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CWCB Water Project Loan Application <br />Lender Name & Address <br />Please see attached. <br />Remaining Annual Maturity <br />Amount PMIn Date <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? <br />YES_0 NO Lr L. If YES, please give detailed explanation. <br />3. 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, USDA Rural <br />Development, NRCS, Colorado Water Resources and Power Development Authority, Colorado <br />Division of Local Government, etc.). Greeley has requested funding assistance from Natural Resources Conservation <br />Service (NRCS), Federal Emergency Management Agency (FEMA), Colorado Department of Public Health and Environment <br />(CDPHE), Colorado Department of Natural Resources (DNR), and Colorado Water Resources and Power Authority (CWRPA). <br />4. What collateral will you be offering for this loan? Possibilities include a pledge of revenues, <br />the project itself, real estate, water rights. Pledge of revenues created by water rates charged to water customers. <br />The above statements are true, to the best of my knowledge: <br />Signature of A <br />Printed Name J Onl <br />Title wafer ? Seae� 0ireAof' <br />Date ( ac .zo) Z <br />21 <br />