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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 — SUBCONTRACI t Yi REC�UE"T <br />Local Assistance Procedures Manual Exhibit 16-D <br />CONTRACrORNAME <br />n1 t2rlGih'cna� Ut-1 1 iAdeWl it1J<�• <br />COUNTY �,ytyl(�Q <br />18.#4 <br />ROUTR <br />BUSINESSADDRESS <br />CONTRAerNUMBER <br />84M5 ^ram✓ c cr eo d <br />1 ea- tdcv, 1 - <br />CITYANDSTATE <br />ZIrCoDE <br />FEDERALYAIDPRO)ECrNUMBER <br />44. <br />cIr�"{!PJ <br />HJ' P <br />A. 5uHooN1'RAGTDH <br />B. BIDITEM <br />C PERCINTAG90F <br />D. SUBLLSTED <br />E.CERTBSED <br />P.. DESCRIBE WORK <br />G.DOLLARAAIOUNT <br />(Neme;Bua4re4sAd4rew,Rhanej <br />NuMBER(S) <br />BID ITEM <br />ATBB?TIME <br />WE <br />WHSNLE%THAN <br />BAsenoNTn6BID <br />SUBCONrRACM <br />100% OR WORK is <br />AMOUNT <br />SUBCONTRACTED <br />Yes No <br />Yes No <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 />Yes No <br />Yes No <br />certify at: <br />The Standard Provisions for labor set forth in the contract apply to the subcontracted work. <br />If applicable, Form FI3W A- 3 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 />This section Is to be completed by the resident engineer. <br />1. Total of bid items <br />2. Ceau:tractor must perform with own forces(line l X contract req,%) <br />3. Bid items previously subcontracted (taken from previously approved 16-13) <br />4. Bid items subcontracted (this request) <br />$. Total bid items subcontracted (line 3plus 4) <br />6. Balance of work contractor to perform (line I minus 5) <br />WADIINT ENGINEWSSIGNATURE <br />Copy Distribution: Origlna6Contractor Copy. Resident Engineer <br />$ <br />$ <br />$ <br />324,1949 <br />Page 1 of 2 <br />January 2018 <br />P-33 of P-38 <br />