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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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0380 |
Request for Payment Exhibit-A Local Agency Programs |
DSD-Local Agency Program |
8/20/25 |
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0381 |
Project Cost Reporting and Certification Exhibit-B Local Agency Programs |
DSD-Local Agency Program |
8/28/25 |
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0633T |
Application for Approval to Provide Real Estate Appraisal & Appraisal Review Services |
DSD-Contracts |
8/20/25 |
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2067 |
Annual Certification of Employee-related Conditions - County Road Agency |
FOD-Act 51 |
8/21/25 |
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3071 |
FY 20__ Coordination Plan for Local Bus Operating Assistance |
Passenger Transportation |
8/5/25 |
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3174 |
MDOT Review of Procurements |
Passenger Transportation-Procurement Forms |
8/21/25 |
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3078 |
FY 20__ Resolution of Intent |
Passenger Transportation |
8/6/25 |
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3182 |
Procurement Guidelines-For Grantees Receiving Federal Transit Funds and/or State Funds Via MDOT |
Passenger Transportation-Procurement Forms |
8/21/25 |
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5027 |
Development Information Form |
Office of Economic Development |
8/21/25 |
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5105 |
Consultant Contract Request |
Contract Services Division |
8/20/25 |
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5108 |
Certification of Overhead Rate |
Contract Services Division |
8/4/25 |
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5635 |
Official Entry Form - MDOT ACEC Partnership Charter Award |
Office of Organizational Development (OOD) |
8/21/25 |
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NEW |
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Form Number |
Form Name |
Division Name |
New Form Create Date |
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0573 |
County Firm Unit Prices |
BFS-Transportation Systems Management Operations |
8/14/25 |
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1095 |
Disposal of Hazardous Material |
BFS-Construction Field Services |
8/19/25 |
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1096 |
Disposal of Non-Hazardous Material |
BFS-Construction Field Services |
8/19/25 |
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1993 |
Onsite Group Meal Request |
Contract Services Division |
8/20/25 |
Obsolete Forms:
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0976 - MDOT - Human Resources Onboarding Checklist |
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1580 - Vehicle Purchase Specification Certification |
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5108L - Certificate of Overhead Cost Rate |
ADA Compliant Updated Forms:
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1905 - Testing of Bituminous Mixtures (Centrifuge Worksheet) |
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1907 - MDOT Report of Compacted HMA Core Density & Percent Compaction |
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1907J - Report of Compacted Longitudinal Joint Core Density & Percent Compaction |
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1911 - Job Mix Formula (JMF) HMA Field Communication |
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1912 - Testing of Bituminous Mixtures Ignition Furnace Worksheet |
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1920 - Field Report for Concrete Pipe |
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1920A - Field Report for Precast Drainage Items |
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1923 - Sample Identification |
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1923B - Sample Identification (Bituminous Materials) |
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1927 - Mechanical Anchoring System Proof Test |
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1928 - Adhesive Anchoring System Proof Test |
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1934 - Daily Bituminous Plant & Street Communication Worksheet |
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1937 - Tensile Strength Ratio (TSR) Worksheet |
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1940 - Soil Erosion and Sedimentation Control (SESC) Quality Assurance Review Checklist-Project Delivery |
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1941 - Inspector's Daily Report for Bridge Painting |
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1942 - Fabrication Inspection File Checklist |
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1944 - Bid Requests Fax Transmission |
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1945 - Report of Test |
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1946 - CPM-HMA Ultra-Thin Overlay (Worksheet) |
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1947 - CPM-HMA Ultra-Thin Overlay (Cursory Inspection) |
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1948 - CPM-Paver Placed Surface Seal (Cursory Inspection) |
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1949 - CPM-Paver Placed Surface Seal (Worksheets) |
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1951 - Prevailing Wage Claim Form |
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1953 - Claim Content and Certification |
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1954 - Certified Payroll Status Log |
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1956 - LRFD Pile and Driving Equipment Data |
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1959 - Technical Report Documentation Page |
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1960 - Checklist for Constructability Review Project Development Phase |
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1961 - Checklist for Constructability Review Early Project Scoping |
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1962 - Value Engineering Change Proposal |
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1963 - Interim Project File Review |
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1964 - Local Agency Project Field Review |
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1965 - Prevailing Wage Quality Assurance Review Checklist |
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1967 - Jobsite Poster Inspection Checklist |
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1968 - Receipt of Required Claimant Information |
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1969 - Engineer Certification and Final Project Reviews Contract and Related Documents Checklist |
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1970 - Engineer Certification and Final Project Reviews Construction Item/IDR Checklist |
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1971 - Engineer Certification and Final Project Reviews - HMA Items Checklist |
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1972 - Engineer Certification and Final Project Reviews - Material Review Checklist |
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1973 - Engineer Certification and Final Project Reviews -Concrete Items Review Checklist |
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1976 - Job Mix Formula (JMF) Concrete Field Communication |
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1978 - Proposed Ride Quality Excluded Areas |
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1981 - Repair Observation Report |
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1985 - Bar Reinforcement Report |
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1988-20 - Drilled Shaft Inspection Record for Ancillary Freeway Structures, Highway Signs, Luminaires, and Traffic Signal Foundations |
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1989 - Micropile Installation Record |
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1990 - Cofferdam Installation, Piling Placement, and Tremie Pour Inspector's Checklist |
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1994 - Stake Request Form |
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1995 - Work Zone Monitoring Report Form |
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1997 - Air Meter Calibration Sheets |
