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 use in managing Disadvantaged Business Enterprise (DBE) utilization changes on municipal contracts. The form serves as the official mechanism for prime contractors to request approval from the City's Compliance Section prior to modifying their proposed DBE participation, including releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work assigned to DBE subcontractors, or reducing amounts originally proposed for DBE subcontractors. The form requires completion by an authorized representative of the prime contractor and mandates submission to the Public Transit Department Compliance Section at ptdcompliance@phoenix.gov for written approval before any changes are implemented. No substitutions, terminations, scope reductions, or amount modifications may occur without explicit approval. The form captures contract identification information, affected DBE subcontractor details, scope of work descriptions, and requires documentation of good faith efforts undertaken to find additional DBE participation to justify the requested exemption or substitution.
The form emphasizes that all DBE substitutions and exemptions must be supported by documentation demonstrating the prime contractor's good faith efforts to maintain or increase DBE participation levels. Upon submission, the City's Contract Compliance Section reviews the request and determines whether to approve it, with authority to revise the DBE goal and DBE utilization percentages accordingly. The compliance review process includes examination of supporting documentation, with a designated Contract Compliance Specialist responsible for approving or denying requests and maintaining records of initial SBPP plans, DBE annual SBPP plans, exemption requests, and certifications of final payment.
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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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