Attachment_-_Certification_of_Full_-_Final_Payments_to_DBE_Firms.pdf
PDF 106 KB Posted
- Attached to
- Lutron Lighting Systems
- Solicitation number
- IFB PCC-26-0101
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Certification of Full/Final Payment to Disadvantaged Business Enterprise (DBE) Firms form issued by the City of Phoenix Public Transit Department for state and local contract opportunities. The form serves as a dual affidavit document to be completed upon project completion by both the prime contractor and the DBE subcontractor to certify that full payment, including all retention amounts, has been made for materials and work performed. The certification applies to the Lutron Lighting Systems contract for the Phoenix Convention Center, a five-year agreement commencing March 1, 2026, which encompasses preventive and corrective maintenance, diagnostics, system optimization, parts replacement, and emergency response services. The non-mandatory pre-offer conference and site visit were scheduled for November 19, 2025, with written inquiries due by December 5, 2025, and sealed offers due by December 19, 2025. The contract will be awarded by City Council and becomes effective upon signature and recording by the City Clerk's department, with termination occurring at the end of the five-year term or upon specific agreement provisions.
The payment certification document requires contractors to document the total value of all payments made to DBE firms and maintain supporting documentation for a minimum of three years from project acceptance. The form emphasizes significant focus on DBE and small business participation as a set-aside requirement, mandating that contractors use good faith efforts to promote DBE firm involvement and submit monthly documentation through the City's Certification and Compliance System along with an annual Small Business Participation Plan. Both the contractor and DBE firm must declare under penalty of perjury that statements are true and complete. Supporting documentation is subject to audit, and contractors must provide documentation of any delayed or withheld payments to DBE firms. The specific contract value is not explicitly stated in the solicitation materials, though the five-year term and multiple Convention Center locations suggest a substantial procurement opportunity.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
By:
Date:
City of Phoenix
PUBLIC TRANSIT DEPARTMENT
CERTIFICATION OF FULL/FINAL PAYMENT TO DBE FIRMS
(TO BE COMPLETED BY THE CONTRACTOR & DBE FIRM UPON COMPLETION OF WORK)
CONTRACTOR AFFIDAVIT:
The undersigned, having contracted as the Contractor on Project _________________ (Project Number and Name) hereby certifies that full payment (including all retention) has been made to the DBE firm cited below. The total value of all payments made to the DBE firm for materials and/or work performed on this project contract is as follows:
DBE Firm:
Total Amount Paid:
This certification is made under Federal and State laws concerning false statement.
Supporting documentation for this payment is subject to audit and should be retained for a minimum of three (3) years from the project acceptance date. In the event the DBE was not paid in accordance with affidavits submitted by the Successful Bidder, all documentation supporting the Successful Bidder 's position with regards to delayed or withheld payment(s) should be submitted.
I DECLARE UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY
OTHER APPLICABLE STATE OR FEDERAL LAW, THE STATEMENTS MADE ON
THIS DOCUMENT ARE TRUE AND COMPLETE TO THE BEST OF MY
KNOWLEDGE.
Signature of Authorized Agent for Contractor
Printed Name and Title
By:
Date:
DBE FIRM AFFIDAVIT:
(Name of DBE)
The undersigned DBE firm hereby certifies that a contract was entered into with the above named Contractor to perform work or provide materials on the project cited in this document. I further certify that the total amount of payments received as provided herein by the prime contract is accurate and unchallenged.
I DECLARE UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY
OTHER APPLICABLE STATE OF FEDERAL LAWS, THE STATEMENTS MADE ON
THIS DOCUMENT ARE TRUE AND COMPLETE TO THE BEST OF MY
KNOWLEDGE.
Signature of Authorized Agent for DBE Firm
Printed Name and Title
| Exhibit - Initial SBPP Plan |
| Exhibit - DBE Annual SBPP Plan |
| Exhibit - DBE Request for Substitution or Exemption |
| Exhibit - DBE Certification of Final Payment |
| CONTRACTOR AFFIDAVIT: |
| DBE Firm: |
| Total Amount Paid: |
| Printed Name and Title: |
| Text57: |
| Name of DBE: |
| Printed Name and Title_2: |
File details come from the government source that posted it. Updated .