Laserfiche WebLink
CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6918 <br />MAIN ST & 15TH ST TRAFFIC SIGNAL INSTALLATION <br />FEDERAL PROJECT NO: HSIPL 5063 (189) <br />EXHIBIT 16-B — SUBCONTRACTING REQUEST <br />Local Assistance Procedures Manual <br />Exhibit 16-B <br />�•,,••••,•L�••�•,•••� <br />ElecnBelco Electric, Inc. <br />COUNnor <br />San Bernardino <br />ROUTE <br />BUSINESSADDRESS <br />14320 Albers Way <br />CONTRACTNUMBER <br />CITY AND STATE <br />Chino, CA <br />ZIPCODE <br />FEDERAL-AIDPROJECTNUMBER <br />91710 <br />HSIPL-5063(190) <br />A. SUBCONTRACTOR <br />B. BM ITEM <br />C. PERCENTAGE OF <br />D, SUBLISI'ED <br />E. CERTIFIED <br />F. DERIBE WORK <br />G.DOLLARAMOUNT <br />(Name amfness Address, PM1wie) <br />NOMBER(S) <br />BN ITEM <br />AT BID TIME <br />DBE <br />WHEN 1E THAN <br />BASED ON THE BID <br />SUBCONTRACTED <br />100%OF WORK Is <br />AMOUNT <br />SUBCONTRACTED <br />Yes No <br />Yes No <br />❑❑❑ <br />❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />Yes No <br />Yes No <br />❑ ❑ <br />❑ ❑ <br />- ��• Wr u.u•. <br />• The Standard Provisions for labor set forth in the contract apply to the subcontracted work. <br />• If applicable, Form FHWA-1273 of the Special Provisions has been inserted in the subcontracts and should be <br />incorporated in any lower -tier subcontract. Written contracts have been executed for the above noted <br />11/8/2021 <br />This section is to Icomp) t U by th resident engineer. <br />1. 'fulat of bid R <br />2. Contractor raw perfor own forces (line 1 X contract req. %) <br />3. Bid items previously subcontracted (taken from previously approved 16-➢) <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 />Copy DistribuEon:Original-Contractor Copy -Resident Engineer Copy-OB6Q sm dlbusittvssedvocrle fol oor fax to (916) <br />Page 1 of 2 January 2018 <br />P-46 of P-52 <br />