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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 />EXHIBIT 16-B — SUBCONTRACTING REQUEST <br />Local Assistance Procedures Manual <br />Exhibit 16-B <br />CONTRACrORNAME _. <br />COUNTY <br />ROUTE <br />International Line Builder's Inc. <br />Orange Count <br />BusmEsS ADDRESS <br />CONTRACTNUMBER <br />3955 Temescal Canyon Road <br />17-6894 <br />CITY AND STATE <br />ZIPCODE <br />FEDERAL -AID PROJECT NUMBER <br />Corona CA <br />92883 <br />HSIPL 5063 171 <br />A. SUBCONTRACTOR <br />B. BIDITEM <br />C. PERCENTAGEOF <br />D. SUB Lmm <br />RCERTIFIED <br />F. DESCRIBE WORK <br />G. DOLLAR AMOUNT <br />(Name. Bwe Address. Phone) <br />NUMBERS) <br />BID ITEM <br />AT BID TIME <br />DBE <br />WHEN LEA THAN <br />BASEDONTHEBID <br />SUBCONTRACTED <br />100% OF WORK IS <br />AMOUNT <br />SUBCONTRACTED <br />8U -fa..+ L'' <br />�i" ITCLl <br />13 <br />i��o <br />Yes No <br />d <br />Yes No <br />,J1ynlny '4 <br />t�,�So.vo <br />llclo <br />❑ <br />El <br />rt�ipl�� <br />-ra'I IW1U" t-lt4j-V V <br />�qny 6, Lna <br />14,1 IL1b <br />1L1u <br />Lis N o <br />Yes No <br />Yes No <br />d <br />L(iUYDJ <br />a 9j30. 00 <br />4-IN)ti-j}-y55Lv <br />E4 ❑ <br />❑ <br />AtI4N,—Vvari,(fpn <br />tzle4nct, LA <br />IF <br />I t �1,13 <br />pl�� ° <br />Ye No <br />Yes No <br />G r LC <br />a-+4103.0 0 <br />�151 -�tcov <br />El <br />El <br />Zn�ld& Dw�E <br />>W111" e4VV2eJICit,- <br />I <br />��ho <br />Yes No <br />Yes No <br />i <br />D eFiC.}1Gr" <br />�t <br />( T,(�UU.DO <br />0151 5 a3 a- <br />Eld <br />❑ <br />D¢,lltnv�+ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ El <br />I certify that: <br />• The Standard Provisions for labor set forth in the contract apply to the subcontracted work. <br />• If applicable, Form F IW 73 of the Special Provisions has been inserted in the subcontracts and should be <br />incorporated in any to er-ti subcontract. 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 ]i <br />Z Contractor must perform with own forces (line 1 X contract req. %) $ <br />3. Bid items previously subcontracted (taken from previously approved 16-B) $ <br />4. Bid items subcontracted (this request) $ <br />5. Total bid items subcontracted (line 3 plus 4) <br />6. Balance of work contractor to perform (line 1 minus 5) <br />Approved <br />RESIDENT ENGINEERS SIGNATURE Dg1ti <br />wpy ,.nu,vuvun. vny�nao-e.onaaaor a.opy-neooenr engineer wpy-unto-smantu>mes>+neocatc+iJ �ptcTenv or fax to(916) 324-1949 <br />Page 1 of 2 January 2018 <br />P-34 of P-39 <br />