Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- HVAC Filter Maintenance and Repair
- Solicitation number
- 27-FMD-007
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution/Exemption form from the City of Phoenix Public Transit Department used to request approval for changes to Disadvantaged Business Enterprise (DBE) utilization on contracts. The form permits prime contractors to request exemptions or modifications to DBE participation through formal submission to the Compliance Section at ptdcompliance@phoenix.gov. Allowable requests include releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work performed by DBE subcontractors, or reducing the amount originally proposed for DBE subcontractors. The form requires prime contractors to provide detailed summaries of their exemption requests and document good faith efforts made to identify additional DBE participation. A pre-offer conference for the related HVAC Filter Maintenance and Repair contract is scheduled for February 18, 2026, at 9:00 a.m. via Microsoft Teams, with written inquiries due by March 25, 2026, at 9:00 a.m., and sealed offers due April 8, 2026, at 11:00 a.m. The contract term is three years commencing September 1, 2026, with two optional one-year extension periods.
The HVAC filter maintenance and repair contract requires full-service coverage at approximately 120 municipal facilities with supply and installation of MERV 13 rated filters in various configurations at specified service intervals. All offers must remain firm and fixed for 180 calendar days from the solicitation opening date. The City has established DBE and Small Business Participation Plan requirements in compliance with 49 C.F.R. Part 26, requiring successful contractors to submit comprehensive initial and annual DBE participation plans, maintain documentation of good faith efforts, and provide monthly reporting of DBE and small business expenditures through the City's Certification and Compliance System portal. Contractors must maintain all required licenses and certifications, comply with federal civil rights regulations including Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, E-Verify employment verification requirements, and City of Phoenix Equal Employment Opportunity requirements. Payment terms are to be submitted by offerors with City payment efforts estimated within thirty to forty-five calendar days after receipt of correct invoices.
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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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