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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:

 

REVISIED

 

Form

Number

Form Name

Division

Name

Form

Revision

Date

0637B

Quit Claim Deed (Restrictive Covenant)

DSD-Acquisition

6/30/25

0640F

Consent To Perform Soil Borings

DSD-Acquisition

6/17/25

0818

Out-of-State Travel Request

Executive Office

6/30/25

1137

Work Order

BFS-Construction Field Services

6/3/25

2067

Annual Certification of Employee-related Conditions - County Road Agency

FOD-Act 51

6/16/25

2068

Annual Certification of Employee-related Conditions - City or Village

FOD-Act 51

6/16/25

2484

Drainage Design Requirements for Accessing State Trunkline Drainage Systems

DSD-Permits-Construction

6/11/25

2606

MDOT Small Urban Program - Road Project Application

Transportation Planning

6/27/25

2638

MDOT Small Urban Program - Transit Project Application

Transportation Planning

6/27/25

2744A

CTRAK Application Access Request

Financial Operations Division (FOD)

6/24/25

2744B

Phase Initiator (PI) Application Access Request

Financial Operations Division (FOD)

6/24/25

2744-QUADS

QUADS Application Access Request

QUADS Application Access Request

6/4/25

3119

Report of New Equipment

BFS-Transportation Systems Management Operations

6/30/25

3594

MDOT Aggregate Source Identification Request

BFS-Construction Field Services

6/30/25

4106

Small Business Program Pre-Application Checklist

Office of Business Development

6/27/25

 

NEW

 

Form

Number

Form Name

Division

Name

New Form

Create

Date

2670

Small Business Program Supplier Participation Declaration

Office of Business Development

6/27/25

2671

Contractor Compliance Monitoring (CCM) Review

Office of Business Development

6/9/25

2672

Small Business Program Removal/Substitution Request

Office of Business Development

6/27/25

 

Obsolete Forms:

 
 
 
 
 

 

ADA Compliant Updated Forms:

0621 - Building Report

0622 - Fixture Appraisal Checklist

0625B - Replacement Housing Determination

0625C - Replacement Rental Determination

0625D - Replacement Mobile Home Determination

0633 - Requirements for Writing Appraisal Reports

0633AR - Guidelines for Written Narrative Appraisal Review Analysis

0633BC - Appraisal Review Report Summary

0633C - Market Study Requirements and Guidelines

0633E - Appraisal Checklist

0633K - Certificate of Appraiser

0633PP - Photo Page

0633Q - Request for Reconsideration of Valuation

0633R - Certificate of Review Appraiser

0633T - Application for Approval to Provide Real Estate Appraisal & Appraisal Review Services

0634 - Rent Loss Agreement

0637B - Quit Claim Deed (Restrictive Covenant)

0640F - Consent to Obtain Soil Boring(s)

0640G - Consent to Construct Temporary Drive

0650 - Unsecured Parcel Requirements

0657 - Replacement Dwelling Certification

0668 - Rental Application

0669 - Property Tax Information

0728 - Minor Construction Changes

0734 - Unsecured Parcel Transmittal

0741A - Tax Proration Breakdown Schedule

0749 - Possession & Use Agreement

0772 - Application to Use MDOT Controlled Freight Railroad Property

0774 - Tenant Certification of Total Gross Income

0802A - Airport Sponsor Reimbursement Request

0802NM - Local Agency Certification of Non-Monetary

0802NMP - Planning Agency Certification of Non-Monetary

0802P - Local Agency Request for Reimbursement

0802PL - Planning Agency Request for Reimbursement

0802Q - Railroad Request for Reimbursement

0828 - Mentor Protege Application

0831 - Aviation Economic Benefit Worksheet

0838 - Memorandum Job Report - Accounts Receivable

0848 - Stores Receiving Report

0974 - MDOT Welcome Center Vendor Information Updates Form

0976 - MDOT - Human Resources Onboarding Checklist

1013S - Inspector's Checklist for Inspection for Solar Boards

1022N - New Materials Product Evaluation Request Form

1022Q - Qualified Products Evaluation Request Form

1029 - Initial Acceptance for Pavement Warranty Work

1029A - Initial Acceptance for Bridge Warranty Work

1033-Byways - Pure MI Byways Planning Grant Activities

1033-RTF - Rural Task Force and Small Urban Program Assistance

1033-TPS - Transportation Planning Services

1034 - Disadvantaged Business Enterprise (DBE) Program DBE Regular Dealer Inventory List

