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<br />CWCR Construction Fund Loan Application <br /> <br />I. List any existing liability or indebtedness that exceeds one thousand dollars. For example, bank <br />loans, government agency loans, bond issues, accounts payable, etc. Include names and <br />addresses of lenders, amounts, due dates and maturity dates. Attach a separate schedule, if <br />needed. <br /> <br />Annual <br />Payment <br /> <br />Maturity <br />Date <br /> <br />Lender Name & Address <br /> <br />Remaining <br />Amount <br /> <br />None <br /> <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? <br />YES_ NO N/A . If YES, please give detailed explanation. <br /> <br />3. Please provide a summary of all revenues received during the last two fiscal years by category <br />(such as service charges, tap fees, assessments, etc.). 2000: $2300 2001: $2300 in <br />assessments - see attached financial statements for 2000 and 2001. <br /> <br />4. Please provide a brief narrative description of sources of funding, in addition to the CWCB, <br />which have been explored for this project (Examples would be Banks, Rural Development, <br />NRCS, Colorado Water Resources and Power Development Authority, Colorado Division of <br />Local Government, etc.). We have applied to the NRCS and received fundin!! for 65% of <br />this proiect. See attached NRCS documentation. <br /> <br />5. What collateral will you be offering for this loan? Possibilities include the project itself, pledge <br />of revenues, real estate, water rights. We could !!ive a certificate of deposit in the amount of <br />one loan pavment and the proiect we are buildin!!. <br /> <br />The above statements are true, to the best of my knowledge: <br />Signature of Applicant' /-~ <br />By ,;q rJ5~.J, ~ b_J ) <br />Printed Name Ro!!er Warren <br />Title President <br />Date <br /> <br />4 <br />