Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Chlorine and PH Analyzers
- Solicitation number
- IFB-26-0142
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This file is a Request for Substitution/Exemption form from the City of Phoenix Public Transit Department used to obtain approval for modifications to Disadvantaged Business Enterprise (DBE) utilization on public transit contracts. The form must be submitted to the Public Transit Department Compliance Section prior to implementing any changes to the proposed DBE statement of utilization or the contractor's monthly DBE utilization form. The document establishes the procedural requirements for prime contractors seeking to release proposed DBE subcontractors, substitute DBE subcontractors, change the scope of work assigned to DBE subcontractors, or reduce the amount originally proposed for DBE subcontractor participation. The form requires the duly authorized representative of the prime contractor to provide a comprehensive summary of the request, document the good faith efforts undertaken to locate additional DBE participation, and include all supporting documentation necessary to justify the exemption request.
The form designates specific fields for contract compliance use only, including approval authority, revised DBE goals, revised DBE utilization percentages, and the assigning contract compliance specialist. All requests are subject to review and approval by the City of Phoenix Contract Compliance Section before any modifications to DBE participation can be implemented. The form emphasizes that no DBE subcontractor may be substituted or terminated, nor shall their scope of work be reduced or proposed amount changed without explicit written approval from the Compliance Section. This administrative control mechanism ensures that the City maintains oversight of DBE participation commitments throughout the contract period and protects the integrity of small business and disadvantaged business enterprise goals in City of Phoenix procurement activities.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .