Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Performance Entertainment Coordination Services
- Solicitation number
- RFQu-24-0427
- 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 by prime contractors seeking approval to modify Disadvantaged Business Enterprise (DBE) subcontractor participation on public transit contracts. The form permits prime contractors to request exemptions to release proposed DBE subcontractors, substitute DBE subcontractors, change the scope of work assigned to DBE subcontractors, or reduce the dollar amounts originally proposed for DBE participation. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any changes to the DBE utilization statement. The form requires the duly authorized representative of the prime contractor to provide detailed justification for the exemption request and document the good faith efforts undertaken to secure additional DBE participation as an alternative to the requested substitution or reduction.
The form serves as a compliance mechanism within the City's Small Business and Professional Participation (SBPP) program and requires the prime contractor to submit supporting documentation and additional pages as necessary to substantiate the exemption request. The Contract Compliance Section reviews all submissions and determines whether to approve the request, establishing revised DBE goals and utilization percentages accordingly. The form designates specific exhibits required for the compliance review process, including the Initial SBPP Plan, DBE Annual SBPP Plan, and DBE Certification of Final Payment. No DBE subcontractor may be substituted, terminated, have their scope of work reduced, or have their proposed amount modified without written approval from the Compliance Section, ensuring accountability in DBE participation throughout the contract term.
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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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