Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
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- Solicitation number
- RFQu-EED-27-0422
- 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 the Disadvantaged Business Enterprise-Neutral (DBE-N) Program. The form must be submitted to the City of Phoenix Public Transit Department Compliance Section for approval prior to any modifications to small business utilization commitments. The document applies to the Head Start Birth to Five Professional Development Training contract, which runs from December 2, 2026, through April 5, 2028, with no extension options. The service commencement is contingent upon Phoenix City Council approval or the effective date, whichever occurs later.
The form requires prime contractors to request exemptions for releasing proposed small business subcontractors, substituting existing small business subcontractors, changing the scope of work for small business subcontractors, or reducing originally proposed amounts for small business subcontractors. Contractors must document good faith efforts in finding additional small business participation and provide supporting documentation justifying any requested exemptions. No small business subcontractor may be substituted, terminated, have their scope of work reduced, or have their proposed amount changed without written approval from the Contract Compliance Section. The form includes fields for the revised small business commitment amount and requires authorization and approval signatures from both the prime contractor's representative and the contract compliance specialist.
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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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