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Name of Applicant: E. L anrnr-r Cr►i -v W-) O D Mrrc-4- <br />Date Received: Atag 4� 1 tI ®d 3 <br />HB 05 -1254: Evaluation checklist for Entities <br />NP <br />Yes <br />No <br />Comments: <br />Is the applicant a covered entity? <br />✓ <br />780 a008 <br />Does the covered entity have a state approved water conservation plan in <br />cippra t<d o <br />accordance with statutory revision 37 -60 -126? (HB 04- 1365)? <br />(If answered no to the above question) then, Does the covered entity have <br />a locally adopted water conservation plan with defined water saving <br />goals? <br />Did the applicant provide disclosure of its organizational structure /chart? <br />U/ <br />Did the applicant provide its charter? <br />Did the applicant provide a written statement from the entity's governing <br />- QrDryl Gt�NI <br />board, stating the entity's commitment to the project and the entity's <br />commitment to implementing long -term water saving measures and <br />progra (w /authorized signature)? <br />Did the applicant provide a cover letter with the entities: name, contact <br />Spec <br />information, and a signature of an individual with the authority to commit <br />AD C °rnVWr fzr <br />the resourc of the entity <br />Did the applicant provide a list of people and /or organizations that will be <br />,5 10 1 (9 <br />involved in assisting with the grant project (list of who will be utilizing <br />Vol, <br />PO a 4 W <br />the grant money)? <br />Characterizing Water System: <br />- - - -- <br />- - - -- <br />------ - - - - -- <br />Did the entity provide their annual retail water demand for the past five <br />✓ <br />Pg 3 <br />years (in acre ft. or million gallons)? <br />Did the entity identify their retail water delivery for each of the past five <br />Pg9 <br />years (in acre feet or million gallons)? <br />(Not required, but preferred), Did the applicant provide information <br />b j{ P3 ° I <br />characterizing past water use by sector, (e.g. residential, commercial, and <br />s�pQs <�c <br />industrial) and the source (e.g. surface water, groundwater, etc). <br />P3 5 <br />Did the entity provide current (and if available past) per capita water use <br />✓ <br />Q3 3 <br />for the last five years and the basis for this calculation? <br />Did the entity provide their past, current, and predicted future population <br />/ <br />served by the entity, (and the source of this information)? <br />Did the entity state the water savings that was accomplished in the aAst <br />h (� <br />five years through water conservation efforts? <br />V <br />Did the entity state water savings to be achieved through th <br />"project "? <br />O <br />V 111 <br />pg� �rrons ova <br />go 0 4 5016 <br />implementation of the <br />`S CO LA- . <br />Adequacy, Stability, and reliability of the entity's water system <br />✓ <br />*to be measured and examined by staff through analysis <br />Description of Project: <br />- - - - -- <br />- - - -- <br />------- - - - - -- <br />Did the applicant write a paragraph stating the purpose and the primary <br />V/' <br />10 <br />features of the project? <br />Did the applicant provide a detailed narrative (description) of tasks to be <br />10 —to <br />performed with grant monies (stating how grant money will be used to <br />achieve proje t goals)? *(a "scope of work" can combine this item with <br />described <br />V <br />the timeline below) <br />M <br />-e5 <br />Wi <br />