Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
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- Attached to
- Forcible Entry Props and Related Accessories
- Solicitation number
- IFB-27-0393
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution or Exemption form for the Disadvantaged Business Enterprise - Neutral (DBE-N) Program administered by the City of Phoenix Public Transit Department for contract 02_26-IFR-PTD. The form permits prime contractors to request approval for modifications to small business (SB) subcontractor participation, including releasing proposed SB subcontractors, substituting SB subcontractors, changing the scope of work assigned to SB subcontractors, or reducing the proposed contract amount for SB subcontractors. All requests must be submitted to the City of Phoenix Public Transit Department Compliance Section prior to implementing any changes to the proposed Statement of Small Business Utilization or the contractor's monthly statement. The related contract opportunity is for Forcible Entry Props and Related Accessories with an effective date upon final signature and recording by the City Clerk's department, a commencement date of January 1, 2027 or the effective date, whichever is later, and a five-year term with no options to extend.
No substitution or termination of small business subcontractors, nor any reduction in their scope of work or proposed contract amount, is permitted without explicit approval from the Contract Compliance Section. Prime contractors requesting exemptions must demonstrate good faith efforts in seeking additional small business participation and provide detailed justification with supporting documentation. The form requires authorization from a duly authorized representative of the prime contractor and must be reviewed and approved by a Contract Compliance Specialist, who will document any revised small business commitment amounts resulting from the approval decision.
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Text version
Disadvantaged Business Enterprise - Neutral (DBE-N) Program AGENCY: Public Transit Department
02_26-IFR - PTD
REQUEST FOR SUBSTITUTION/EXEMPTION
THIS FORM MUST BE SUBMITTED TO THE CITY OF PHOENIX, PUBLIC TRANSIT DEPARTMENT COMPLIANCE SECTION, FOR APPROVAL PRIOR TO MAKING ANY CHANGES TO THE PROPOSED STATEMENT OF SMALL BUSINESS (SB) UTILIZATION OR CONTRACTOR’S MONTHLY STATEMENT OF SMALL BUSINESS UTILIZATION FORM. NO SMALL BUSINESS SHALL BE SUBSTITUTED OR TERMINATED, NOR SHALL THEIR SCOPE OF WORK
BE REDUCED OR PROPOSED AMOUNT CHANGED WITHOUT THE APPROVAL OF THE CONTRACT
COMPLIANCE SECTION.
Prime Contractor: Contract Number:
Project Number and Description:
Affected Small Business Subcontractor(s):
Scope of Work to be Performed by Affected Small Business 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 (circle those that apply);
A. Release a proposed SB subcontractor C. Substitute a SB subcontractor B. Change the scope of work to be performed by an SB subcontractor D. Reduce the amount originally proposed for a
SB subcontractor
3. I have summarized the Prime Contractor's request for an exemption and the good faith efforts required in finding additional Small Business participation on the above-mentioned contract as follows: (Attach additional pages and supporting documentation as necessary.)
Authorized Signature: ________________________________________________ Date: ___________________ Prime Contractor's Representative
Name and Title: _____________________________________________________ Phone: __________________
FOR CONTRACT COMPLIANCE USE ONLY
Request Approved: YES NO Revised Small Business Commitment: $
REVISED SMALL BUSINESS UTILIZATION
Contract Compliance Specialist: Date:
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