Art3_Fontana_FY25_BikePed_RandallPepper_ClaimSigned San Bernardino County Transportation Authority
Claim Form
Article 3 Grant Program
Project Name: Randall Pepper(O'Day Short)Elementary SRTS Sidewalk Gap Closure Grant Allocation No: L26-Art3-FON-09
Claimant: City of Fontana
Address: 16860 Valencia Ave, Fontana,CA 92335
Attention: City of Fontana
Phone No: (909)350-6681
E-mail Address: gbravo@fontanaca.gov
Award Amount $ 250,000.00
Purpose: Please check one purpose.
0 Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUQ 99233.3
❑ 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: � �A1dR7_�24
Signature
V6 It i van_
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.
TDA3 Claim Form FY25-BikePed Randall Pepper.xlsx
Claim Form Page 1