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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 16-8 <br />CONTRACrORNAME <br />CXNTY <br />ROUTE <br />Elecnor Belco Electric, Inc. <br />San Bernardino <br />BUs1NESSADDRE55 <br />CONTRACTNUMBER <br />14320 Albers Way <br />CICYANDSTATF. <br />ZJp CADS <br />FEDERALNUMBER <br />Chino, CA <br />917I0 <br />HSIPL-5063(19 )a <br />A. SUBCONTRACTOR <br />B. Bwfnm <br />C.PERCENTAGEOF <br />D. SUBLFTED <br />E.CERTIFIED <br />F. DESCRIBE WORK <br />G. DOLLAR AMOUNT <br />(Name, Bvslness Address, Phone) <br />NOMBER(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 />❑ ❑ <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 />1 certify that: <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 />1 t/8/2021 <br />This section is to compl fd3 by lha resident engineer. <br />1. Total of bid it r�i\it+Mfb/J < 2. Contractor mus perfo own forces (line I X contract mq. %) $ <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 DA11 <br />Copy Distribution: Original -Contractor Copy- Resident Engineer Copy. OBEO-smallbisinessadvonte4donlrneov or fax to (916) 324-1949 <br />Page 1 of 2 January 2018 <br />P-46 of P-52 <br />