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Name of Applicant: t x•-> Ms.Q- (A-5 S ni .,tc:r- <br /> Date Received:_243_47 201 <br /> Grant Amount: 3f,)(oo( . 'RA <br /> HB 05-1254: Evaluation Checklist for Entities <br /> For Applicants: Yes No Comments: <br /> Is the applicant a covered entity? <br /> Does the applicant have a state approved water conservation plan inDEO\tom wA- tz <br /> accordance with statutory revision 37-60-126? (HB 04-1365)? \// ��s <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 /> If the applicant is a covered entity, have they fully complied with <br /> HB1051 requirements? /A <br /> Did the applicant provide a written statement from the entity's <br /> governing board, stating the entity's commitment to the project and the <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 /> 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 <br /> be involved in assisting with the grant project (list of who will be utilizing <br /> the grant money)? <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 <br /> each of the past five years (in acre feet or million gallons)? <br /> (Not required, but preferred), Did the applicant provide information <br /> characterizing past water use by sector, (e.g. residential, commercial, ✓' <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 <br /> use for the last five years and the basis for this calculation? <br /> Did the entity provide their past, current, and predicted future <br /> population served by the entity, (and the source of this information)? <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 <br /> implementation of the "project"? <br /> Adequacy, Stability, and reliability of the entity's water system <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 <br /> features of the project? <br /> Did the applicant provide a detailed Scope of Work (tasks to be ��' <br />