Art3_Yucaipa_FY21_Transit_Transit Stops_Inv Claimant: City of Yucaipa Date: 2/2/2026
Please see below instructions and checkmark the items included in your submittal.
1. Claim Form (one-time submission)—required prior to,or along with,your first reimbursement
request.
2. Authorizing Resolution(one-time submission)—required within SIX months of the project
award by SBCTA Board or prior to requesting reimbursement of funds,whichever comes first.
Resolution should authorize the filing of the claim form,authorize the submission of
reimbursement requests and designate the individuals authorized to certify project completion
(Authorized Agent).Sample language is available upon request.
3. Reimbursement Request Form (as needed)—this form is required every time a
reimbursement is requested. Please note, progressive payments are only eligible on awards over
$200,000 and local match share percentage must be met regardless of reimbursement amount
requested.
004. Backup Documentation(required with Reimbursement Request Form)—invoices, paychecks,
purchase orders,etc.to support both the reimbursement and match amounts noted on the
Reimbursement Request Form.Please note,staff administration and/or contract project
management expenses are NOT eligible match expenses. However,staff expenses may qualify for
local match under select circumstances.Please identify whether supporting documentation
includes staff expenses under one of the following allowable conditions:
❑ Award is for an ATP Safe Routes to School(SRTS)program project,not a SRTS infrastructure
project.
❑ Necessary staff time directly related to in-house completion of design,right-of-way
acquisition,or construction including inspection and/or construction management.
❑ Note: No travel costs or per diems allowed for staff time
we 5. Certification of Completion(completed projects only)—prior to filing the final request for
reimbursement,written verification of project completion by the agency's Authorized Agent is
required(see Authorizing resolution above).Sample language is available upon request.
WO 6. Photos of Completed Project(completed projects only)—required when project is complete
and should be attached to final reimbursement request.
V7. Other(optional)—Claimants may attach additional information not included in this list to
support the claim or reimbursement request.SBCTA may request additional information as
necessary.
0
San Bernardino Associated Governments
Claim Form
Article 3 Grant Program
Project Name: Transit Stops Access in the City of Yucaipa Grant Allocation No: L22-0702-0752-00
Claimant: City of Yucaipa
Address: 34272 Yucaipa Blvd
Yucaipa,CA 92399
Attention: Todd Gutjahr
Phone No: 909-797-2489x289
E-mail Address: tgutjahr@yucaipa.gov
Award Amount $ 13,200.00
Purpose: Please check one purpose.
❑ Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3
O Transit Stop Access Improvements,PUC99133.3
Authorizing Signature:
(Authorized Agent specified in Authorizing Resolution)
Date: 2/2/2026
Signa
Fermin Preciado,PE-Director of Development Services/City Engineer
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.
Ana Yucaipa_FY21_Transit_StopAccess_Claim
Claim Form Page 1
RESOLUTION NO. 2022-08
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF YUCAIPA
AUTHORIZING SUBMITTAL OF A CLAIM TO SBCTA FOR TDA ARTICLE 3
FUNDS FOR THE CITY-WIDE BUS STOP ENHANCEMENTS—PROJECT NO. 11169
WHEREAS, the Mills-Alquist-Deddeli Act (S13 325) was enacted by the California
Legislature to improve existing public transportation services and encourage regional.
