Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Solicitation number
- RFP GGS-26-0117
- 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 managing Disadvantaged Business Enterprise (DBE) subcontractor changes on transit contracts. The form enables prime contractors to request approval for releasing, substituting, or modifying the scope of work or proposed amounts for DBE subcontractors. Contractors must submit requests to the Public Transit Department Compliance Section (ptdcompliance@phoenix.gov) prior to implementing any changes to their DBE utilization statement. The form requires the authorized representative of the prime contractor to document the request type, provide a summary of good faith efforts made to secure additional DBE participation, and obtain written approval from the Contract Compliance Specialist before proceeding. Upon approval, the compliance section revises the DBE goal and utilization percentages and documents the decision with supporting exhibits including the initial Small Business Procurement Plan (SBPP), annual SBPP plan, and certification of final payment.
The form serves as a control mechanism to ensure compliance with DBE participation mandates and prevent unauthorized substitutions or scope reductions that would undermine diversity goals. Prime contractors are required to demonstrate adequate good faith efforts in seeking replacement DBE participation when requesting exemptions or substitutions. The form explicitly prohibits any changes to DBE utilization without prior written approval from the Compliance Section, establishing clear documentation requirements and an approval workflow that protects the integrity of DBE participation commitments on City of Phoenix contracts.
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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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