SBCTA Claim Form_Base Line Rd and Deer Creek Trail Crossing San Bernardino County Transportation Authority
Claim Form
Article 3 Grant Program
Project Name: Base Line Road and Deer Creek Trail Crossing Enhancements Grant Allocation No: L26-Art3-RCH-13
Claimant- City of Rancho Cucamonga
Address: 10500 Civic Center Drive
Rancho Cucamonga,CA 91730
Attention: Marlena Perez
Phone No: 909-774.4058
E-mail Address: Marlena.Perez@cityofrc.us
Award Amount $ 250,000.00
Purpose: Please check one purpose.
EJ Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUQ 99233.3
11 Transit Stop Access Improvements,PUC 99233.3
Note:this form only needs to be completed and submited with the full award amount once.
Authorizing Signature:
(Authorized Agent specified in Authorizing Resolution)
Date:
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.
Arta Rancho FY25_BikePetl_BaselineDeerCreekCrossing_Claim
Claim Form Page 1