Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Variable Frequency Drives State and local contract opportunity
- Solicitation number
- IFB-26-0087
- Issued by
- Maricopa County, 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 public transit contracts. The form must be submitted to the City's Public Transit Department Compliance Section for approval prior to any modifications to proposed DBE utilization or contractor monthly DBE statements. Prime contractors are authorized to request exemptions for releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work for DBE subcontractors, or reducing amounts originally proposed for DBE subcontractors. The form requires contractors to document good faith efforts in finding additional DBE participation and provide detailed justification for any requested changes, with supporting documentation attached as necessary. All requests require authorization signatures from duly authorized representatives and are reviewed by the City's Contract Compliance Section for approval, including determination of revised DBE goals and utilization percentages.
In the context of the City of Phoenix Water Services Department's Variable Frequency Drives procurement (IFB-26-0087), this substitution/exemption process is a critical compliance mechanism for managing DBE participation requirements. The five-year VFD contract, with a pre-offer conference scheduled for September 2, 2025, and final offers due September 15, 2025, emphasizes mandatory DBE and small business engagement through the City's Certification and Compliance System. Contractors must make good faith efforts to engage DBE-certified suppliers and document monthly DBE and small business participation, with this substitution form serving as the formal mechanism for requesting modifications to originally proposed DBE subcontractor arrangements. The form ensures transparency and City oversight of any changes to DBE utilization commitments made during the bidding process.
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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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