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Name of Applicant: l l LxA' 7e R- <br />Date Received: -7 AI / 201( f <br />Grant Amount: 33 00c> ---Y 2 P 2'd;r_> <br />HB 05-1254: Evaluation Checklist for Entities <br />For Applicants: <br />Yes <br />No <br />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)? <br />(If answered no to the above question) then, Does the covered entity have a <br />locally adopted water conservation plan with defined water saving goals? <br />If the applicant is a covered entity, have they fully complied with HB1051 <br />requirements? <br />Did the applicant provide a written statement from the entity's governing <br />board, stating the entity's commitment to the project and the entity's <br />/ <br />commitment to implementing long-term water saving measures and programs <br />(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 commit the <br />resources of the entity? <br />Did the applicant provide a list of people and/or organizations that will be <br />involved in assisting with the grant project (list of who will be utilizing the grant <br />,/ <br />money)? <br />Characterizing Water System: <br />----- <br />----- <br />------------ <br />Did the entity provide their annual retail water demand (Metered Water Use) <br />/ <br />for the past five years (in acre ft. or million gallons)? <br />V/ <br />Did the entity identify their retail water delivery (Distributed Water) for each of <br />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, ands1O' <br />industrial) and the source (e.g. surface water, groundwater, etc). <br />Did the entity provide current (and if available past) per capita water use for <br />the last five years and the basis for this calculation? <br />Did the entity provide their past, current, and predicted future population <br />vP Tn 2,�a_3 <br />served by the entity, (and the source of this information)? <br />Did the entity state the water savings that was accomplished in the past five <br />, <br />years through water conservation efforts? <br />✓ <br />s''"-��''� �" <br />Did the entity state water savings Roals to be achieved through the <br />"project"? <br />✓ <br />3 �i� <br />implementation of the <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 />------ <br />----- <br />------------- <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 performed <br />with grant monies stating how grant money will be used to achieve project <br />goals)? <br />Did the applicant provide a "project" timeline, stating milestones with dates <br />and end products with dates; also state the estimated dates when progress <br />reports will be submitted to CWCB staff (50% & 75% completion)? <br />