SBCTA Claim Form_Foothill Bike Lane San Bernardino County Transportation Authority
Claim Form
Article 3 Grant Program
Project Name: Foothill Bike Lane Restriping Grant Allocation No: L26-Art3-RCH-14
Claimant: City of Rancho Cucamonga
Address: 10500 Civic Center Drive
Rancho Cucamonga,CA 91730
Attention: Marlena Perez,Principal Civil Engineer
Phone No: (909)7744058
E-mail Address: Marlena.Perez@cityofrc.us
Award Amount $ 342,D00.00
Purpose: Please check one purpose.
Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3
t Transit Stop Access Improvements,PUC 99233.3
Note:this farm only needs to be completed and submlted with the full award amount once.
Authorizing Signature:
(Authorized Agent specified in Authorizing Resolution)
Date: Z/-)/Zs�P_4
Signature
Jason Welday,Director of Engineering 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.
AA3_Rancho_FY25_BikePed_FoothiiBikeLane Claim
Claim Form Peyi t