Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
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- Attached to
- Air-Fed Vertical Collating System
- Solicitation number
- IFB-27-0411
- 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 serves as the official mechanism through which prime contractors must request approval from the City's Contract Compliance Section prior to making modifications to small business (SB) utilization commitments. Specifically, the form allows prime contractors to request exemptions to release proposed SB subcontractors, substitute existing SB subcontractors, change the scope of work assigned to SB subcontractors, or reduce the contract amounts originally proposed for SB subcontractor participation. The form requires the prime contractor's authorized representative to provide a comprehensive summary of the exemption request and documentation of good faith efforts undertaken to secure additional small business participation on the contract.
The form emphasizes that no small business subcontractor may be substituted, terminated, have their scope of work reduced, or have their proposed amount changed without prior written approval from the Contract Compliance Section. Upon submission, the form is reviewed and approved or denied by a Contract Compliance Specialist, who documents the decision and any revised small business utilization commitment amount. This procedural requirement ensures compliance with the City of Phoenix's small business participation goals and maintains accountability in the utilization of disadvantaged business enterprises throughout the contract performance period.
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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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