Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
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- Attached to
- Animal Boarding Services
- Solicitation number
- RFQu-27-0399
- 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 in Arizona. The form is designed to be submitted to the City's Contract Compliance Section for approval prior to making changes to the proposed Statement of Small Business (SB) Utilization or a contractor's monthly utilization statement. The document outlines the process for requesting exemptions or modifications to small business subcontractor commitments, specifically allowing prime contractors to request approval to release proposed small business subcontractors, substitute existing small business subcontractors, change the scope of work performed by small business subcontractors, or reduce the amount originally proposed for small business participation. The form requires the duly authorized representative of the prime contractor to provide documentation of good faith efforts undertaken in attempting to secure additional small business participation.
The form mandates that no small business subcontractor shall be substituted, terminated, or have their scope of work reduced or proposed amount modified without explicit approval from the Contract Compliance Section. Upon submission and review, the Contract Compliance Specialist will indicate approval or denial and document any revised small business commitment amount on the form. The related Animal Boarding Services contract with the City of Phoenix carries a five-year term commencing January 1, 2027, with no extension options, and requires sealed offers through the City's Procurement Portal.
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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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