Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Solicitation number
- IFB-26-0111
- 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 managing Disadvantaged Business Enterprise (DBE) utilization changes on public transit contracts. The form enables prime contractors to request approval for modifications to their DBE participation commitments, including releasing or substituting DBE subcontractors, changing the scope of work assigned to DBE firms, or reducing 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 implementation. The form requires contractors to document good faith efforts undertaken to secure continued or replacement DBE participation and mandates authorization by a duly authorized representative of the prime contractor. The City's Contract Compliance Section reviews all requests and may approve changes, revise DBE goals and utilization percentages, and maintain documentation including initial SBPP plans, annual SBPP plans, and certification of final payment records.
The form serves as a compliance mechanism under 49 CFR Part 26 requirements and does not establish pricing, contract amounts, or financial terms. Instead, it functions as an administrative tool for managing deviations from originally proposed DBE utilization goals throughout the contract period. Contractors must demonstrate meaningful engagement with certified DBE firms and justify any reductions in DBE participation through documented outreach efforts. Approval decisions rest with the designated Contract Compliance Specialist, who evaluates requests against the City's DBE participation objectives and regulatory compliance standards.
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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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