PROJ00054

• Contract/PO #: C153473
• Contractor Name: Stewart Ditch and Reservoir Company
• Contract Type: Loan
• Water District: 40
• County: Delta
• Bill Number: EO 08-08-86
• Loan Projects - Doc Type: Contract Documents

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Puroose:

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STATE Of COLORAlX)

Colorado Water Conservation Board

Borrower Verification Form

To update Borrower's current information.

ITEM

Company Name:

Address:

Business Phone Number:
Fax Number:
E-mail Address:
Contact Person:
Contact's Title:
Contact's Phone Number:
Loan Contract Number:
Payment Amount:
Payment Due Date:

CWCB DATA

NEW DATA

Stewart Ditch and Reservoir
Company

P. O. Box 386

Paonia, CO 81428-

[phone]

Nonnan Smith
President

[phone]

CI53473

$7,991.86

Januaryl

I. January I
2, February I
3, Other

Additional Comments:

Please return this comDleted form to:

Colorado Water Conservation Board
Attention: Water Supply Planning & Finance Section
1313 Sherman Street, Room 721
. Denver, CO 80203

Phone Number:
Fax Number:
E.mail Address:

[phone]
[phone]
steve. [e-mail]