COMMUTER BICYCLE INCENTIVE PROGRAM
APPLICATION AND USAGE AGREEMENT

Submit this original application and a copy of your purchase receipt (if applicable) to:


Yolo TMA
P. O. Box 969
Woodland, CA  95695

This program promotes bicycle commuting.  The Yolo TMA has received funding from the Yolo-Solano Air Quality Management District to help subsidize selected bicycle commuters. The incentive, provided through The Rideshare Incentive Program (TRIP), may be used to help defray the costs of a new commuter bicycle, or related safety and/or commute equipment.

Under the bicycling category,  TRIP will provide a financial incentive of $25 per month for three months to the first twenty-five (25) commuters who commit to riding their bicycle as their primary mode of transportation during commute times. For individuals supplying a recent purchase receipt, the Yolo TMA will match the first $25 incentive with a $25 cash rebate.

At the end of the three month period, if the cyclist has used their cycling rideshare alternative at least ten (10) days per month over the three month period, they will receive a coupon toward a bicycle tune-up from a local bicycle shop selected by the Yolo TMA (such as Foy?s in Woodland or B&L Bike Shop in Davis). Maximum coupon value will be $50 per participant. With your help, the Yolo TMA will track commute usage, document the results and report to the air district and other funding partners.

Submitting an application does not guarantee selection to receive funding. Upon selection and notification, the incentive will be awarded when the appropriate documentation verifying ridership and/or purchase is received by the TMA
.  Documentation of purchase must be received within one month of qualification to guarantee awarding of the incentive.

Name:______________________________________________________________

Employer Name:______________________________________________________

Work Phone Number:___________________  Email Address:__________________

Participant's usual mode of travel prior to applying  for the bicycle incentive.
How many times a week?  (Select all that apply)
 

____Drive Alone ____Carpool 
 ____Transit _____Vanpool
_____Walk ____Bicycle 
                                                                  _____Telecommute

Participant's One Way Commute Miles: _______________

Check One: 

_____Participant already has a commute bicycle.
_____Bicycle will be for a new bicycle commuter
_____Bicycle will replace an existing commute bicycle

Please initial
_____During fair weather, I agree to commute by bicycle at least two (2) days per week.

_____I agree to register with SACOG's Bike Buddy Program through www.1800commute.org.

Briefly explain why you are interested in purchasing a new bicycle.
 

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

I understand that the Commuter Bicycle Incentive Program shall terminate upon depletion of program funding or by a decision of the Yolo TMA Board of Directors.  The Yolo TMA shall be under no obligation to honor requests received following the depletion of program funding or termination of the program.

The participant agrees to complete a monthly Usage Survey for three months.  Participant also agrees to become familiar with California Vehicle Code Laws relating to bicyclists and follow them.  In the event any of these terms are not met, the incentive shall be returned to the Yolo TMA.

The incentive check(s) will be given to your Employee Transportation Coordinator, who will provide to you at a staff gathering or similar event in your office.  Purchaser agrees to notify TMA if the purchaser's residential address or workplace changes.

Purchaser agrees to defend, indemnify and hold harmless the Yolo TMA and the Yolo-Solano AQMD, their officers, agents, employees and volunteers from any and all losses, costs, damages, fines or expenses (including attorney fees, court costs and expert fees) or liability of any kind or character to any person or property arising from, or alleged to arise from, any breach of the responsibilities required of the participant by this Agreement or which are related in any way to the Commuter Bicycle Incentive Program or other incentives received.  Commuter signature below verifies that they have read and understand, as well as agree to, comply with program policy, procedures and guidelines.

Name of Commuter (printed):_______________________________________________

Signature of Commuter: __________________________________________________   Date: __________

Signature of Employee Transportation Coordinator:____________________________      Date: __________