Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Solicitation number
- IFB-26-0107
- 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 enables prime contractors to request approval for modifications to their DBE utilization commitments, including the release or substitution of proposed DBE subcontractors, changes to scope of work, or reductions to originally proposed amounts for DBE participation. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section prior to implementing any changes. The form requires the prime contractor's authorized representative to document the rationale for the exemption request and demonstrate good faith efforts undertaken to secure additional DBE participation, with supporting documentation attached as necessary. The Compliance Section reviews and approves requests, noting the revised DBE goal and utilization percentage on the form.
The form serves as a critical compliance tool for the City of Phoenix's DBE program, ensuring transparency and accountability in subcontractor participation on contracts such as the Parts, Installation and Service for Direct Current Batteries and Power Plants contract (IFB-26-0107). Contractors responding to City of Phoenix solicitations are required to maintain monthly documentation of DBE participation in the City's Certification and Compliance System and submit annual Small Business Participation Plans. The substitution/exemption process protects the integrity of DBE commitments while allowing flexibility when circumstances warrant documented changes, with all decisions recorded by the Contract Compliance Specialist for audit and accountability purposes.
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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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