounts payable, etc. Include names and <br />addresses of lenders, amounts, due dates and maturity dates. Attach a separate schedule, if <br />needed. <br /> <br />Lender Name & Address <br /> <br />Remaining <br />Amount <br /> <br />Annual <br />Payment <br /> <br />Maturity <br />Date <br /> <br />N/A <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 _' If YES, please give detailed explanation. N/A <br /> <br />3. Please provide a summary of all revenues received during the last two fiscal years by category <br />(such as service charges, tap fees, assessments, etc.). See attached financial statement for <br />the year 2002. <br /> <br />4. Please provide a brief narrative description of sources of funding, in addition to the CWCB, <br />which have been explored for this project (Examples would be Banks, Rural Development, <br />NRCS, Colorado Water Resources and Power Development Authority, Colorado Division of <br />Local Government, etc.). NRCS will provide aU en~ineerin~ at no cost to the Ditch <br />Company. This is to include a feasibility study, desi~ns of the new stmctures, settin~ <br />structures in place at the time of construction and construction inspection. <br /> <br />5. What collateral will you be offering for this loan? Possibilities include the project itself, pledge <br />of revenues, real estate, water rights. We could ~ive you a pled~e of ditch assessment <br />revenues and the project we are buildin~. <br /> <br />4 <br /> <br />CFLA902 <br />