Attachment_-_Request_for_Substitution_-_Exemption.pdf

PDF 102 KB Posted

Attached to
35-65-95 Gallon Containers
Solicitation number
RFP 27-SW-001
Issued by
Maricopa County, Phoenix City, Arizona

About this file

Summary of Request for Substitution/Exemption Form

This is a Request for Substitution/Exemption form from the City of Phoenix Public Transit Department used to manage Disadvantaged Business Enterprise (DBE) subcontractor changes on transit-related contracts. The form requires submission to the Public Transit Department Compliance Section (ptdcompliance@phoenix.gov) prior to implementing any modifications to DBE utilization statements. Prime contractors may request exemptions to release proposed DBE subcontractors, substitute DBE subcontractors, change the scope of work assigned to DBE subcontractors, or reduce the amount originally proposed for DBE subcontractors. The form requires the duly authorized representative of the prime contractor to certify their authority, summarize the exemption request, and document good faith efforts undertaken to identify additional DBE participation. All requests must include supporting documentation as necessary to justify the proposed changes.

The form includes a dedicated compliance review section for City personnel to document approval status, revised DBE goals, revised DBE utilization percentages, and the assigned Contract Compliance Specialist. No DBE may be substituted, terminated, or have their scope of work reduced or proposed amount modified without prior written approval from the Compliance Section. This administrative process ensures federal transit funding requirements mandating DBE participation are properly monitored and maintained throughout the contract performance period, particularly relevant to the City's 35-65-95 gallon container procurement commencing July 1, 2026, which carries significant federal DBE and Small Business Participation Plan requirements.

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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 .