transportation coordination. Known as the Transportation Development Act (TDA) of
1971, this law provides funding to be allocated to transit and non-transit related
purposes that comply with regional transportation plans; and
WHEREAS, TDA provides two funding sources, the Local Transportation Fund
(LTF) and State Transit Assistance Fund (STA); and
WHEREAS, STA is derived from the statewide sales tax on diesel fuel, plus an
additional vehicle registration fee authorized under Senate Bill 1, referred to as the
State of Good Repair, and both are apportioned by the State Controller's Office 50%
by population and 50% by transit operator revenues;.and
WHEREAS, the San Bernardino County Transportation Authority (SBCTA)
authorizes funding for a wide variety of transportation programs in San Bernardino _
County, including planning and program activities, pedestrian and bicycle facilities, r
community transit services, public transportation, and bus and rail projects` to local
transportation agencies through annual apportionment and allocation processes, and
approves payments periodically throughout the year; and
WHEREAS, SBCTA awarded the City of Yucaipa a TDA Article 3 grant funds in
the amount of S13,200 for the City-Wide Bus Stop Enhancement development Project within
the City ofYucaipa's jurisdiction through a competitive "Call for Projects'; and
WHEREAS, TDA Article 3 grant funds are provided on a reimbursement basis;
and
WHEREAS, SBCTA requires the City of Yucaipa to submit a claim and
request(s) for reimbursement; and
WHEREAS, submittal of the claim for TDA Article 3 funds must be first
authorized by the City Council of the City of Yucaipa; and
WHEREAS, the City-Wide Bus Stop Enhancement Project award is over$200,000,
and is eligible for progress reimbursement, or under, and eligible for reimbursement at
project completion; and
WHEREAS, SBCTA requires the designation of individuals authorized to certify
Project completion; and
WHEREAS, the City Council of the City of Yucaipa or their designee is authorized
to certify project completion, and
NOW, THEREFORE, BE IT RESOLVED THAT THE CITY COUNCIL OF THE
CITY OF YUCAIPA. HEREBY FINDS, DETERMINES, ORDERS, AND RESOLVES AS
FOLLOWS: that the City Council of the City of Yucaipa authorizes submittal of a claim for
TDA Article 3 funds for the City-Wide Bus Stop Enhancement Project in the amount of S 13,200.
PASSED, APPROVED, AND ADOPTED by the City Council of the City of Yucaipa this
281h day of February 2022.
t Cat
DA ID AVILA
MAYOR
ATTEST:
JENNIFER CRA ORD
ASSISTANT CIT MANAGER/CITY CLERK
San Bernardino Associated Governments
Reimbursement Request
Article 3 Grant Program
Claimant: City of Yucaipa Allocation #: L22-0702-0752-00
Grant Information(completed by SBCTA)
Total Project Article 3 Award Percent Article
Project Name Local Mach ATP Funds
Cost Amount 3
Transit Stops Access in the City of Yucaipa $26,400.00 $13,200.00 50% $13,200.00
Instructions: Please complete 1 through 5 below.
Amount
1)Article 3 Cost(amount being requested for
reimbursement) $10,784.00
2) Local Match/ATP Funds Cost $10,784.00 flmalld sham seat,ge to et
rflocol share is,wf met
Total $21,568.00
Project Costs to Date(include amount requested above)
3)Article 3 $10,784.00 Article 3 Balance Remaining $2,416.00
4)Local Match $10,784.00 Local Match $2,416.00
5)ATP(if applicable) $0.00 ATP Funds(if applicable) $0.00
Total $21,568.00 Total Amount Remaining $4,832.nn
I certify that the information on this Financial Reporting form is true and accurate to the best of my knowledge.
(Authorized Agent T
uthorizing Resolution)
Signed: Date: 2/2/26
Art3_Yucaipa_FY21_Transit StopAccess_Claim
Reimbursement Request Page 1 `�+J
Bus Stop Pad Information
Bid Item# Quantity Cost/Unit Total Cost
#1 7 113 $ 16.00 $ 1,808.00
Oak Glen 8 34 $ 85.00 $ 2,890.00
Rd./Yucaipa Blvd. 10 130 $ 10.00 $ 1,300.00
#2 7 36 $ 16.00 $ 576.00
Yucaipa Blvd./ 10 36 $ 10.00 $ 360.00
1 Oth St.
#3 7 100 $ 16.00 $ 1,600.00
Yucaipa Blvd./ 9 1 $ 24.00 $ 24.00
1Oth St. 10 100 $ 10.00 $ 1,000.00
#4 7 150 $ 16.00 $ 2,400.00
Yucaipa Blvd./
6th St.
#5 7 150 $ 16.00 $ 2,400.00
California St./
Bella Vista Dr.
