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CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT N0: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET EXHIBIT 16-B Local Assistance Procedures Manual Subcontracting Request INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST FORM All First-tier subcontractors must be included on a subcontrac ting request. Submit in accordance with Section 8-1.01 of the Caltrans Standard Specifications. Type or print requested information. Information copy is to be retained by the contractor. Submit other copies to project's Resident Engineer. After approval, the original will be. returned to the contractor. When an entire item is subcontracted, the value to be shown is the contractor's bid price. When a portion of an item is subcontracted, describe the portion, and show the % of bid item and value. THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS. Prior to submittal of Form CEM -1201 involving a replacement Subcontractor, submit a separate written request for approval to substitute a listed subcontractor, Section 4107 of the Government Code covers the conditions for substitution, Submit a separate written request for approval of any DBE/MBE/WBE/DVBE substitution. Include appropriate backup information and state what efforts were made to accomplish the same dollar value of work by other certified DBE/M.B E/ W BE/D V BEs. NOTE: For contractors who will be performing work on railroad property, it is necessary for the contractor to complete raid submit the Certificate of Insurance (State Form DH-OS-AIOA) naming the subcontractor as insured. No work shall be allowed which involves encroachment on railroad properly until the specified insurance has been approved. Page 16.52 October 5, 2012 LPP 12 P-36 of P-40 20D-51 Back