City of Rancho Palos Verdes

Please carefully read and "Submit" to the appropriate portal to ensure that it will reach the appropriate staff person for processing. Thank you for your electronic submittal!
By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Public Safety Reimbursement Program - Neighborhood or HOA Application

  1. City Logo PS Reimbursement Neighborhood & HOA Applicant
  3. This is my first time applying for a Public Safety Reimbursement*

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

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

  5. Please provide the cross streets and the cardinal directions.

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

  7. Please enter the total cost excluding tax.

  8. Up to 50% of the cost for a neighborhood with a maximum reimbursement of $2000.

  9. I have already purchased a device which I am submitting for reimbursement*
  10. Terms and Conditions

    On behalf of the (Neighborhood) I agree to adhere to the City of Rancho Palos Verdes’ Public Safety Reimbursement Program (Program) terms, a copy of which are provided herein, and reviewed by me, including each of the conditions of all City-issued permits issued in connection therewith. As an authorized representative, 

    I acknowledge and agree to the following Program conditions on behalf of the Neighborhood as follows. 

  11. Terms and Conditions (cont.)*
  12. 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.

  13. Signature*
  14. Leave This Blank:

  15. This field is not part of the form submission.