#6 2 140 $ 19.00 $ 2,660.00
5th St./Ave.H 7 175 $ 16:00 $ 2,800.00
10 175 $ 10.00 $ 1,750.00
$ 21,568.00
**No work compelted at California St.and County Line Rd.
$ 10,784.00 50%
City of Yucaipa
STREET LOCATIONS FOR CONCRETE CONSTRUCTION
Address Street Name or Location Bid Quantity Unit Layout(ft)
Number Item
11736 3rd Street 3 6 LF --
12867 Ith Street 2 152 SF 4'x38'
13388 Canyon Heights Drive 2 50 SF 4'x12.5'
13401 Canyon Heights Drive 2 74 SF 4'x 18.5'
13464 Canyon Heights Drive 2 84 SF 4'x2 F
13478 Canyon Heights Drive 2 88 SF 4'x22'
13478 Canyon Heights Drive 5 74 SF 7'x10.5'
36246 Canyon Terrace Drive 2 24 SF 4'x6'
36307 Canyon Terrace Drive 2 138 SF 4'x34.5'
36307 Canyon Terrace Drive 2 40 SF 4'x40'
35160 County Line Road 5 53 SF 7'x7.5'
--- Date Avenue @Comberton Street(SW 4 420 SF 6'x24'Cross Gutter,24'x23'/2
Corner) Spandrel
--- Date Avenue @Vista Lane(NE Comer) 4 414 SF 6'x23'Cross Gutter,24'x23'/2
Spandrel
12749 Lantana Avenue 2 64 SF 4'xl6'
12749 Lantana Avenue 5 24 SF 4'x6'
13280 Mesa Grande N/O Sharon Way(West 2 60 SF 4'x15'
Side)
33291- Oak Glen Road(South Side) 6 40 LF -Five(5)locations along wall—see
33459 photos
33527 Oak Glen Road 2 205 SF 6'Wide @ curb returns
33527 Oak Glen Road 3 44 LF Two curb returns
33527 Oak Glen Road 4 70 SF Two spandrels
35111 Oak Glen Road 1 340 LF --
Oak Glen Road,Stonewood Pl.to 2nd St. 2 378 SF Various locations 5'xl0',
(South Side) 5'XlO',5'Xl6', 5'Xl0' &5'x20'
--- Mesa Grande S/O Sharon Way(West 2 464 SF 4'x116'
Side)
33811 Plum Tree Lane 2 64 SF 4'x16'
13536 San Juan Avenue 2 136 SF 4'x34'
13536 San Juan Avenue 5 76 SF 4'xl9'
36139 Sharon Way 2 200 SF 4'x50'
36139 Sharon Way 5 32 SF 4'x8'
36151 Sharon Way 2 60 SF 4'xl5'
--- Bus Stop#1 @Yucaipa Blvd&Oak Glen 7 113 SF 25'x4.5'
Road
--- Bus Stop#1 @Yucaipa Blvd&Oak Glen 8 34 LF ---
Road
--- Bus Stop#1 @Yucaipa Blvd&Oak Glen 10 130 SF 26x5
Road
--- Bus Stop#2 @Yucaipa Blvd loth St 7 36 SF 12.5'x3'
--- Bus Stop#2 @Yucaipa Blvd IOth St 10 36 SF 12.5'x3'
--- Bus Stop#3@Yucaipa Blvd& 1 Oth St 7 100 SF 25'x4'
2024/2025 Concrete Program—Project No. 11214 69
City of Yucaipa
--- Bus Stop#3@Yucaipa Blvd& I Oth St 9 I EA ---
--- Bus Stop#3@Yucaipa Blvd& 1 Oth St to 100 SF 25'x4'
--- Bus Stop#4 @ Yucaipa Blvd&6th St 7 150 SF 30'x5'
Bus Stop#5 @ California St&Bella 7 150 SF 25'x6'
Vista Dr
--- Bus Stop 46 @ 5th St&Avenue H 2 140 SF 35'x4'
--- Bus Stop#6 @ 5th St&Avenue H 7 175 SF 25'xT
--- Bus Stop#6 @ 5th St&Avenue H 10 175 SF 25'xT
2024/2025 Concrete Program—Project No. 11214 70
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Application and Certificate For Payment Page 1
To Owner: CITY OF YUCAIPA Project: YUC CONCRETE PROGRAM
34272 YUCAIPA BLVD ) Application No: 1 Date: 09/30/2024
YUCAIPA, CA 92399 Period To: 09/30/24
Architect's
From Three Peaks Corporation Project No:
Contractor)ob
(Contractor): 1025 Calimesa Blvd Suite 6 Number: 24031 Contract Date: 08/01/24
Calimesa, CA 92320
Via (Architect):
Phone: 909 795-1690 Contract For:
Contractor's Application For Payment
Change Order Summary Additions Deductions Original contract sum 165,600.00
Change orders approved in
previous months by owner Net change by change orders 22,816.00
Date Contract sum to date 188,416.00
Number Approved
Change 1 09/30/24 22,816.00 Total completed and stored to date 188,416.00
orders
approved e Retsina
this month 9
5.0% of completed work ECEIVE 9,420.80
Totals 22,816.00 0.0% of stored material 0.00
