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Art3_Barstow_FY25_BikePed_Rimrock_SignedClaim San Bemardino County Transportation Authority Claim Form Article 3 Grant Program Project Name: Rimrock Road Reconstruction Project(Bike/Ped Components) Grant Allocation No:L26-Art3-BAR-G4 Claimant: City of Barstow Address:220 E. Mt. View Suite A Barstow, CA 92311 Attention: Phone No: E-mail Address: Award Amount $ 490,000M; Purpose: Please check one purpose. Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUQ 99233.3 ❑ Transit Stop Access Improvements,PUC99233.3 Note:this form only needs to be completed and submited with the full award amount once. Authorizing Signature: (Authorized Agent specified in A ing Resolution) ///Z�Z Date: v h Z/ Signature _Rochelle Clayton, City Manager 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. M3_Barstow_FY25_Bike Ped_RimrockReco n_Claim Claim Form Page 1