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MTC Claim Application - Document A(a) <br /> Claimant Information <br /> FY 2011 -12 <br /> Submittal Date: 5/3/2011 Enter requested information in yellow cells <br /> Enter requested information using dropdown menu <br /> Information appears automatically in cells highlightec <br /> Claimant Information <br /> 1 Claimant Name City of Pleasanton <br /> 2 Street Address 5353 Sunol Blvd. <br /> 3 City Pleasanton <br /> 4 ZIP Code 94566 <br /> 5 County Alameda <br /> Claimant Personnel Information <br /> 6 Authorized Signature Name Susan Andrade -Wax <br /> 7 Authorized Signature Title Director of Community Services <br /> 8 CFO Name Emily Wagner <br /> 9 CFO Title Finance Director <br /> 10 Contact Person Name Pam Deaton <br /> 11 Contact Person Title Recreation Supevisor <br /> 12 Contact Person's Telephone (925) 931 -5367 <br /> 13 Contact Person's FAX (925) 485 -3685 <br /> 14 Contact E -Mail Address pdeaton@ci.pleasanton.ca.us <br /> Application Submittal Date <br /> 15 Fiscal Year 2011 -12 <br /> 16 Claim Submittal Date L 5/3/2011 <br /> Public Transportation Modes Operated <br /> Mode Ty i e Service Name <br /> 17 Demand Response _ Pleasanton Paratransit Service (PPS) <br /> 18 <br /> 19 <br /> 20 <br /> 21 <br /> 22 <br /> 23 <br /> 24 <br /> 25 <br /> 26 <br /> MTC Programming and Allocations Section February 2005 Page lot 1 <br />