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FISCAL YEAR: <br />1996-97 <br />CLAIMANT: <br />San Bernardino Associated Governments <br />County Transportation Commission <br />Curb -Cut <br />TDA Article 3 Claim Form <br />DATE: <br />PAYMENT RECIPIENT: <br />City of Colton City of Colton <br />COUNTY LTF: (Claimant) <br />San Bernardino County 160 South 10"' Street <br />PURPOSE: (Mailing Address) <br />Colton, CA 92324 <br />(X) Article 3, PUC Section 99234a <br />Pedestrian and Bicycle Facilities <br />(City, State & zip) <br />Randy Rivera, Street Superintendent <br />(Attention - Name & Title) <br />Randy Rivera, (909) 370-6107 <br />(Contact Person - Phone #) <br />DETAIL OF REQUESTED ALLOCATION: AMOUNT: <br />LTI= Article 3 $ 29,850 <br />Curb -Cut Projects <br />CONDITION OF APPROVAL: <br />Approval of this claim and payment by the <br />County Auditor to this claimant are subject to <br />monies being available, and to the provision that <br />such monies will be used only in accordance with <br />the allocation instructions. <br />AUTHORIZING SIGNATURE: <br />(Claimant's Chief Administrator of <br />Financial Officer) <br />(Signature) <br />Anna Vega, Finance Director. <br />(Print Name & Title) <br />*SAMPLE* <br />M:LTFCCCL7.VLB Page 2 <br />