Union City City Council
September 8, 2026

STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
Division of Rail and Mass Transportation
State Transit Assistance State of Good Repair Program
Authorized Agent Form
Authorized Agent
The following individual(s) are hereby authorized to execute for and on behalf of the named Regional Entity/Transit Operator, and to take any actions necessary for the purpose of obtaining State Transit Assistance State of Good Repair funds provided by the California Department of Transportation, Division of Rail and Mass Transportation. This form is valid at the beginning of Fiscal Year 2017-2018 until the end of the State of Good Repair Program. If there is a change in the authorized agent, the project sponsor must submit a new form. This form is required even when the authorized agent is the executive authority himself. __________________________________________________________________ OR (Name and Title of Authorized Agent)
__________________________________________________________________ OR (Name and Title of Authorized Agent)
__________________________________________________________________ . (Name and Title of Authorized Agent)
AS THE __________________________________________________ (Chief Executive Officer / Director / President / Secretary) OF THE __________________________________________________ (Name of County/City Organization) ______________________________________________________________ _________________________________________ (Print Name) (Title)
__________________________________________
(Signature)
Approved this ______________day of _________________, 20_____ FY 22-23 SB 1 STA State of Good Repair
Exhibit A