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Vincent A. Brown, Program Administrator <br />Mecklenburg Transportation System <br /> <br />Name of Service Provider <br /> <br />Signature of Authorized Official and Title. <br /> <br />Date <br /> <br />The following price list is to be completed by each provider. Trips will be assigned based <br />on most appropriate cost per category. <br /> <br />PRICE LIST <br /> <br />Price for One Way Ride <br /> <br />Ambulatory <br />$9.00 <br /> <br />Non-Ambulatory <br />$25.00 <br /> <br /> <br />