Laserfiche WebLink
CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT N0, 14-6799: New Traffic Signal on Newhope St and Camille St <br />PROJECT NO, 14.6800: Traffic Signal Modification on Segerstrom Ave and Bear St <br />EXEIt1SIT 15-G CONSTRUCTION CONTRACT DBE CoAIN1l'rN ENT <br />1, Local Agency: City of Santa Ana ^, 2. Contract DDE Goal: q.ggoA <br />3. Project Description New traffle signal on Nawhone otreet at Camille Slrt, <br />4. Project Location: Newhope Street at Camille Street in the City of Santa Ana <br />7. Bid <br />5. Bidder's Name: PTM General Engineering Svcs, Inc. 6. Prime certified DBE: ❑ Amount: 215801.00 <br />S. Total Dollar Amount for ALL Subcontractors: 97643.00 9. Total Number of ALL Subcontractors. 5 <br />10. Bid <br />Item <br />Number <br />11. Description of Work, Service, or Materials <br />Supplied <br />12 DBE <br />Cortificatlon <br />Number <br />13. DBE Contact Information <br />(Must be certified on the date bids are <br />opened) <br />14, DBE <br />Dollar <br />Amount <br />Ptn. #9, <br />Traffic Loops Crac filling Inc. <br />10A 11 <br />Portion of loop install, <br />38033 <br />946 S. Emerald St. Anaheim, Co 92804 <br />6610.00 <br />71 .520.4026 <br />Local Agency to Complete this Section <br />$ 6610.00 <br />21. Local Agency Contract Number: <br />22, Federal -Aid Project Number: <br />HSIPL 5469(152) <br />23. Bid Opening Date: October 6, 2015 <br />15. TOTAL CLAIMED DBE PARTICIPATION 3.0 <br />070 <br />24. Contract Award. Date: <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />regardless of tier. Names of the First Tier DBE <br />Subcontractors and their respective items) of work listed <br />above must beonsistent, where applicable with the names <br />Local Agency certifies that all DBE certifications are valid and information on <br />this form Is complete and accurate, <br />and items oft work in the °Subcontractor List' submitted <br />with your bid tten confirmation of each listed DBE is <br />rayylr <br />25. Local Agency Representative's Signature 26, pate <br />16. Preparer's Signature 17. Date <br />Elizabeth H. Mendoza de McRae 951.710.100 <br />27. Local Agency Representative's Nama 28. Phone <br />i8. Preparer' -Name 19. Phone <br />President/CFO <br />29. Local Agency Representative's Title <br />20. Pre arer's Title <br />DISTRIBUTION: 1. Original - Lo cal Agency <br />'2. Copy - Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days <br />of contract execution may result in de -obligation of federal funds on contract. Include additional copy <br />with award package, <br />ADA Notice: For Individuals with sensory disabilities, this dooumant Is available In alternate formats. For Infomlallon call 1916) 554-6410 <br />or TDD (916) 064-3880 or write Records and Forms Management,1120 N Street, MS -69, Sacramento, GA 05814, <br />BP -27 <br />