City of Rancho Palos Verdes

2. 
4. NEIGHBORHOOD/HOA PUBLIC SAFETY REIMBURSEMENT PROGRAM APPLICATION

   The City will reimburse 50% of the total cost of the Security Safety camera installation, not to exceed a maximum of up to $2,500 per neighborhood or HOA. Reimbursement is contingent on City pre-approval, verified installation, and submission of all required documentation. Program participation requires compliance with all privacy, access, and permit regulations outlined in the program guidelines.

6. HOA or Neighborhood Name*
8. HOA / Neighborhood Mailing Address*
10. Representative Title
12. Representative First Name*
13. Representative Last Name*
15. Representative Email Address *
16. Representative Phone Number*
18. Neighborhood or HOA Location / Boundaries (cross streets, gates, etc.)*
20. Neighborhood/HOA location information*

    Please provide a labled map indicating your neighborhood or HOA boundaries.

24. 1. Eligibility Attestation
26. Eligibility Requirements *

    1. Neighborhood or HOA is registered and located within Rancho Palos Verdes
    2. Neighborhood or HOA has received pre-approval from the City for this installation
    3. Security Camera System
    4. Flock
    5. Ring
    6. Other
    7. System will be used only for public safety and crime prevention
28. Vendor Name*

    Participants are encouraged to conduct their own due diligence in selecting a camera type and vendor.  

30. Community Consensus Attestation
    Community Consensus Attestation for Neighborhoods and HOAs

    To demonstrate community consensus, neighbors may write or sign their name. If the project is within 50 feet of private property, the property owner (Adjacent Property Owner) should be notified of the proposed project. 

    The neighborhood should use its discretion in the numbers of signatures it should collect to demonstrate consensus and support for the project. 

    Applicant should consider receiving signatures from 40% of homeowners within the neighborhood. Utilize additional pages as needed. We, the undersigned, support the proposed public safety project. 

    If the undersigned is a member of the neighborhood (“Financial Contributor”), undersigned additionally agrees to be responsible for all equipment, service, and installation costs associated with the proposed project and agrees to all terms outlined by the City’s Public Safety Reimbursement Program, as signed by the Designated Representative.

31. This is my first time applying for a Public Safety Reimbursement*

    1. Yes
    2. No, my neighborhood has applied in a previous year.

    If you are a returning applicant, please complete the returning application page for expedited processing as funds are available. 

33. New applicants must upload the Attestation of Community Consensus form*
37. 2. Camera and Installation Details
39. Number of Cameras Installed *
40. Proposed Camera Location (s)*

    Please provide the cross streets and the cardinal directions.

42. Attach a map / diagram showing camera locations and nearest cross streets*
44. Attach proof of installation (e.g., photo, Flock report, installer confirmation)*
48. 3. Required Documentation
50. I have already purchased a device which I am submitting for reimbursement*

    1. Yes, I have uploaded the receipt
    2. Yes, I will email the receipt
    3. No, I haven't purchased my device
51. Proof of Payment*
52. Upload image of installed camera (s)*
54. Invoice for Security Camera showing full cost and number of cameras*
58. 4. Access Acknowledgement
60. Acknowledge the Following:*

    1. Only HOA President or designated Neighborhood Representative will access the security camera system dashboard
    2. Access will be granted to RPV City staff and LASD Lomita Station
    3. Credentials will not be shared with others. Any credentials that are updated must be immediately communicated to the City's Public Safety Division
    4. Access and usage will comply with Flock Safety's data policies
64. 5. Permit Compliance
66. Compliance*

    1. I acknowledge that all necessary permits will be obtained
68. Note:

    Participation in the program waives permit fees but does not waive the requirement for permit approval where applicable (e.g., Encroachment Permit, Coastal Permit, Site Plan Review).