'JV 2 0 2024
Net change by change antlers ara 22,e16.00 Total retainage 9,420.80
BY: �/�
The f the work
Contractor certifies that to the best n the Contractor's completed
i tic rdancemforonabon,with
and Total earned less retainage 178,995.20
belief ct work covered by this punts have
for Payment has been completed in accordance with the
Contract Documents, that all amounts nave been paid by the Contractor for wort for which previous ``Cj Z02So j)
Certificates for Payment were issued and Payments received from the Owner, and that current Less previous certificates of payment 0.00
Payment shown herein is now due.
0.000% of taxable amount N T E R E 0.00
By, Ca1P._ 11/20/2024
Current sales tax 0.00
State of: County or
subscribed and sworn to before me this_day of BY-
(year). Notary public. Current payment due 178,995.20
My commission expires Balance to finish, including retainage 9,420.80
Architect's Certificate for Payment
In accordance with the Contract Documents, based on on-site observations and the Architect:
data comprising the above application the Architect certifies to the Owner that to the
best of the Architect's knowledge, information and belief the Work has progressed as By: Date:
indicated, the quality of the Work is in accordance with the Contract Documents, and
the Contractor is entitled to payment of the Amount Certified. This Certification is not negotiable. The Amount Certified is payable only to the Contractor named herein. Issuance.
payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this
Amount Certified: $ Contract.
Application and Certiflcate For Payment—page 2
To Owner: CITY OF YUCAIPA Application No: 1 Date: 09/30/24 Period To:09/30/24
From(Contractor): Three Peaks Corporation Contractor's Sob Number: 24031
Project: YUC CONCRETE PROGRAM Architects Project No:
Wodc CamDieted Work Completed Completed and Stored To Date
Previous Application This Period
Item Unit Contract Scheduled
Number Description Price Quantity UM Yalue Quantity Amount Quantity Amount Quantity Amount % Retention Mertes
2 CONTRACr
01 2024rJMCONCREIEPROGRAG 185.600=00 1.000 Le 165.600.00 am% Moo 100.00% 165,600A0 100.00% 165.600m 1002 5.=M
PROJECTNO 11214
Total CONTRACT 165.600A0 0.00 165.600.00 165.6WA0 e.200.00
2 CHANGE ORDERS
01 Morgo 0rtler01 Barg Tobi 0.0000 +000 L8 22.S1aA0 0.00% 0.00 100A% a,alaao 100Jmz 2Zele.o0 1000 1a40.e0 �._...
Te ICHANGEORDERS 22.616.00 0.00 22.816.00 22.elam 1.140.80
Application Total laap15.00 0.00 168+416.00 IM41CLW spme0
City of Yucaipa,CA PAGE:1 OF 1
VENDOR NUMBER VENDOR NAME CHECK NUMBER CHECK DATE CHECKAMOUNT
10328 THREE PEAKS CORPORATION 17714 11125/2024 $178,995.20
INVOICE DATE INVOICE NUMBER DESCRIPTION INVOICE AMOUNT
11120/2024 11214-1 FY 2024/25 CONCRETE PRG $178.995.20
PO#:20250314-Engineering
7 F CITY OF YUCAIPA Vendor Number Check Number Check Date
34272 YUCAIPA BLVD. 10328 17714 1112512024
/ 9/ YUCAIPA,CA 92399
P:909.797.2489
'•'One Hundred And Seventy-Eight Thousand Nine Hundred And Ninety-Five Dollars And Twenty Cents'•' $178,995.20
Pay To THREE PEAKS CORPORATION
FILE COPY
The CALIMESA, NON-NEGOTIABLE
Order Of CALIMESA, CA92320
CITY COUNCIL MINUTE EXCERPT
A Regular meeting of the City Council of the City of Yucaipa was called to order in the City Hall
Council Chambers, located at 34272 Yucaipa Boulevard, Yucaipa, California, at the hour of 6:00
PM.,on the 13th day of November 2024 with Mayor Beaver presiding.
