Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- 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 use in managing Disadvantaged Business Enterprise (DBE) participation on public transit contracts. The form serves as the official mechanism for prime contractors to request approval for modifications to their DBE utilization plans, including releasing proposed DBE subcontractors, substituting existing DBE subcontractors, changing the scope of work assigned to DBE subcontractors, or reducing the dollar amount allocated to DBE subcontractors. All requests must be submitted to the City's Compliance Section at ptdcompliance@phoenix.gov prior to implementing any changes. The form requires the prime contractor's authorized representative to document their good faith efforts in identifying alternative DBE participation and to provide supporting documentation justifying the exemption request.
The form establishes a clear approval workflow, with the Compliance Section responsible for reviewing requests and determining whether exemptions will be granted. Upon approval, the Compliance Section documents the revised DBE goals and utilization percentages, assigns a compliance specialist to oversee the modification, and maintains exhibits including the initial Small Business Procurement Plan (SBPP), DBE Annual SBPP Plan, and final payment certification. No DBE subcontractor may be substituted, terminated, or have their scope of work reduced without documented approval from the Compliance Section, ensuring accountability in the use of federal DBE program funds on this Parks and Recreation Event-Related Services contract for the City of Phoenix.
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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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