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.(Select all that apply)
Drive Alone Carpool Transit Vanpool Walk Bicycle Telecommute

How many times a week? 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.

Please initial
_____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

Signature of Commuter
_________________________________________________Date:

Signature of Transportation Coordinator
______________________________ __________________Date:

Please print and mail to: Yolo TMA, P.O. Box 996, Woodland, CA 95776