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DocuSign Envelope ID Cl F01626-C35A-41 E3-9669-4136828DC776 <br /> ATTACHMENT 01 <br /> Grant Application Form — EXHIBIT A <br /> California Automated Permit Processing (CaIAPP) Program <br /> 1. APPLICANT INFORMATION (REQUIRED) <br /> Jurisdiction Name (please use full legal name as it would appear on the executed grant): <br /> City of Pleasanton <br /> Jurisdiction Type (select one): <br /> n City fl County fl City and County <br /> Current Estimated Population State of California Department of Finance Demographics <br /> (https://dof.ca.gov/forecasting/Demographics/): <br /> ri Less than 50,000 [1 From 100,000 to 200,000 <br /> n From 50,000 to 99,999 Greater than 200,000 <br /> Project Manager Name Robert Queirolo <br /> (serves as point <br /> of contact for all Street Address 200 Old Bernal Avenue <br /> communications) City and Pleasanton, CA 94566 <br /> Zip Code <br /> Phone Number (925) 931-5310 <br /> E-Mail Address rqueirolo@cityofpleasantonca.gov <br /> 2. FUNDING (REQUIRED) <br /> Assigned Maximum Grant Amount (select one) <br /> IT Group 1 ($40,000): Population less than 50,000 <br /> ri Group 2 ($60,000): Population from 50,000 to 99,999 <br /> Group 3 ($80,000): Population from 100,000 to 200,000 <br /> ri Group 4 ($100,000): Population greater than 200,000 <br /> March 2023 Page 1 of 4 APP-22-133 <br /> CaIAPP Attachment 01 City of Pleasanton <br />