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Name of Applicant: C of ot� <br /> Date Received: to/to /2044 <br /> Grant Amount: if,41) o00 49 `tlA <br /> HB 05-1254: Evaluation Checklist for Entities <br /> IFor, Yes No Comments: <br /> Is the applicant a covered entity? <br /> Does the applicant have a state approved water conservation plan in <br /> accordance with statutory revision 37-60-126? (HB 04-1365)? ✓ ��' �Iq <br /> (If answered no to the above question) then, Does the covered entity <br /> have a locally adopted water conservation plan with defined water <br /> saving goals? <br /> Did the applicant provide a written statement from the entity's ch.,/ <br /> governing board, stating the entity's commitment to the project and the j , <br /> entity's commitment to implementing long-term water saving measures <br /> and programs (w/authorized signature)? <br /> Did the applicant provide a cover letter with the entity's: name, contact <br /> Pct. i► <br /> information, and a signature of an individual with the authority to <br /> commit the resources of the entity? <br /> Did the applicant provide a list of people and/or organizations that will w• 1gN7 wa1-6; <br /> be involved in assisting with the grant project (list of who will be utilizing <br /> E*cr c 5uLrfer'8'S <br /> the grant money)? (t 2-- 4 <br /> Characterizing Water System: <br /> Did the entity provide their annual retail water demand (Metered Water <br /> Use) for the past five years (in acre ft. or million gallons)? <br /> Did the entity identify their retail water delivery (Distributed Water)for ✓ ,—aftV t- <br /> each of the past five years (in acre feet or million gallons)? <br /> (Not required, but preferred), Did the applicant provide information Test - PERcFr„A4e <br /> characterizing past water use by sector, (e.g. residential, commercial, <br /> °"' <br /> g p Y ( <br /> and industrial) and the source (e.g. surface water, groundwater, etc). <br /> Did the entity provide current (and if available past) per capita water `° ,�a�,Q€� ` 40$9a � <br /> use for the last five years and the basis for this calculation? SF s <br /> TA6L - 2 <br /> Did the entity provide their past, current, and predicted future ✓ `3•6,1' <br /> population served by the entity, (and the source of this information)? -rwi5c 16gio- a 4) <br /> Did the entity state the water savings that was accomplished in the past - <br /> five years through water conservation efforts? <br /> Did the entity state water savings goals to be achieved through the r 'p' ` g't,'"' <br /> UNsolug %Ast4ta1E <br /> implementation of the "project"? 15 Cs Tr0-6A,evo <br /> Adequacy, Stability, and reliability of the entity's water system ✓ 8 <br /> *to be measured and examined by staff through analysis <br /> Description of Project: <br /> Did the applicant write a paragraph stating the purpose and the primary ✓r <br /> features of the project? <br /> Did the applicant provide a detailed Scope of Work (tasks to be APPEJot)t o <br /> performed with grant monies stating how grant money will be used to <br /> achieve project goals)? <br />