Art3_Victorville_FY19_BikePed_OldTownPhase1_ClaimSigned San Bemardino Associated Governments
Claim Form
Article 3 Grant Program
Project Name: Old Town Sidewalk Connectivity Project Grant Allocation No: L20-0702-0751-00
Claimant: City of Victorville
Address: 14343 Civil Dr
Victorville,Ca 92392
Attention: Brian Gengler
Phone No: 760-955-5200
E-mail Address: Wenglerd-Wictorvilleca.gov
Amount Requested
for Reimbursement: 5 244,000.00
Purpose: Please check one purpose.
(X) Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3
( ) Transit Stop Access Improvements,PUC 99233.3
Authorizing Signature:
(Claimant's Chief Adminstrator or Financial Officer)
fsu� Date: T- 26--22
Signature If
Brian Gengler,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.
Art3_V iotorvi Ile_FY19_B i kePed_OldTown_C la i m.xlsx
Claim Form Page 1