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March 2023 MDOT Electronic Forms Update
Michigan DOT sent this bulletin at 04/04/2023 02:11 PM EDT|
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All MDOT forms can be located at the MDOT Forms homepage located at: MDOT - WebForms (state.mi.us)
MDOT users can view a listing of all forms that have been updated for the last 3 months by going to the MDOT Sharepoint Forms Intranet webpage and clicking on New/Revised Forms on the left side of the screen in the navigational bar.
The following forms were created, modified, or made fillable last month. All forms are available electronically at Inside MDOT Forms Management Page and the public website as appropriate:
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REVISIED |
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Form Number |
Form Name |
Division Name |
Form Revision Date |
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0267 |
DETAILED BEAMS, Survey Report (Bridge Layout ORIENTATION Sheet) |
BOBS-Structure Preservation and Management |
3/10/23 |
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0193 |
Disadvantaged Business Enterprise (DBE) Supplier Participation Affidavit |
Office of Business Development |
3/6/23 |
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0386 |
Heat Straightening Program General Information |
BOBS-Structural Fabrication Unit |
3/14/23 |
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0411 |
State Trunkline Maintenance Materials Report |
BFS-Transportation Systems Management Operations |
3/7/23 |
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0420 |
Summary of Maintenance Charges |
BFS-Transportation Systems Management Operations |
3/27/23 |
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0431 |
Maintenance Worker Work Experience Evaluation |
BFS-Transportation Systems Management Operations |
3/20/23 |
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0431A |
Maintenance Work Element Program Progress Evaluation |
BFS-Transportation Systems Management Operations |
3/13/23 |
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0431B |
Maintenance Work Element Program Exam Schedule |
BFS-Transportation Systems Management Operations |
3/13/23 |
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0514A |
Soil Boring Log |
BOBS-Geotechnical Services |
3/1/23 |
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0564 |
Worksheet for Sand Patch Test |
BFS-Construction Field Services |
3/13/23 |
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0677 |
Relocation Claim Business/Non-Profit/Farm |
DSD-Relocation |
3/20/23 |
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1386 |
Post Certification of Subcontract Compliance |
BFS-Construction Field Services |
3/15/23 |
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1459 |
Structure Installation Inspection Request |
BOBS-Structure Preservation and Management |
3/308/23 |
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2744A |
CTRAK Application Access Request |
Financial Operations Division (FOD) |
3/23/23 |
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2744B |
Phase Initiator (PI) Application Access Request |
Financial Operations Division (FOD) |
3/23/23 |
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3891 |
Michigan Design and Build Bridge Challenge Reimbursement Form |
Superior Region |
3/22/23 |
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NEW |
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Form Number |
Form Name |
Division Name |
New Form Create Date |
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3594 |
MDOT Aggregate Source Identification Request |
BFS-Construction Field Services |
3/15/23 |
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3596 |
Checklist for Riprap |
BOBS-Geotechnical Service |
3/31/23 |
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1871 – Requesting Type II Noise Abatement 1028 - Traffic Signal Strain Pole Inspection Report |
Area change: from BFS-Construction Field Services TO BOBS-Structure Preservation and Management |
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0511 – Activity Report (Geoenvironmental Unit) 0986 - Sewage Disposal System Events Claim Information |
Area change: from BFS-Construction Field Services TO Environmental |
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5606 - Transfer of Portable Nuclear Density Gauges - Superior Region |
Area change: from BFS-Construction Field Services TO Superior Region |
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5606 - Transfer of Portable Nuclear Density Gauges - Bay Region |
Area change: from BFS-Construction Field Services TO Bay Region |
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5607 - Transfer of Portable Nuclear Density Gauges - North Region |
Area change: from BFS-Construction Field Services TO North Region |
Obsolete Forms:
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0074 - Special Placement in the Engineering Technician Work Element Program - Special Selection Element Certification Form |
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0075 - Special Placement in the Engineering Technician Work Element Program - Special Selection Waiver |
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0080 - Checklist for on Boarding Process for New Employees and Transfers from Other State Agencies |
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0084 - Religious Accommodation Request Form |
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0506 - Report of Sign Inspection |
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0555 - CPE, PPP and CPV Pipe Installation and Mandrel Testing Results - Sewers |
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0563 - CPE, PPP and CPV Pipe Installation and Mandrel Testing Results - Culverts |
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0633N - Restricted Use Appraisal Report |
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0645A - Attachment - Option for Purchase of Land |
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0937 - Working Out of Class Pay Adjustments Request |
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0980 - MSEA Employee Grievance - Step 1 |
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0980A - MSEA Step 2 Appeal/Response (Labor & Trades, Safety & Regulatory) |
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1028 - Traffic Signal Strain Pole Inspection Report |
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1100 - Recommendation/Auth.: Changes/Extra/Extension/Adj. Contract |
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1129 - Transp. Engineer IV, V, VI Construction Trainee Record |
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1135 - Monthly Personnel Report |
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1162 - Winter Concrete Temperature Record |
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1168 - Force Account Worksheet for Equipment 1990 Specifications |
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1175 - Post Final Construction Estimates |
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1836 - Chain of Custody Record |
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1871 - Requesting Type II Noise Abatement |
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1872 - Concrete Pavement Cores (Worksheet) |
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1922 - Shipment of Tested Stock Report |
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1957 - Employee Request for Engineering Technician Work Element Certification |
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1958 – Engineering Technician Work Element Certification Form |
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1992 - DBE Trucker Project Site Review |
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5616 - Pre and Post Pour Inspection Checklist |
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CONEBLK - One Point Michigan Cone Test Chart Black |
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T-99BLK - One Point T-99 Test Chart Black |