6-PA1858 Request for Approval Change to Original Schedule of Subcontractors.pdf

Exhibit B

REQUEST FOR APPROVAL OF CHANGE TO

ORIGINAL SCHEDULE OF SUBCONTRACTORS

Contract/Solicitation Number________________________________________________________________________

Project Name_____________________________________________________________________________________

Contractor Name_________________________________________________________________________, requests approval of the following addition(s) and/or deletion(s) on the SCHEDULE OF SUBCONTRACTORS (M/WBE Form No. 90), as originally submitted as part of the bid/proposal on the above-named project.

CHANGE

Check (X) block for each transaction.

ADD DELETE COMPANY NAME TRADE M/WBE

STATUS

RELEVANT

MARKET AREA

COUNTY

DOLLAR

AMOUNT

JUSTIFICATION

The Contractor must demonstrate good cause to terminate or substitute the M/WBE and seek BDDD approval prior to taking any termination or substitution action. Good cause includes the following circumstances: 1. The listed M/WBE subcontractor fails or refuses to execute a written contract. 2. The listed M/WBE subcontractor fails or refuses to meet the Contractor’s reasonable, nondiscriminatory bond requirements. 3. The listed M/WBE subcontractor becomes bankrupt, insolvent or exhibits credit unworthiness. 4. The listed M/WBE is ineligible to work on Airport projects because of suspension and debarment proceedings pursuant to federal or state law or other applicable laws or regulations. 5. BDDD has determined that the listed M/WBE subcontractor is not a responsible contractor. 6. The listed M/WBE subcontractor voluntarily withdraws from the project and provides BDDD written notice of its withdrawal. 7. The listed M/WBE subcontractor is ineligible to receive credit for the type of work required. 8. The M/WBE owner dies or becomes disabled with the result that the listed M/WBE subcontractor is unable to complete its work on the Contract. 9. Other good cause as determined in BDDD’s sole discretion. Attach additional sheets as necessary.

CERTIFICATION OF AFFIDAVIT

The above information is true and complete to the best of my knowledge and belief. I further understand and agree that this certification shall become a part of my contract with the Dallas/Fort Worth International Airport Board.

Name of Authorized Representative: _________________________________________ E-mail Address: ___________________________ (Please print or type)

Signature__________________________________________________ Date: ___________________________________

Routed To: Approved by:

(Check One) _____ Design, Code & Construction Dept. Vice President or Designee _____ Procurement & Materials Management Dept. Business Diversity & Development Dept.