Attachment_-_Request_for_Substitution_-_Exemption.pdf
PDF 102 KB Posted
- Attached to
- Fixed Wing Pilot Training PP24-284
- Solicitation number
- RFQu-26-0124
- 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 state and local contracts. The form serves as the official mechanism for prime contractors to request approval for modifications to their proposed DBE utilization, including the release or substitution of DBE subcontractors, changes to the scope of work performed by DBE firms, or reductions to amounts originally proposed for DBE participation. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section at ptdcompliance@phoenix.gov prior to implementing any changes. The form requires the prime contractor's authorized representative to certify their authority, identify the affected DBE subcontractor(s) and their scope of work, document the good faith efforts undertaken to find additional DBE participation, and provide supporting documentation as necessary. The Compliance Section reviews each submission and indicates approval status, revised DBE goals, and revised DBE utilization percentages.
The form is directly applicable to the City of Phoenix's Fixed Wing Pilot Training contract (PP24-284), a five-year agreement commencing March 1, 2026, which includes significant DBE and Small Business Participation requirements under USDOT regulations (49 CFR Part 26). Contractors awarded this pilot training contract must submit an initial DBE and Small Business Participation Plan within 30 calendar days of award and provide annual updates through the City's Certification and Compliance System. Any modifications to the initially approved DBE participation plan during contract performance must follow the substitution/exemption process outlined in this form, with contractors required to demonstrate good faith efforts in locating replacement DBE-certified firms using the Arizona UTRACS database and maintaining detailed documentation of all business engagement attempts.
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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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