Request_for_Substitution_or_Exemption_PTD_02_2026_(DBE-N).pdf
PDF 114 KB Posted
- Attached to
- Heavy Duty Truck Brake Services
- Solicitation number
- IFB-26-FSD-0412-2
- 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, applicable to solicitation 02_26-IFR related to Heavy Duty Truck Brake Services in Arizona. The form provides the procedural mechanism by which a prime contractor may request approval from the City's Contract Compliance Section to make modifications to its proposed Small Business (SB) utilization commitments. Specifically, the form allows prime contractors to request exemptions for releasing a proposed SB subcontractor, substituting an SB subcontractor, changing the scope of work performed by an SB subcontractor, or reducing the dollar amount originally proposed for an SB subcontractor. The related contract opportunity involves heavy duty brake services for the City, with an effective date upon final signature and recording, a commencement date of approximately January 1, 2027, and a three-year initial term with two optional one-year extensions exercisable at the City's discretion.
The form requires prime contractors to document good faith efforts undertaken in attempting to secure additional Small Business participation and mandates that no substitution, termination, scope reduction, or amount modification may occur without prior written approval from the Contract Compliance Section. All requests must include supporting documentation and justification. Upon review, the Contract Compliance Specialist indicates approval status and any revised Small Business utilization commitment amount. The form does not establish pricing terms, funding sources, or specific set-aside percentages in the document itself; rather, it serves as a compliance and approval mechanism to ensure adherence to the City's DBE-N program requirements throughout contract performance.
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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 .