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VV Sunhill Dr & Chalon Rd Claim Form Signed_Signed Claim San Bernardino County Transportation Authority Claim Form Article 3 Grant Program Project Name: Victorville-Sunhill Drive&Chalon Road Grant Allocation No: L24-0702-0751-01 Claimant: VVTA Address: 17150 Smoke Tree Street Hesperia,CA 92345 Attention: Megan Christian Phone No: 760-995-3472 E-mail Address: Mchristian@vvta.org Award Amount S 76,080.00 Purpose: Please check one purpose. ❑ Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3 0 Transit Stop Access Improvements,PUC99233.3 Authorizing Signature: (Authorized Agent specified in Authorizing Resolution) \►.{. Date: e Signature Nancie Goff,Chief Executive Officer Type Name&Title Condition of Approval: Approval of this claim and payment by the County Auditor to this claimant are subject to monies being available and to the provision that such monies will be used only in accordance with the approved allocation instruction. Arta_VVTA FY24 Transit Victorville-SunhillDrive_Claim Claim Form Pagel