Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Concrete Flatwork Services
- Solicitation number
- IFB 26-0078
- 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 awarded contracts. The form must be submitted to the Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any modifications to proposed or actual DBE utilization statements. Prime contractors are authorized to request exemptions for releasing proposed DBE subcontractors, substituting existing DBE subcontractors, changing the scope of work performed by DBE subcontractors, or reducing the amount originally proposed for DBE subcontractors. The form requires the duly authorized representative of the prime contractor to document good faith efforts undertaken to identify additional DBE participation and must include supporting documentation justifying the requested exemption. The City's Contract Compliance Section reviews all requests and indicates approval status, revised DBE goals, and revised DBE utilization percentages on the form.
This substitution/exemption process applies to the City of Phoenix's Concrete Flatwork Services contract (IFB 26-0078), a five-year agreement commencing June 1, 2026, which encompasses concrete installation and replacement services across the Phoenix Metro area. The solicitation emphasizes mandatory DBE and Small Business participation requirements, with contractors required to submit initial and annual DBE/Small Business Participation Plans and document monthly participation through the City's Certification and Compliance System. Contractors must demonstrate good faith efforts in engaging certified DBE firms and maintain monthly documentation and annual summaries of expenditures to certified DBEs using federal and city databases. The pre-offer conference was scheduled for October 15, 2025, with written inquiries due by October 29, 2025, and bid responses due November 12, 2025, at 2:00pm.
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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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