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Water Supply Reserve Account -Grant Application Form <br />Form Revised May 2007 <br />8 . Additional Information - If you feel you would like to add any additional pertinent information please <br />feel free to do so here. <br />The above statements are true to the best of my knowledge: <br />Digitally signed by Nicole Seltzer <br />Signature of Applicant: DN: CN =Nicole Seltzer, C = US, 0 = CFWE, OU =Executive Director <br />N I I I L 1 Reason: I am the author of this document <br />coe et e1 .. ~~ <br />Date: 2008.05.21 13.32.25 -06 00 <br />Print Applicant's Name: N i co l e An n e S e l tze r <br />Project Title: Solicitation of stakeholder in ut...throu h...a South Platte...Headwaters <br />p g <br />Return this application to: <br />Mr. Rick Brown <br />Intrastate Water Management and Development Section <br />COLORADO WATER CONSERVATION BOARD <br />15 80 Logan Street, Suite 600 <br />Denver, CO 80203 <br />To submit applications by Email, send to: rick.brown(a,state.co.us <br />Reference Information <br />The following information is available via the Internet. The reference information provides additional detail <br />and background information regarding these criteria and guidelines and water policy issues affecting our <br />state. <br />Sample Contract and Purchase Order - httpa/cwcb.state.co.uslIWMDIRelatedInformationlToolsResourcesl <br />Colorado Water Conservation Board Policies <br />Loan and Grant policies and information are available at - httpa/cwcb.state.co.us/Financel <br />11 <br />