Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Purchase of Motorcycles
- Solicitation number
- 26-FSD-031
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution/Exemption form issued by the City of Phoenix Public Transit Department for use in connection with Disadvantaged Business Enterprise (DBE) participation on public contracts. The form must be submitted to the City's Compliance Section prior to any modifications to proposed DBE utilization statements or contractor monthly DBE documentation. Prime contractors may request exemptions to release proposed DBE subcontractors, substitute DBE subcontractors, change the scope of work assigned to DBE subcontractors, or reduce amounts originally proposed for DBE subcontractors. The form requires the authorized representative of the prime contractor to certify their authority to submit the request and to provide a summary of good faith efforts undertaken to identify additional DBE participation, with supporting documentation attached as necessary. The City's Contract Compliance Section reviews submissions and indicates approval status, revised DBE goals, revised DBE utilization percentages, and the assigned compliance specialist responsible for the request.
This form applies to the City of Phoenix's IFB #26-FSD-031 for the purchase of BMW R 1300 RT-P motorcycles or equivalent models for police operations. The three-year contract with two potential one-year extensions commences on or about February 1, 2026, with a response deadline of November 19, 2025, at 11:00 am. The procurement requires contractors to demonstrate DBE and small business participation through annual participation plans and monthly documentation via the City's Certification and Compliance System, with contractors expected to identify and engage potential DBE suppliers using City and Federal databases. Pricing is fixed for the initial contract year with potential annual adjustments subject to proper documentation. The City reserves the right to purchase additional quantities up to 100 percent of the specified amount and requires new, current model year equipment with comprehensive warranty and support provisions.
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Text version
City of Phoenix
PUBLIC TRANSIT DEPARTMENT
REQUEST FOR SUBSTITUTION/EXEMPTION
This form must be submitted to the City of Phoenix, Public Transit Department Compliance Section (ptdcompliance@phoenix.gov), for approval prior to making any changes to the proposed statement of DBE utilization or Contractor’s monthly statement of DBE utilization form. No DBE shall be substituted or terminated, nor shall their scope of work be reduced or proposed amount changed without the approval of the Compliance Section.
Prime Contractor: Contract Number:
Project Number and Description:
Affected DBE Subcontractor(s):
Scope of Work to be Performed by Affected DBE Subcontractors(s):
1. I am the duly authorized representative of the above listed Prime Contractor and am authorized to request this exemption on behalf of the Prime Contractor.
2. I hereby request that an exemption be granted to the above-mentioned Prime Contractor to (check those that apply):
Release proposed DBE subcontractor Substitute DBE subcontractor
Change scope of work to be performed by DBE subcontractor
Reduce amount originally proposed for DBE subcontractor
3. I have summarized the Prime Contractor's request for an exemption and the good faith efforts required in finding additional DBE participation on the above-mentioned contract as follows: (Attach additional pages and supporting documentation as necessary.)
Date:
Phone:
Yes No %
Date:
Authorized Signature:
Signature of Authorized Agent for Contractor
Name and Title:
FOR CONTRACT COMPLIANCE USE ONLY
Request Approved: Revised DBE Goal:
Revised DBE Utilization:
Contract Compliance Specialist:
| Exhibit - Initial SBPP Plan |
| Exhibit - DBE Annual SBPP Plan |
| Exhibit - DBE Request for Substitution or Exemption |
| Exhibit - DBE Certification of Final Payment |
| Phone: |
| Prime Contractor: |
| Contract Number: |
| Project Number and Description: |
| Affected DBE Subcontractors: |
| Scope of Work to be Performed by Affected DBE Subcontractorss: |
| to check those that apply: |
| Substitute DBE subcontractor: |
| undefined: |
| proposed for DBE: |
| follows Attach additional pages and supporting documentation as necessary: |
| Name and Title: |
| FOR CONTRACT COMPLIANCE USE ONLY: |
| No: |
| Date_2: |
| Text39: |
| Text40: |
| Text41: |
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