1035 - PAPI Angle Datasheet

1036 - Airport Sponsor Final Credit Request

1037 - MDOT DBE Business Change Disclosure

1039 - Interstate Certification Declaration of Eligibility (DOE)

1042 - Report of Ultrasonic Inspection

1043 - Statewide Signs Job Request

1046 - CPM-HMA Crack Treatment Detailed Inspection

1047 - CPM-HMA Crack Treatment Cursory Inspection

1049 - Waiver Valuation: Broker Price Opinion - Requirements for independent consultants, with

           certification

1060 - Chemical Storage Facility Replacement/Repair Cost Sharing Percentage Calculation

1080 - Meteorological Evaluation Tower (MET) Notification

1100A - Extension of Contract Time-Request Number

1100RR - RR - Recommendation and Authorization

1101 - Force Account Statement

1101A - Force Account - Daily Field Record

1105 - Final Estimate Submittal Form (Project Let Prior To October 5, 2018)

1105A - Final Estimate Submittal Form

1107 - Daily Weight Record

1107A - Weigh Tickets Storage Envelope (9 X 12 BrownKraft)

1110 - Project Engineer Evaluation (Confidential)

1113A - Borrow Area Restoration Report

1115 - Concrete Pavement Warranty Cursory Inspection

1116 - Weekly Statement of Working Days Charged

1117 - Project Record Certification

1119D - Damage Claim Notice

1120 - Final Inspection/Acceptance

1122 - On-the-Job Training (OJT) Program Trucking Tuition Voucher

1122A - Inspector's Daily Record Of Contract Removal Items

1122B - Inspector's Daily Report

1122C - Inspector's Daily Report Worksheet

1122C-2 - Inspector's Daily Report Worksheet Continuation

1122CA - Warranty Corrective Action Record

1124 - Earthwork Data Sheet

1125 - Permit to Place

1126 - National Pollutant Discharge Elimination System (NPDES) and Soil Erosion and Sedimentation

           Control (SESC) Inspection Report

1130 - Progress Schedule

1130A - Progress Schedule - 2020 Spec Book

1131 - Bridge Decks Concrete Depth Measurements

1134 - Superpave & Hot Mix Asphalt (First Cursory Inspection)

1134A - Superpave & Hot Mix Asphalt (Second Cursory Inspection)

1134C - Superpave & Hot Mix Asphalt (Detailed Inspection)

1137 - Work Order

1138 - Bridge Reinforcing Computations

1143 - Testing Earth Grade with Compactor

1145 - Grade Check

1147 - Final Estimate Review Summary

1155 - Weekly Summary of Cert. Concrete/Comm. Central-Transit Mix

1156-T1 - Minimum Wage Rate Interview Sheet Tier 1

1156-T2 - Minimum Wage Rate Interview Sheet Tier 2

1157 - Test Pile Record

1157L - Test Pile Record, LRFD

1160 - Report of Modulus of Rupture

1160A - Concrete Cylinder/Core Compression Test Results

1161 - Foundation Piling Record

1161L - Foundation Piling Record, LRFD

1165 - Notice of Non-Compliance with Contract Requirements

1167B - Field Evaluation of Warranty Performance Chip Seal CPM 2001

1174 - Concrete Proportioning Plant Report

1174R - Inspector's Report of Concrete Placed - Roadway

1174S - Inspector's Report of concrete Placed - Structure


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