72. 6. Reimbursement Information
74. Total Cost of Security Camera System *
76. Reimbursement Check Payable To*
78. Mailing Address for Reimbursement Check
80. Note:

    The City will reimburse 50% of the total cost, not to exceed $2,500

84. Terms and Conditions

    HOA and Neighborhood Public Safety Reimbursement Program Guidelines 2025 

    To promote neighborhood safety and deter criminal activity, the City of Rancho Palos Verdes is proud to partner with local Homeowners Associations (HOAs) and Neighborhoods through a reimbursement program supporting the installation of security cameras. This program offers a cost-sharing opportunity for qualified HOAs and neighborhoods to enhance surveillance and crime prevention efforts in their communities.

    Program Overview: The City will reimburse 50% of the total cost of the camera installation, not to exceed a maximum of $2,500 per HOA/Neighborhood. All reimbursements are subject to compliance with the guidelines outlined below. 

    Eligibility Requirements: 1. Registered HOA and/or Neighborhood must be located within city boundaries. 2. HOA and/or Neighborhood must submit a formal request and receive pre-approval from the City prior to installation. 3. HOAs and/or Neighborhoods utilizing FLOCK: The security camera system must be provided through Flock Safety and used solely for public safety and crime prevention purposes. 4. HOAs and/or Neighborhoods must submit an attestation of community consensus, an example of which is included in the application materials. All neighborhoods, whether they are formally represented or not, must submit the attestation, with the signatures of at least 40% of the homeowners in the neighborhood.

    Application Requirements: To be considered for reimbursement, the HOA or Neighborhood must submit the following: 1. A completed Security Camera Program Application. 2. Detailed invoice indicating the full cost of installation and the number of cameras installed. 3. Proof of payment for the system (receipt or payment confirmation). 4. A detailed map or diagram clearly indicating the camera location(s), including nearest cross streets or neighborhood entry points. 5.Confirmation that the HOA President or designated Neighborhood representative, and designated city personnel will be the only parties granted system access, as outlined below. 

    Access Requirements: To ensure privacy, proper data management, and secure access: 1. Only the HOA President or designated Neighborhood represented shall be granted access to the camera system dashboard for their association. 2. The City of Rancho Palos Verdes and the Los Angeles County Sheriff’s Department (Lomita Station) must also be granted direct, secure access to the system. 3. Log-in credentials may not be shared with any other HOA board members, residents, or third parties. Any credentials that are updated must be immediately communicated to the City’s Public Safety Division. 4. All access to security camera data must adhere to the company’s data usage policies and be used solely for public safety or investigatory purposes. 

    Reimbursement Process: Upon successful installation and documentation submission: 1. The City will review and verify all materials. 2. If all requirements are met, the City will issue a reimbursement of 50% of the total invoice amount, not to exceed $2,500. 3. Payment may take up to 4–6 weeks to process from the date of approval. 

    Additional Terms: • HOA and Neighborhoods with a Flock System or similar system must maintain it system in good operational condition and comply with any updates required by the camera manufacturer or the City. • Failure to comply with access limitations or program requirements may result in termination of access and forfeiture of future reimbursement opportunities. • Proof of installation (e.g., photos, verification report from camera manufacturer, or completion acknowledgment from installer) must be included with the reimbursement request. • The neighborhood/HOA and their selected vendor are responsible for preparing and submitting all necessary permits related to installation of the purchase, including as appropriate, but not limited to: Encroachment Permit for any installations in the public right-of-way, Coastal Permit for any installations in the Coastal Zone (area seaward from Palos Verdes Drive South), and Minor Site Plan Review for installations on private property. Cameras cannot be installed on city property for neighborhood use. Participation in the program shall waive permit fees associated with necessary permits, but in no way exempts a project from the permitting process.

88. Signature and Date

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 4) By signing below, I certify under penalty of perjury that all information provided is true and complete to the best of my knowledge. I agree to comply with all program requirements and understand that information provided may be a public record.

90. Signature*

    1. I agree. Electronic signature
91. Signature *
92. Date Submitted*
    Date Submitted Start Date

    —

    Date Submitted End Date
Leave This Blank:


94. 1. Receive an email copy of this form.
95. Email address

    This field is not part of the form submission.

96. Submit Submit and Print

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