Attachment_-_Certification_of_Full_-_Final_Payments_to_DBE_Firms.pdf
PDF 106 KB Posted
- Attached to
- Alco-Sensor Equipment, Parts and Supplies
- Solicitation number
- IFB-26-0123
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Certification of Full/Final Payment to DBE Firms form issued by the City of Phoenix Public Transit Department for contractors and Disadvantaged Business Enterprise (DBE) firms to document payment completion upon project conclusion. The form requires dual certification—one affidavit from the prime contractor and one from the DBE firm—confirming that full payment, including all retention amounts, has been made for materials and work performed on the contract. Both parties must declare under penalty of perjury that the payment information is accurate and complete, with supporting documentation subject to audit and retention for a minimum of three years from the project acceptance date. The certification process applies to the Alco-Sensor Equipment, Parts and Supplies contract (IFB-26-0123) for the Phoenix Police Department, a five-year agreement commencing November 1, 2026, covering 175 Alco-Sensor FST units with associated parts, mouthpieces, and case kits with annual replenishment requirements.
The form serves as a compliance mechanism under 49 CFR Parts 26 and 23, requiring contractors to demonstrate good faith efforts in DBE and small business participation. Contractors must submit an initial Small Business Participation Plan within thirty calendar days after contract award and track all DBE and small business expenditures monthly through the City's Certification and Compliance System. Sealed offers for the Alco-Sensor procurement were due March 3, 2026 at 2:00 p.m., with award to the lowest responsive and responsible offeror; pricing is firm and fixed for the initial one-year period with permitted annual increases upon sixty days' notice. No specific budget or award value is disclosed in available solicitation materials. All contractor payments must be made within thirty to forty-five days of invoice receipt or product acceptance, whichever is later.
View the file
Other files
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 .