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Resolution No. 2011 -089 Attachment B Page 1 of 1 TDA Article 3 Project Application Form Fiscal Year of this Claim: 11/12 Applicant: City of San Leandro Contact person: Keith R. Cooke Mailing Address: 835 East 14th Street, San Leandro, CA 94577 E -Mail Address: kcooke(alsanleandro.orq Telephone: (510) 577 -3439 Secondary Contact (in event primary not available) Tara Peterson E -Mail Address: tpeterson(a sanleandro.orq Telephone: (510) 577 -3432 Short Title Description of Protect: Citywide Pedestrian Accessibility Improvements 11112 Amount of claim: $57,689.00 Functional Description of Project: Prolect will provide for the design, construction and Inspection of curb ramps, sidewalk bulb-outs, in- pavement lighted crosswalk, pedestrian safety signage, accessible pedestrian traffic signal equipment and sidewalks at various locations throughout City. Financial Plan: List the project elements for which TDA funding is being requested (e.g., planning, environmental, engineering, right -of -way, construction, inspection, contingency, audit). Use the table below to show the project budget. Include prior and proposed future funding of the project. If the project is a segment of a larger project, include prior and proposed funding sources for the other segments. Project Elements: Engineering, Construction and Inspection Funding Source 1 All Prior FYs 1 Application FY 1 Next FY 1 Following FYs 1 Totals TDA Article 3 $57,689 $57,689 list all other sources: 1. 2. 3. 4. Totals $57,689 Project Eligibility: YES ?INO? A. Has the project been approved by the claimant's goveming body? (If 'NO,' provide the approximate date approval is Yes anticipated). B. Has this project previously received TDA Article 3 funding? If 'YES; provide an explanation on a separate page. No C. For 'bikeways,' does the project meet Caltrans minimum safety design criteria pursuant to Chapter 1000 of the Califomia N/A Highway Design Manual? (Available on the internet via: http: / /www.dot.ca.gov). D. Has the project been reviewed by a Bicycle Advisory Committee? (If "N0," provide an explanation). Yes E. Has the public availability of the environmental compliance documentation for the project (pursuant to CEQA) been N/A evidenced by the dated stamping of the document by the county Berk or county recorder? (required only for projects that indude construction). F. Will the project be completed before the allocation expires? Enter the anticipated completion date of project (month and Yes year) June 2013 G. Have provisions been made by the claimant to maintain the project or facility, or has the claimant arranged for such Yes maintenance by another agency? (If an agency other than the Claimant is to maintain the facility provide its name: 1