Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
PDF 114 KB Posted
- Attached to
- Membrane Diffusers State and local contract opportunity
- Solicitation number
- IFB-26-0382
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution or Exemption form issued by the City of Phoenix Public Transit Department for the Disadvantaged Business Enterprise - Neutral (DBE-N) Program under solicitation 02_26-IFR - PTD. The form is designed to document and obtain approval for modifications to small business subcontractor commitments on prime contracts. Specifically, the form permits prime contractors to request exemptions for releasing proposed small business subcontractors, substituting small business subcontractors, changing the scope of work performed by small business subcontractors, or reducing the originally proposed amounts for small business subcontractors. Prime contractors must document their good faith efforts in finding additional small business participation when requesting such exemptions.
No substitution, termination, scope of work reduction, or amount change for any small business subcontractor is permitted without prior written approval from the City of Phoenix Public Transit Department's Contract Compliance Section. The form requires the authorized representative of the prime contractor to submit the request with supporting documentation explaining the exemption request and detailing good faith efforts undertaken. The Contract Compliance Specialist reviews and approves or denies the request, with approval resulting in a revised small business utilization commitment amount. The underlying Membrane Diffusers contract to which this form applies is a five-year agreement with a commencement date on or around September 23, 2026, and no options to extend beyond the five-year term.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Membrane_Diffusers.pdf | ||
| Acceptance_of_Offer_Form_2026.pdf | ||
| Supplemental-Terms-And-Conditions-To-All-Airport-Contracts_Rev_4-29-26.pdf | ||
| Addendum_Form.docx | DOCX document | |
| SAP_Open_Catalog_Interface_5_1.pdf | ||
| Certification_of_Final_Payment_PTD_02_2026_(DBE-N).pdf | ||
| DBE-N_Annual_SBPP.pdf | ||
| Sensitive_Security_Information_Acknowledgement_Form.docx | DOCX document |
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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:
File details come from the government source that posted it. Updated .