Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Attached to
- Bypass Spools and Tailpieces
- Solicitation number
- IFB-26-0112
- 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) participation on public transit contracts. The form serves as the mechanism through which prime contractors can request approval to release proposed DBE subcontractors, substitute existing DBE subcontractors, modify the scope of work assigned to DBE subcontractors, or reduce the contract amounts originally proposed for DBE participation. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any changes to the DBE utilization statement. The form requires the duly authorized representative of the prime contractor to document the exemption request, provide supporting documentation detailing good faith efforts undertaken to locate additional DBE participation, and submit the application for review and approval by the City's Contract Compliance Specialist. The Compliance Section will review each request and determine whether to approve it, establish a revised DBE goal, and calculate revised DBE utilization percentages for the affected contract.
The form establishes strict controls over DBE subcontractor modifications by prohibiting any substitutions, terminations, scope reductions, or amount changes without prior written approval from the Compliance Section. Contractors must demonstrate good faith efforts in attempting to maintain or identify replacement DBE participation when seeking exemptions. The approval process requires the Contract Compliance Specialist to review the initial Small Business Participation Plan, the DBE Annual Small Business Participation Plan, and any supporting documentation provided by the contractor before issuing a determination. This procedural requirement ensures that DBE participation goals, which are mandated by federal regulations, are maintained or appropriately adjusted with proper documentation and justification throughout the life of City 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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