Art3_Redlands_FY13_BikePed_OBTIII_Inv12_180208_CLOSED City of
a REDLANDS MAUL DOOR
MUED Director
Incorporated 18M SAVAT KHAMPHOU
' Municipal Utilities& Engineering Department
RR 9�6 35 Cajon Street, Suite 15A Assistant City Engineer
Redlands,CA 92373
909-798-7698
February 8, 2018
Nancy Strickert tit
San Bernardino County Transportation Authority
1170 W. 3rd Street, 2nd Floor C ��
San Bernardino, CA 92410-1715 J
ORANGE BLOSSOM TRAIL PHASE III PROGRESS PAYMENT REQUEST #12
Ms. Strickert,
City of Redlands submits to San Bernardino County Transportation Authority (SBCTA)progress
payment request #12 for Phase III of the Orange Blossom Trail. City Resolution No. 7299,
adopted on July 16, 2013, accepted Transportation Development Act Article 3 grant funding in
the amount of$918,722.00 and allocated $162,128.00 of City's Palmetto Grove Fund to be used
as the grant match. Progress payment request#12 is in the amount of$4,848.40.
Attached are the following documents for your review and processing:
1. Claim Form Checklist
2. Claim Form
3. Financial Reporting Form t�
4. Invoice, check and backup documents for payments
If Yq you have an uestions�p lease contact me at 909-798-7524 Ext. 1.
Y
Since rel ,
!� ss Wittman
Senior Project Manager
I L�ANI]S"AC&TwWow"
San Bernardino County Transportation Commission
Local Transportation Fund - Article 3 Pedestrian, Bicycle Facilities
and Access to Transit
Claim Form
Claimant: City of Redlands Date: 2/8/2018
The Check-List below are items that must be included with your submission for reimbursement
X 1. Claim Form
X 2. Financial Reporting Form
(Complete the estimated column for anticipated interest, refunds and expenditures)
X 3. Request for Progress Payment (projects over$200,000)
(Certified copy of resolution or minute action authorizing the filing of the claim and
requesting progress payments)
4. Governing Body Authorization (Completed Projects)
(Certified copy of minute action or resolution authorizing the filing of the claim and
Project acceptance)
5. Project Completion Report
(Council's Project acceptance can be used. Pictures of completed project must be
included.)
X 0. Other (optional)
(List any other information you wish to submit to support your claim)
#12-Check List, Claim Form &Financial Reporting Form
Check List Page 1
San Bernardino County Transportation Commission
Local Transportation Fund - Article 3
Pedestrian, Bicycle Facilities and Access to Transit
Claim Form
Fiscal Year: FY2018
Claimant: City of Redlands Attention: Ross Wittman
35 Cajon Street, Suite 15A Senior Project Manager
Redlands, CA 92373 Phone#: 909-798-7698
Amount: $ 4,848.40
PURPOSE: { )Article 3, PUC Section 99234a Pedestrian Facilities
(x)Article 3, PUC Section 99234a Bicycle Facilities
( )Article 3, PUC Section 99234a Pedestrian Access to Transit Facilities
Authorizing Signature:
(Sign tore)
Pau Toor UED Director
(Type Rarne&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 allocation instruction.
#12-Check List,Claim Form&Financial Reporting Form
Claim Form
Page 2
San Bernardino County Transportation Commission
Local Transportation Fund - Article 3
Bicycle, Pedestrian and Access to Transit
Financial Reporting Form
Claimant: City of Redlands Date: 2/8/2018
Project % Project
Budget TDA Actual
Cost Budget Cost
1. Project Name: Orange Blossom Trail Phase Total Project Expenditure $ 1,080,850 $ 5,704.00
3 TDA Article 3 (SB 821) $ 918,722 1 85% $ 4,848.40
* Local Match $ 162,128 $ 855.60
2. Project Name: Total Project Expenditure $ -
TDA Article 3 (SB 821) $
Local Match $ -
3. Project Name: Total Project Expenditure $ -
TDA Article 3 (SB 821) $ -
Local Match $ -
I certify that the information on this Financial Reporting form is true and accurate to the best of my knowledge.
