Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Various Metals Supply
- Solicitation number
- IFB-26-0075
- 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 changes to their proposed DBE utilization, including the release of proposed DBE subcontractors, substitution of DBE subcontractors, modification of DBE scope of work, or reduction of originally proposed DBE amounts. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section prior to implementing any changes. The form requires prime contractors to provide detailed information about affected DBE subcontractors, their scope of work, and documentation of good faith efforts undertaken to maintain or secure DBE participation.
The form establishes a formal approval process wherein the Contract Compliance Section reviews all substitution and exemption requests and documents their decision, including any revised DBE goals and utilization percentages. Authorized representatives of prime contractors must certify their authority to submit the request and provide supporting documentation as necessary. The form indicates that various exhibits, including Initial SBPP Plans, DBE Annual SBPP Plans, DBE Certification of Final Payment, and related documentation, must accompany submissions. This form is directly applicable to the City of Phoenix's Various Metals Supply contract, a five-year agreement commencing on or about July 1, 2026, which is subject to DBE participation requirements and compliance oversight through the Public Transit Department's compliance framework.
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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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