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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6834 <br />TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, <br />MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE <br />AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET <br />FEDERAL PROJECT NO: HSIPL 5063(156) <br />EXHIBIT 16-B - SUBCONTRACTING REQUEST <br />Local Assistance Procedures Manual <br />STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION <br />SUBCONTRACTING REQUEST <br />DC -CEM -1201 (REV. 4/94) (OLD HC -45) CT# 7541-3514-7 <br />EXITIBIT I6 -B <br />FRONT <br />See Instructions <br />On Back Page <br />REQUEST NUMBER <br />CONTR T NAME - <br />i orma Professional Engineering, Inc. <br />Total of bid items ....... ............... ................ A ........ <br />COUNTY <br />l7 1W&1t-- <br />ROUTE <br />U SSADDRESS <br />�D-Ave (mrC <br />3, <br />CONTRACT NO. <br />_ 3 <br />,......,.,..... $ <br />CITY/ST 1'E <br />LCA C�- <br />ZIP CODE(''� <br />I b <br />FEDERAL AID PROJECT NO. (FSp ial <br />Provisions) 13,14 C <br />SUBCONTRACTOR BID ITEM <br />(Name, Business Address, NUMBER(S) <br />Phone) <br />ru -TW-y N�. WlA <br />M V0 1'130 I X15110 tFSYeetei Ilmi k al prf1� 11-11 <br />% <br />BID <br />ITEM <br />SUBBED <br />'•-to7o <br />CHECK <br />(Sec Categories <br />Below)(1) <br />(3) <br />IF: DESCRIBE WORK <br />WHEN LESS THAN <br />(2) 100%OFWORK IS <br />SUBBED <br />w L, AArD,W0. <br />$ <br />AMOUNT <br />BASED <br />ON <br />BID $ <br />AMOUNT <br />g cu <br />ALL tMit I Wrr r -leo E. ' <br />at 1-^) Io-NsLo, I.. <br />�I1e53yVW1A 5'fWb DI -T 6'} T—WIMe-L ep <br />WYv8+9—tel�a3 <br />Cc,�s1i-&-Ip,N 18.3UN.<q�lxex-ysY t71'blm94rH <br />Lig <br />Y ��501'v <br />17-37/ <br />.�:: a-� <br />1uoD <br />ICJJwiu <br />!�>t'k <br />`� <br />Y <br />8. <br />Total (lines 6+7).. .................. .................. ............... .......- <br />C,tv t— <br />FA-eA tyif-- <br />31�'1'PtN� <br />r (51<1-1 <br />115,3Gt� <br />Categories: 1) Specialty 2) Listed Under Fair Practices Act 3) Certified DBE/MBE/WBE/DVBE <br />• The Standard Provisions for labor set forth in the contract apply to the subcontracted work <br />• If applicable, (Federal Aid Projects only) Section 14 (Federal Requirements) of the Special Provisions have been inserted in the subcontracts <br />and shall be incorporated in any lower -tier subplhnnact. Written contracts have been executed for the above noted subcontracted work <br />CONTRACTOR'S SIGNATURE <br />NOTE: This section is to be completed by the Resident Engineer <br />UA 11, <br />1. <br />Total of bid items ....... ............... ................ A ........ <br />..........,....... ............. ..................$ <br />2. <br />Specialty items (previously requested).................................................................$ <br />3, <br />Specialty items (this request) ........ ......-............... ..,.,.,.,.... ,....... <br />,......,.,..... $ <br />4. <br />Total (lines 2+3). .........._..... ........,.._.. _....._............ <br />...........$ <br />5. <br />Contractor must perform with own forces (lines l minis4)x <br />%........ ........ _.........._.....____$ <br />6, <br />Bid items previously subcontracted._.................................................................$ <br />7. <br />Bid items Subcontracted ( this request) ......... .... ._..... ......... ........... ..- .................. <br />$ <br />8. <br />Total (lines 6+7).. .................. .................. ............... .......- <br />....... $ <br />9. <br />Balance of work Contractor to perform (lilies l minus 8) .... ......._........,.,_..,.,._$ <br />RESIDENT ENGINEER'S SIGNATURE I DATE <br />3. Copy- local agcocy Leber Conolienec Offccr 4 Coptoctor'6TnPonnatioo Copy <br />FOLnmry I, 1998 <br />P-35 of P-40 <br />E. <br />Page 16-51 <br />