Signed:
aul TJY, MU Director
#12-Check List,Claim Form&Financial Reporting Form Page 3
CITY Of I1fhn8.nkN.A.
uarr.rvftrApaee M2
Check No. 183608
C L L'I ► 6 A I1 I A
PO Sox3M5•RabmikCAM373 ACCOUNTS PAYABLE CHECK 12/14/17
Check Dabs
r
SEVEN Hundred FOUR Dollars and ZERO Cents PAY THIS AN'OUNIT
s ******704.00
PAY TO THE VOID IF NOT CASHED WITHIN SIX MONT14S
ORDER OF: CALIFORNIA DEPARTMENT OF
' FISH AND WILDLIFE
F INLAND DESERTS REGION � `'F
3602 INLAND EMPIRE BLVD STE Ci-2209
y ONTARIO, CA 91764 '9*,,,n19
•
INVOICE DATE INVOICE NO. Po NO. AMOUNT PAID DESCRIPTION
11/27 117 OH022082 704 .00 OBT PH3 LAKE/STRMBD ALTER FEE
CITY OF REDLANDS
VENDOR ACCT NO. CHECK DATE CHECK TOTAL VENDORl10. CHECK NO,
E12/14/17 704.00 V00014640 183608
' r
CITY OF REDLANDS
DISBURSEMENT VOUCHER
To: Finance Department Date: 11/27/2017
Pay To: California Department of Fish and Wildlife Requesting Dept: MUED
Inland Deserts Region
3602 Inland Empire Blvd., Suite C-220 RECEIVED
Ontario, CA 91764
Payment Far: California Department of Fish and Wildlife
Orange Blossom Trail Phase 3 FINANCE DEPARTMENT
Lake and Streambed Alteration Fee
ORGKEY Ob ect Job Ledger Invoice No. Amount
240400 5392 47019 PeFmA ApplieeMen 704.00
0��oa aoS
Grand Total $704.00
Prepared By: ROSS WITTMAN
Authorized By: Finance Approval:
Page 1 of I
CITY OPww" t>nlane.nkN�
1iiG 5�a'e Ee■rt 9o-Itso
1Awt.jr Pwk CA 1"M 1222
Check No. 184099
w L i !r O ; N I A
A°5`300-amkaL*CA92373 ACCOUNTS PAYABLE CHECK Checkf)ate 12/27/17
FIVE Thousand Dollars and ZERO Cents PAY THIS Ar.-IOUNJT
S ****5, 000.00
PAY TO THE VOID IF NOT CASHED WTHIN SUC MONTHS
ORDER OF: SAN BERNARDINO COUNTY FLOOD CONTROL
' DEPARTMENT OF PUBLIC WORKS
g P-32016055 ,�S"OV'''M r � J
825 E THIRD STREET ROOM 201
SAN BERNARDINO, CA 92415 "ft4 TO14e
I
INVOICE:DAT9 INVOICE NO. 1 PO NO. AMOUNTPAID DESCRIPTION
12/14/17 OH022169 5,000.00 OHT PH3 INSPECION FEE DEPOSIT
CITY OF REDLANDS
VENDOR ACCT NO. CHECK DATE CHECK TOTAL VENDOR NO. CHECK 110.
12/27/17 5, 000.00 V00001160 184099
RECEIVED
CITY OF REDLANDS
DISBURSEMENT VOUCHER
FINANCE DEPARTMENT
To: Finance Department Date: 12/14/2017
Pay To: San Bernardino County Flood Control District Requesting Dept: MUED
Department of Public Works P-32016055
825 E. Third Street, Room 201
San Bemardino,CA 92415
Payment Far: Orange Blossom Trail Phase 3 Inspection Fee Deposit
ORGKEY Object Job Ledger Invoice No. Amount
240400 5392 47019 5,000.00
N oz�
Grand Total $5,000.00
Prepared By: BOSS WiTTMAN
Authorized By: Finance Approval:
Page 1 of 1