Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Solicitation number
- AVN IFB-26-0125
- 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 managing Disadvantaged Business Enterprise (DBE) participation in municipal contracts. The form serves as the official mechanism through which prime contractors request approval to release, substitute, or modify the scope of work or compensation for proposed DBE subcontractors on City of Phoenix projects. Contractors must submit completed forms to the Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any changes to DBE utilization statements or monthly reporting forms. The form requires the prime contractor's authorized representative to document good faith efforts undertaken to identify additional DBE participation and must include supporting documentation justifying the requested exemption. The Compliance Section reviews submissions and indicates approval status, revised DBE goals, and revised DBE utilization percentages on the form.
The form explicitly prohibits any substitution, termination, scope reduction, or amount modification of DBE subcontractors without prior written approval from the Compliance Section. This requirement ensures the City maintains oversight of DBE participation commitments made during contract award and prevents contractors from unilaterally reducing minority and disadvantaged business participation. The form includes designated fields for both the contractor's request and compliance documentation, establishing a formal administrative process that integrates DBE compliance monitoring into the City's overall contract management framework for the automatic transfer switch testing, maintenance, and repair services contract.
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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 .