Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Odor Control Services
- Solicitation number
- IFB-26-0067
- 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 by prime contractors seeking approval to modify Disadvantaged Business Enterprise (DBE) subcontractor participation on awarded contracts. The form permits contractors to request exemptions for releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work performed by DBE subcontractors, or reducing the originally proposed amount for DBE subcontractors. 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 proposed statement of DBE utilization or the contractor's monthly statement of DBE utilization form. The form requires the prime contractor's authorized representative to certify their authorization, identify the affected DBE subcontractor(s) and their scope of work, document the good faith efforts undertaken to find additional DBE participation, and provide supporting documentation as necessary. The form includes designated approval sections for the Contract Compliance Section to review the request, revise DBE goals and utilization percentages if appropriate, and document the Contract Compliance Specialist's approval decision with supporting exhibits including the Initial SBPP Plan, DBE Annual SBPP Plan, and DBE Certification of Final Payment.
The odor control services procurement (IFB-26-0067) referenced in the related contract opportunity establishes specific DBE and Small Business Participation Plan requirements under 49 CFR Part 26, mandating that contractors demonstrate good faith efforts in promoting DBE and small business participation through proactive outreach and engagement with certified suppliers. Prime contractors are required to submit an Initial Small Business Participation Plan within 30 calendar days of contract award, with annual plans due on each anniversary date of contract execution. No DBE shall be substituted, terminated, or have their scope of work reduced or proposed amount changed without explicit approval from the Compliance Section, making this Request for Substitution/Exemption form the required mechanism for any such modifications during contract performance.
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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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