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Art3_VVTA_FY21_Transit_Apple Valley Turn Out_SignedClaim San Banardino Associated Govaaments Claim Form Article 3 Grant Program Project Name: Apple Valley Bus Turn Out Grant Allocation No: L22-0702-0751-01 Claimant:Victor valley Transit Authority Address: 17150 Smoke Tree Street Hesperia,CA 92345 Attention: Marie Downing Phone No: (760)995-3575 E-mail Address: mdowning@vvta.org Award Amount 75,DOO.00 Purpose: Please check one purpose. ❑ Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3 97 Transit Stop Access Improvements,PUC99233.3 Authorizing Signature: (Authorized Agent specifled in Authorizing Resolution) Date: rJ2J ZIt. O'Signature Kevin Kane,Executive Director/CEO 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. I Art3_1NrA_Ml TransiLAVbusTumOuLCiaim Claim Form Page 1 I