Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Parks and Recreation Event-Related Services
- Solicitation number
- PKS-RFQu-26-0119
- 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 on public transit contracts. The form provides a standardized process for prime contractors to request approval for changes to their proposed DBE utilization, including releasing proposed DBE subcontractors, substituting DBE subcontractors, modifying the scope of work assigned to DBE firms, or reducing the dollar amount allocated to DBE subcontractors. All requests must be submitted to the City's Compliance Section prior to implementation, and contractors must document good faith efforts in sourcing additional DBE participation. The form requires authorization from a duly authorized representative of the prime contractor and includes fields for project identification, affected DBE subcontractor information, scope of work details, and the specific exemption being requested. Upon submission, the Contract Compliance Section reviews the request and indicates approval status, revised DBE goals, and revised DBE utilization percentages.
The form serves as a critical compliance tool within the City of Phoenix's DBE program framework, which is integral to the broader procurement requirements for the Parks and Recreation Event-Related Services contract opportunity. This five-year contract, commencing February 1, 2026, mandates that all vendors establish a Small Business Participation Plan with documented DBE involvement and submit monthly reports of DBE expenditures through the City's Certification and Compliance System. The substitution/exemption process ensures oversight of DBE commitments and prevents unilateral contractor actions that would undermine small business participation goals. Contractors must maintain compliance documentation throughout the contract term, with any modifications subject to the Contract Compliance Specialist's written approval.
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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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