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May 2023 MDOT Electronic Forms Update
Michigan DOT sent this bulletin at 06/05/2023 09:13 AM 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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0196 |
DBE Removal/Substitution Request |
Office of Business Development |
5/30/23 |
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0197 |
Project Worker Interview Form |
Office of Business Development |
5/30/23 |
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0397 |
Work Zone Audit Report |
BFS-Construction Field Services |
5/22/23 |
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0437B |
Maintenance Work Element Time Record |
BFS-Transportation Systems Management Operations |
5/15/23 |
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0500 |
Coring Request |
BFS-Construction Field Services |
5/22/23 |
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0580 |
Concrete Plant Equipment Inspection Report |
BFS-Construction Field Services |
5/10/23 |
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0580A |
Concrete Plant Inspection |
BFS-Construction Field Services |
5/30/23 |
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0631A |
Donation Waiver of Compensation |
DSD-Acquisition |
5/2/23 |
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0633K |
Certificate of Appraiser |
DSD-Appraisal |
5/2/23 |
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0723 |
Appraisal Review Report |
DSD-Appraisal |
5/4/23 |
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0802A |
Airport Sponsor Reimbursement Request |
Aeronautics |
5/22/23 |
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1004 |
Request For Purchase of Materials, Supplies, Services |
BFS-Construction Field Services |
5/2/23 |
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1022N |
New Materials Product Evaluation Request Form |
BFS-Construction Field Services |
5/30/23 |
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1022Q |
Qualified Products Evaluation Request Form |
BFS-Construction Field Services |
5/30/23 |
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1116 |
Weekly Statement of Working Days Charged |
BFS-Construction Field Services |
5/22/23 |
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1117 |
Project Record Certification |
BFS-Construction Field Services |
5/30/23 |
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1178 |
Transfer of Tested Materials Report |
BFS-Construction Field Services |
5/24/23 |
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1156-T1 |
Minimum Wage Rate Interview Sheet Tier 1 |
BFS-Construction Field Services |
5/11/23 |
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1568 |
Approval for Project Staging or Excess Material Locations on MDOT ROW |
BFS-Construction Field Services |
5/16/23 |
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1901 |
Mechanical Analysis Report |
BFS-Construction Field Services |
5/11/23 |
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1920 |
Field Report for Concrete Pipe |
BFS-Construction Field Services |
5/24/23 |
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1945 |
Report of Test |
BFS-Construction Field Services |
5/24/23 |
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1964 |
Local Agency Project Field Review |
BFS-Construction Field Services |
5/30/23 |
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2073 |
Railroad Contact Form |
Office of Rail |
5/1/23 |
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2074 |
MDOT Office of Railroad Authority Contact Form |
Office of Rail |
5/1/23 |
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3145 |
Price Analysis |
Passenger Transportation-Procurement Forms |
5/22/23 |
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4106R |
Michigan Small Business Program Annual Affidavit |
Office of Business Development |
5/17/23 |
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DE26 |
Design Exception Request – Trunkline |
Design Division |
5/30/23 |
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NEW |
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Form Number |
Form Name |
Division Name |
New Form Create Date |
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2744-MSG |
MDOT Grant System (MGS) Access Request Form |
Office of Economic Development |
5/12/23 |
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2744E |
Application Access Request |
BFS-Transportation Systems Management Operations |
5/24/23 |
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3134B - Box Culvert 3134C – Circular Culvert 3134E – Elliptical Culvert 3134P – Pipe Arch Culvert 3134S – Slab Culvert |
Area changed: from DSD-Permits-Construction TO Design Division |
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1928 - Adhesive Anchoring System Proof Test |
Area changed: from BOBS-Bridge Construction TO BOBS-Structural Fabrication Unit |
Obsolete Forms:
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1994D - Stake Request Form |
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1996 - Traffic Control Report Form |
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1998 - Mobility Report |
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0528A - Report of Test on Daily Asphalt Cement - Original |
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0528B - Report of Test on Daily Asphalt Cement - Recovered |
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0582A - Density Retest Record |
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1100B - Recommendation & Authorization For: (Continuation Sheet) |
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1108A - Rainfall Record |
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1112D - Record of Contract Modifications |
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1168-93 - Force Account Worksheet for Equipment 1993 Spec. Provisions |
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1817D - Asphaltic Material - Plant Samples - Worksheet |
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1820C - Bituminous Mixture Analysis - Worksheet |