Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Attached to
- Lutron Lighting Systems
- Solicitation number
- IFB PCC-26-0101
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution/Exemption form utilized by the City of Phoenix Public Transit Department to manage Disadvantaged Business Enterprise (DBE) subcontractor changes on public transit contracts. The form enables prime contractors to request approval for releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work assigned to DBE subcontractors, or reducing the dollar amount originally proposed for DBE subcontractors. All requests must be submitted to the City's Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any modifications. The form requires the prime contractor's authorized representative to provide detailed justification and documentation of good faith efforts undertaken to secure additional DBE participation. Contract Compliance Specialists within the City review submitted requests and determine approval status, noting the revised DBE goal and utilization percentages.
The form functions as a compliance checkpoint within the City of Phoenix's Small Business Participation Program (SBPP), which mandates DBE involvement on public transit projects. No DBE subcontractor may be substituted, terminated, or have their scope of work reduced or proposed amount modified without explicit written approval from the Compliance Section. Prime contractors must demonstrate documented good faith efforts to locate replacement DBE firms before exemptions are granted. The approval process requires the Contract Compliance Specialist to cross-reference the request against initial and annual SBPP plans, maintaining comprehensive records of all DBE participation modifications throughout contract performance and final payment certification.
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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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