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Non-reimbursable Investment Application-CWCB Construction Fund <br /> Form Revised August 8,2003 • <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: <br /> 3. Please provide a summary of all revenues received during the last two fiscal years by <br /> category(such as service charges,tap fees, assessments, etc.): N/A <br /> 4. Please provide a brief narrative description of potential sources of funding (in addition to <br /> the CWCB)which have been explored or which will be explored for the proposed project or • <br /> study. (Examples would be Local County and Town Governments, Water Conservancy <br /> Districts, USDA Rural Development, The Natural Resources Conservation Service, The <br /> U.S. Environmental Protection Agency, Commercial Banks, etc.) <br /> N <br /> The above statements are true,to the best of my knowledge: <br /> Signature of Applicant: <br /> Print Applicants Name:Ray Alvarado <br /> Title: Senior Water Resource Specialist <br /> Date: August 14, 2003 <br /> • <br /> 5 <br />