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Art3_LomaLinda_FY19_Transit_BartonCA_Inv_CLOSEDApproved by Ginger Koblasz on 1/26/23 San Bernardino Associated Governments Reimbursement Request Article 3 Grant Program Claimant: City of Loma Linda Grant Information (completed by SANBAG) Article 3 Total Project Award Percent Local Match Percent Local Project Name Cost Amount Article 3 Amount Accessibility Improvements at Barton and California -EB and WB $ 39,371 $ 31,497 80% $ 7,874 Instructions: Please comnlete 1 throu11h 4 below. Amount 1) Article 3 Project Cost (amount being requested for reimbursement)$ 29,151 2) Local Match Proiect Cost $ 7,288 Total $ 36,439 Project Costs to Date (include amount requested above) 3) Article 3 $ 29,151 Local Match Amount Remaining 4) Local Match $ 7,288 Article 3 Balance Remaining Total $ 36,439 Total Amount Remaining I certify that the information on this Financial Reporting form is true and accurate to the best of my knowledge. The same authority that signs the Claim Form must sign this form. Art3_Lomalinda_FY19_ Transit_BartonCA_Claim (6) Reimbursement Request Date: Match 20% 586 2,346 2,932 Page 1 DATE VENDOR DESCRIPTION AMT 03/19/20 Lowe's Companies Inc Wood, Steel Wire Mesk, Bar ties $94.41 03/25/20 Lowe's Companies Inc Wood and concrete $212.99 03/30/20 Lowe's Companies Inc Wood $48.56 06/15/20 Great Westen Recreation (2)5" canopies w/single bench $6,867.63 03/31/20 Robertson's Concrete for bus pads $1,164.98 02/28/20 Tolar Manufacturing Co., Inc. Construction of bus shelters $20,682.00 09/14/20 Lowe's Companies Inc Concrete for bus pads $208.54 09/16/20 Lowe's Companies Inc Hardwared for bus stop benches $29.65 09/22/20 Lowe's Companies Inc Concrete for bus pads $180.94 $29,489.70 Back-up Documentation Labor Costs/Local Match Amt