ROLL CALL PRESENT: Justin Beaver, Mayor
Chris Venable,Mayor Pro Tern
Matt Gamer, Councilmember
Jon Thorp, Councilmember
Bobby Duncan, Councilmember
ABSENT: None
A quorum of the City Council was present.
AGENDA ITEM NO. 6
SUBJECT: ACCEPTANCE OF CONTRACT WORK—FISCAL YEAR 2024/2025
CONCRETE PROGRAM—PROJECT NO. 11214
RECOMMENDATION: That the City Council:
1. Accept the contract work completed by Three Peaks Corp. in the amount of$188,416 for
the 2024-2025 Concrete Program—Project No. 11214; and
2. Authorize a transfer of Article 3 TDA Funding in the amount of$13,200 to the Pavement
Management Program (PMP) Fund; and
3. Authorize the recordation of the Notice of Completion for the Program; and
Accept the as-built plans for the Program.
ACTION: MOTION BY COUNCILMEMBER DUNCAN, SECOND BY MAYOR
BEAVER, CARRIED 4-0-1, (COUNCILMEMBER GARNER RECUSED HIMSELF) TO
APPROVE CONSENT AGENDA ITEM NUMBER 6.
STATE OF CALIFORNIA }
COUNTY OF SAN BERNARDINO }
CITY OF YUCAIPA } ss
I, Tara Davis,Administrative Assistant of the City of Yucaipa, California, do hereby certify that the
foregoing is a full and correct excerpt ofthe Minutes of a Regular meeting of the Yucaipa City Council
held on the 13th day of November 2024.
4 yUCAtPA, d�'� l
�Z
Tara Davis
Administrative Assistant
r�
0
0
r'cspc+nnr��Frt� .
11/14/24,2:31 PM Balch 18340686 Confirmation
Electronically
RECORDING REQUESTED BY Snrnldinony Records
aBeayCou
City of Yucaipa 10 Assessor-Recorder-County Clerk
WHEN RECORDED RETURN TO: DOC# 2024-0273130
City Clerk 11114/2024 Titles:1 Pages:1
City of Yucaipa 02:01 PM
34272 Yucaipa Blvd. SAN Fees $0.00
Yucaipa,CA 92399 Taxes $0.00
J9965 CA SB2 Fee $0.00
Total $0.00
Recording Fee$0 SPACE ABOVE THIS LINE FOR RECORDER'S USE
Government Code 6103
NOTICE OF COMPLETION
Pursuant to the provisions of Section 9204 of the Civil Code of the State of
California, NOTICE IS HEREBY GIVEN that work on the certain project known as:
PROJECT NO. 11214
2024-2026 CONCRETE PROGRAM
for the City of Yucaipa was completed and accepted by the City of Yucaipa on the
13th day of November 2024.
The said work was performed by Three Peaks Corp. of Calimesa, CA in
accordance with the terms of the written agreement dated the 26th day of August
2024.
Dated November 13, 2024
CITY OF YUCAIPA,a Municipal Corporation,Owner
L 34�caipa Blvd,Yucaipa,CA 92399
iag F,P,
Fermin G. Preciado,Director of Development Services/City Engineer
A notary public or other officer completing this certificate verifies only the identity of the individual
who signed the document,to which this certificate is attached,and not the truthfulness,accuracy,
or validity of the document.
STATE OF CALIFORNIA }
COUNTY OF SAN BERNARDINO }
Subscribed and sworn to(or affirmed)before me on this 13th day of November 2024,
by Fermin G. Preciado, proved to me on the basis of satisfactory evidence to be the
person(s)who appeared before me.
bk ZO
Date
4`4}v�IAA
c+
Director of General Services/City Clerk
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