PEDESTRIAN INCENTIVE PROGRAM
APLICATION AND USAGE AGREEMENT

Yolo TMA
P. O. Box 969
Woodland, CA 95776

The undersigned commuter, a qualified applicant, applies for the pedestrian incentive program administered by the Yolo TMA. The Rideshare Incentive Program (TRIP) will provide a financial incentive of $10 per month for three months to the first twenty (20) commuters who park their SOV and walk a minimum of one (1) mile each way during their daily commute. To qualify, participants need to walk at least fifty percent (50%) of their commute distance per month.

TRIP participants who stay with their walking program for a period of one year and use their rideshare alternative at least ten (10) days per month, will receive a bonus incentive of $50 and a $50 gift certificate from a local shoe store of the TMA’s choice.

Name:
Employer Name:
Carpool Coordinator's residential address:
Work Phone Number:
Email Address:

Walker's usual commute mode prior to applying for vanpool incentive (select one):
Carpool Vanpool Transit Walk Bicycle Telecommute Drive Alone
Total one-way commute miles:
Approximate number of other walking trips taken per week?
Briefly explain why you're interested in walking as a form of commuting:

Please Initial
_____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 participant 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.
_____Commuter agrees to notify TMA if the commuter's residential address or worksite changes.
_____Commuter 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 Pedestrian Commuter

Signature of Commuter
________________________________________________Date:

Signature of Transportation Coordinator
______________________________ __________________Date:

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