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1997D - Air Meter Calibration Sheets |
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1999 - Concrete Field Cylinders Test Results |
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2000 - Mix Design Review Checklist |
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2001 - Fabrication Inspection File Checklist |
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2008A - Request for Change in the Major Street System |
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2008B - Additions and Deletions to City or Village Local Street System |
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2008D - Request for Change in County Primary Road System |
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2008E - Additions and Deletions to County Local Road Systems |
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2012 - Resolution for Designation of Street Administration |
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2044 - Engineering Reimbursement |
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2047 - Project Agreement Checklist |
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2066 - Alternate Overnight Parking Request |
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2067 - Annual Certification of Employee-related Conditions - County Road Agency |
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2068 - Annual Certification of Employee-related Conditions - City or Village |
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2072 - Application for Extension of Time to Complete Ordered Work Issued by the Michigan Department of Transportation Office of Rail, Rail Safety Section |
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2073 - Railroad Contact Form |
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2074 -MDOT Office of Railroad Authority Contact Form |
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2075 - Notice of Trespassing Railroad Property |
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2075A - Notice of Trespassing |
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2076 - Notice of Encroachment |
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2077 - Owned and Leased Fleet Equipment for DBE Credit |
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2078 - On-The-Job Training (OJT) Program - Dependent Child Care Reimbursement |
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2079 - ADA Complaint Form |
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2080 - ADA Complaint Appeal Form Request |
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2081 - MDOT Bridge Painting Project Office Checklist |
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2082 - MDOT Bridge Deck Construction Inspection Checklist |
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2083 - MDOT Bridge Deck Overlay Construction Inspection Checklist |
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2084 - Stop Work Order - Notice of Violation |
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2085A - Guidelines for Establishing a Golf Cart Connector Routes (GCCR) on State Trunkline Highways |
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2085B - Special Conditions for Golf Cart Connector Routes (GCCR) on State Trunkline Highways |
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2122 - MDOT Digital Signature Certificate Request Form |
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2124A - Prime Contractor Bi-Weekly Statement of Subcontractor/Supplier Payments |
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2142 - Category B: Community Service Infrastructure Fund Application |
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2169 - Use of Photo Release |
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2200 - Adopt A Highway Individual App. for Use of State Trunkline |
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2205-1 - General Conditions and Supplemental Specifications |
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2207A - Performance and Indemnification Commitment |
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2207B - Performance Resolution for Municipalities |
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2207C - Performance & Indemnification Resolution for Public School Districts |
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2207D - Performance Resolution for Tribal Governments |
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2207E - Performance Resolution for Universities or Colleges |
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2207F - Resolution to Request Authorization to Adopt an Off-Road Vehicle Ordinance |
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2207G - Collateral Assignment of Certificate of Deposit |
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2209 - Certificate of Agency |
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2213 - Permit Inspection Report |
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2223G - Notice of Violation- Billboards |
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2225 - Michigan Rail Enhancement Grant Program |
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2235 - Construction Permit Fee Schedule |
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2240 - Special Conditions for Tree Removal, Tree Trimming & Herbicide Application |
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2241 - Permit To Establish, Expand And/or Maintain a Junkyard |
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2242 - Environmental Review |
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2243 - Standard Conditions for Serving Refreshments in Rest Areas on Non-Holidays |
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2251 - Special Conditions for Seismic Explorations |
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2252 - Special Conditions for Discharge of Treated Effluent |
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2253 - Special Conditions for Monitoring Wells |
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2254 - Special Conditions for Private Utility-Type Facilities Transverse Crossings |
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2255 - Application for Approval to Provide Real Estate Acquisition & Relocation Services |
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2271 - Water Meter Letter |
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2279 - Special Conditions for Mowing and Brush Cutting |
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2280 - Trunkline Usage Review Sheet |
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2286 - Utilities Status Report |
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2289 - Consent to Access Highway via Joint Driveway System |
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2292 - Special Conditions for Closure of a State Highway by Local Governmental Agency |
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2410 - Protective Maintenance Use Permit |
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2411 - Technician's Work Sheet |
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2432 - Special Conditions for Traffic Signal Installation |
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2433 - Special Conditions for Sidewalk Cafe Permits |
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2445 - Non-Residential Building Rental Agreement |
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2446 - Residential Building Rental Agreement |
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2457 - Special Conditions for Wildflower Seed Collection |
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2458 - Special Conditions for Distribution of Travel Related Information |
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2459 - Special Conditions for Harvesting Hay |
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2464 - L-CAR/MITRIP Construction Restriction Request |
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2465 - Route Survey Certification |
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2475 - Special Conditions for Alternative Environmental Cleanup Methods |
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2480 - Letter Requesting Utility Information at Base Plan Stage |
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2481 - Letter to Public/Private Utilities at Preliminary Plan Stage |
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