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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6875 <br />CITYWIDE TRAFFIC SIGNAL VEHICLE HEAD UPGRADES <br />FEDERAL PROJECT NO: HSIPL 5063(188) <br />EXHIBIT 16-B - SUBCONTRACTING REQUEST <br />Local Assistance Procedures Manual Exhibit 16-8 <br />CONTRAC7oRNAME <br />=n4e¢ngh'cna% Lit-%f, bbilder6.Y tnrv. <br />COUNTY �AylyQ <br />6. <br />ROUTE <br />BUSINESSADDRESS <br />3�155L"nu woad <br />CDNTRACTNUMBER <br />PW eu- NO, 1 <br />CITY AND STATE <br />ZIP CODE <br />9a-883 <br />FEDERAL-AIDPROJECT NUMBER <br />a <br />NJ PL I <br />A. SuBCONntACTOR <br />B. BIDITEM <br />C. PERCENTAGE OF <br />D. SUB LL6TED <br />E. CERTIFIED <br />F. DESCRIBE WORK <br />G. DOI s aR AMOUNT <br />(Name, Busines Address, Phom) <br />NUMBER(s) <br />BID ITEM <br />AT BID TIME <br />DBE <br />WHEN LESS THAN <br />BASEDONTHEBID <br />SUBCONTRACTED <br />100% OF WORK IS <br />AMOUNT <br />SUBCONTRACTED <br />Yes No <br />Yes No <br />�L <br />/T <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑❑❑❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />1 ❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />1 certify that: <br />a The Standard Provisions for labor set forth in the contract apply to the subcontracted work. <br />• if applicable, Form FHW of the Special Provisions has been inserted in the subcontracts and should be <br />incorporated in any low(((((( tier ubcontract. Written contracts have been executed for the above noted subcontracted <br />work. _ <br />Date <br />This section is to be completed by the resident engineer. - <br />1. Total of bid items <br />2. Contractor most perform with own fours (Btu I X contract req. %) $ <br />3. Bid items previously subcontracted (taken from previously approved 16-8) $ <br />4. Bid items subcontracted (this request) $ <br />S. Total bid items subcontracted (line 3 plus 4) <br />6. Balance of work contractor to perform (line 1 minus 5) $ <br />Approved <br />RESIDEX7 ENGINEERS SIGNATURE DATE <br />c, •'^'•" ••+""`•"'••"^`•"• PY" cwuc.0 my..mr ..upY_.mci- __ _ evocaseunop c .,for tax to (Y16)3241949 <br />Page 1 of 2 <br />January 2018 <br />r�� <br />