Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Parks and Recreation Event-Related Services
- Solicitation number
- PKS-RFQu-26-0119
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution/Exemption form from the City of Phoenix Public Transit Department used to manage Disadvantaged Business Enterprise (DBE) subcontractor changes on public contracts. The form must be submitted to the Public Transit Department Compliance Section (ptdcompliance@phoenix.gov) prior to implementing any modifications to DBE utilization statements. The document permits prime contractors to request exemptions for releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work performed by DBE subcontractors, or reducing amounts originally proposed for DBE subcontractors. Authorized representatives of prime contractors must document their good faith efforts in attempting to secure additional DBE participation and provide supporting documentation justifying the requested exemption. The form requires submission of the project number, description, affected DBE subcontractor identification, and scope of work details prior to approval by the Compliance Section.
The form includes approval authority vested with the City of Phoenix Contract Compliance Section, which reviews requests and determines whether to approve exemptions while establishing revised DBE goals and utilization percentages. Compliance specialists must document the initial Small Business Participation Plan (SBPP), annual DBE SBPP plan, substitution or exemption requests, and certification of final payment. This administrative mechanism ensures that prime contractors maintain DBE participation commitments while allowing flexibility for legitimate business circumstances, requiring complete documentation and formal approval before any DBE subcontractor modifications are implemented 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: |
File details come from the government source that posted it. Updated .