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Grant Application-CWCB Construction Fund <br /> Form Revised December 16,1999 <br /> 411 <br /> bank loans, government agency loans, bond issues, accounts payable, etc. Include names <br /> and addresses of lenders, amounts, due dates and maturity dates. (You may attach a separate <br /> schedule if you wish): <br /> Lender Total Annual Maturity <br /> Name/Address Amnnnt Payment Date <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.): <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 /> The above statements are true,to the best of my knowledge: <br /> Signature of Applicant: <br /> • <br /> 5 <br />