Yolo Transportation Management Association

Pedestrian Incentive Program
Application and Usage Agreement

Please complete and sign this Application and Usage Agreement
after you have read and understood the Pedestrian Incentive Program Guidelines.

To be completed by pedestrian commuter:

Applicant Name:
 

Email:

Residential Address:  

Employer:
 

Phone:

Walker's usual commute mode prior to applying for vanpool incentive (select one):

Carpool
Transit
Vanpool
Walk
Bicycle
Telecommute

Total number of one-way commute miles?


Approximate number of walking trips per week?



Briefly explain why you're interest in walking as a form of commuting:

Please check each box

I understand that the Pedestrian 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 applicant agrees to complete a Survey at the end of each month for three months, as well as a follow-up annual survey if applying for the one-year bonus. In the event any of these terms are not met, the incentive shall be returned to the Yolo TMA.

Applicant agrees to notify the Yolo TMA of any residential address or worksite changes.

Applicant agrees to defend, indemnify and hold harmless the Yolo TMA and 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 vanpool incentive program or other incentives received.

Name of Applicant: 



Date of application: