Attachment_-_Certification_of_Full_-_Final_Payments_to_DBE_Firms.pdf
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- Solicitation number
- IFB-26-0107
- 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 contracts in Arizona. The document serves as a dual affidavit requiring both the prime contractor and the DBE subcontractor to certify completion of work and full payment upon project completion. The form applies to the City of Phoenix's five-year contract for parts, installation, and service of direct current batteries and power plants (IFB-26-0107), which commences on or about February 1, 2026. A non-mandatory pre-offer conference is scheduled for November 20, 2025, at 2:00 pm, with written inquiries due by December 1, 2025, and final offer responses due by December 8, 2025, at 2:00 pm. The contract involves delivery, installation, and testing of direct current batteries, power plants, chargers, and associated equipment at Regional Wireless Cooperative radio site locations.
The certification form requires contractors to document the total amount paid to DBE firms for materials and work performed and mandates that supporting documentation be retained for a minimum of three years from the project acceptance date. Both the contractor and DBE firm must declare under penalty of perjury that all statements are true and complete. The City of Phoenix has established specific provisions for DBE participation and Small Business Participation, requiring contractors to make good faith efforts to engage DBE and small business firms, submit monthly documentation through the City's Certification and Compliance System, and provide annual Small Business Participation Plans. Prices are firm and fixed for the initial contract year, with potential annual increases subject to 60 days' written notice and supporting documentation. No specific budget range is provided; however, the comprehensive nature of the contract reflects a significant investment in maintaining the city's critical power infrastructure, with pricing requirements for standard, after-hours, and emergency labor rates, as well as catalog discounts from manufacturers including Narada, Vertiv, Duracom, and CSB Batteries.
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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: |
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