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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6894 <br />EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION <br />FEDERAL PROJECT NO: HSIPL 5063 (171) <br />Local Assistance Procedures Manual Exhibit 16-B <br />Subcontracting Request <br />INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST FORM <br />All first -tier subcontractors must be included on a subcontractor request. <br />Before subcontracting work starts, the contractor will submit an original CEM-1201 for approval according to the <br />Standard Specifications. After approval, the RE returns the original to the contractor and complete the remaining <br />distribution as listed on the bottom of the form. <br />D. If subcontractor was listed at bid time per the Fair Practices Act, check yes, otherwise check no. <br />E. If subcontractor is a certified DBE contractor, check yes, otherwise check no. <br />F and G. When a portion of an item is subcontracted, describe the portion and show the percentage of the bid item <br />and value. <br />G. When an entire item is subcontracted, show the full bid item value. <br />THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS OF SUBCONTRACTORS AND UDBE, DVBE OR <br />SMALL BUSINESS ENTITIES. <br />Page 2 of 2 January 2018 <br />F 3R P=33 <br />