MEASURE K BICYCLE, PEDESTRIAN, AND SAFE ROUTES TO
SCHOOL NON-COMPETITIVE PROGRAM GUIDELINES
CLAIM FORM - CYCLE 2 (2022 –2026)
Claims for this cycle must be made before June 30, 2025
1. Project Title: ____________________________________________________________________________________
2. Applicant Agency ________________________________________________________________________________
3. Agency Address__________________________________________________________________________________
4. Project Manager_______________________________________________ Title: ____________________________ Email: ______________________________________________ Phone Number: ____________________________
5. Project Description. Briefly describe the project location(s), existing conditions, scope, and expected benefits. If the project is a component within a larger or multi-phase project, describe the “parent” project as well:
__________________________________________________________________________________________________ __________________________________________________________________________________________________ _______________________________________________________________________________________________ _________________________________________________________________________________________________
6. Please attach a copy of the page from a local or regional plan that identifies this project.
7. Non-Competitive Measure K funds claimed: $ ___________________________
8. Total Project Cost: $ ___________________________
9. Schedule
Start Date Completion
Environmental ____________ ____________ *Please provide a schedule for Design ____________ ____________ non-infrastructure projects as needed ROW ____________ ____________
Construction ____________ ____________
Approved:
By: _____________________________________ Date: _________________________ Diane Nguyen
Executive Director
San Joaquin Council of Governments
By: _____________________________________ Date: _________________________ Steve Dial
Deputy Executive Director/CFO
San Joaquin Council of Governments
MEASURE K BICYCLE, PEDESTRIAN, AND SAFE ROUTES TO
SCHOOL NON-COMPETITIVE PROGRAM GUIDELINES
CLAIM FORM - CYCLE 2 (2012 –2026)
Infrastructure Type (only intended for Infrastructure projects) Note: do not double-count the improvements that benefit both Bicyclists and Pedestrian (i.e. new RRFB/Signal should only show as a Pedestrian or Bicycle Improvement).
Bicycle Improvements
New Bike Lanes/Routes: Class 1: ___________________ Linear Feet Class 2: ___________________ Linear Feet Class 3: ___________________ Linear Feet Class 4: ___________________ Linear Feet Signalized Intersections: New Detection/Bike Boxes: ______ Number Timing Improvements: ___________________ Number Un-Signalized Intersections: New RRFB/Signal: _____________ Number Crossing-Surface Improvements: ___________ Number Mid-Block Crossing: New RRFB/Signal: _____________ Number Crossing-Surface Improvements: ___________ Number Lighting: Intersection: _____________ Number Roadway Segments: ___________________ Linear Feet Bike Share Program: New Bike Share Station: _________ Number New Bike Share Bikes: ___________________ Number Bike Racks/Lockers: New Racks: ___________________ Number New Lockers: __________________________ Number Other Bicycle Improvements #1: ________________________________ #:______ #2: ____________________________________ #: ___ Pedestrian Improvements
Sidewalks: New (4’ to 8’ wide): __________Linear Feet New (Over 8’ wide): __________________ Linear Feet Widen Existing: _____________ Linear Feet Reconstruct/Enhance Existing: __________ Linear Feet ADA Ramp Improvements: New Ramp (none exist): _________ Number Reconstruct Ramp to Standard: ____________ Number Signalized Intersections: New Crosswalk: _______________ Number Enhance Existing Crosswalk: ______________ Number Pedestrian signal heads: _________ Number Shorten Crossing: _______________________ Number Timing Improvements: __________ Number
Un-Signalized Intersections: New Traffic Signal: _____________ Number New Roundabout: _______________________ Number New RRFB/Signal: _____________ Number Crossing-Surface Improvements: ___________ Number Shorten Crossing: ______________ Number
Mid-Block Crossing: New RRFB/Signal: _____________ Number Crossing-Surface Improvements: ___________ Number Lighting: Intersection: __________________ Number Roadway Segments: ________________ Linear Feet Pedestrian Amenities: Benches: _____________________ Number Trash Cans: _______________ Number Shade Trees: __________________ Number Shade Tree Type: ______________________________ Other Ped Improvements #1: _________________________________ #:______ #2: ____________________________________ #: ___ Multi-use Trail Improvements
Class 1 Trails: New (8’ or less wide): ________________ Linear Feet New (Over 8’ wide): __________________ Linear Feet Widen Existing: _____________________ Linear Feet
Non-Class 1 Trails: New ______________________________ Linear Feet Widen Existing): _____________________ Linear Feet Other Trail Improvements #1: _________________________________ #:______ #2: __________________________________ #: _____ Vehicular-Roadway Traffic-Calming Improvements
Road Diets: Remove Travel Lane: ______________ Linear Feet Remove Right-Turn Pocket: _______ Number Speed Feedback Signs: Speed Feedback Signs: _____________ Number Signalized Intersections: Timing Improvements: _____________ Number New Roundabout ________________ Number Un-Signalized Intersections: New Traffic Signal: ________________ Number New Roundabout: _______________ Number Other Traffic-Calming: #1: _________________________________ #:______ #2: ___________________________________ #: _____
ASSURANCES
MEASURE K BICYCLE, PEDESTRIAN, AND SAFE ROUTES TO
SCHOOL NON-COMPETITIVE PROGRAM GUIDELINES
I hereby certify, and am authorized to make, the following assurances on behalf of the agency claiming Measure K Bicycle, Pedestrian, and Safe Routes to School Program (BP-SRtS) Non-Competitive funds.
This project lies entirely within San Joaquin County, and does not duplicate an existing bicycle facility and that the project is, or will be, contained in an adopted local or regional bicycle plan, pedestrian plan, Safe Routes to School plan, or Active Transportation plan.
The claim for the project has been authorized by the governing board of my agency in a resolution that includes all stipulated understandings and assurances as defined in this claim.
The project is not by nature a maintenance or rehabilitation project, and this agency certifies that it will bear responsibility for the maintenance and operation of the facility presented in the claim.
Measure K funds identified in this claim are not being used in place of developer funds.
This agency, as a condition of eligibility for BP-SRtS funds for this project and can finance, acquire, and construct it.
The agency will cause work to be commenced on the project within a reasonable time after approval of a Measure K Non-Competitive BP-SRtS Program claim form. The claim form will be used in lieu of a contract. Successful claimants will encumber allocated (claim approved) BP-SRtS funds by June 30, 2025. Extensions for unclaimed funds must be requested in writing by the end of the grace period.
The agency will comply where applicable with provisions of the California Environmental Quality Act, the American with Disabilities Act, and any other applicable federal, state and/or local laws and/or regulations.
I certify that the information contained in the BP-SRtS claim, including attachments, is accurate to the best of my knowledge that I have read and understand the information contained in the claim, and agree to the assurances on this form.
Signed _______________________________________________ Date ____________________ Printed (Name and Title) _________________________________________________________ Agency _______________________________________________________________________ Project Title____________________________________________________________________