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Forms
for Contractor Use
| Affidavit
for Compliance with Prevailing Wage Law |
(117 kb, 1 page) |
| Contractor
Affidavit Regarding Settlement of Claims (C-242) |
(50 kb, 1 page) |
| Contractor Nuclear Density Form |
(68 kb, 2 pages) |
| Contractor Performance Rating - 2011 |
(94 kb, 13 pages) |
| Lead Abatement MODOT Contractor Informational Packet |
(50 kb 1 page) |
| Lead Abatement MODOT FA Project Notification |
(69 kb 1 page) |
| Lead Abatement MODOT Project Notification |
(78 kb 1 page) |
| Lead Abatement MODOT Project Re-Notification |
(73 kb 1 page) |
| Lead Abatement Program Contact Info |
(25 kb 1 page) |
| Request
to Subcontract Work (C-220) |
(120 kb, 3 pages - NEW! Excel Format) |
| Subcontractor
Certification Regarding Affirmative Action |
(100 kb, 1 page) |
| Value
Engineering Proposal (C-104) |
(139 kb, 2 pages) |
| Contractor
Questionnaire |
(24 kb, 2 pages) |
| DBE
Program Submittal |
(5.8 mb, 144 pages) |
| Prequalification
Questionnaire |
(115 kb, 5 pages) |
| Contractor's
Monthly Trainee Report |
(52 kb 1 page) |
| Trainee
Notification |
(42 kb 1 page) |
| Trainee
Example Letter |
(9 kb 1 page) |
| Project
Conflict Resolution Flowchart |
(14 kb 1 page) |
| Wage
Flowchart for Federal Jobs - Precon |
(9 kb 1 page) |
| Wage
Flowchart for State Jobs - Precon |
(8 kb 1 page) |
| 2AA
Sheet - Blank |
(47kb 1 page) |
| 2AA
Sheet - Example |
(114kb 1page) |
| Welder Qualification Form |
530kb 1 page Electronically fillable |
| Waste Disposal Agreement |
264kb 1 page Electronically fillable |
| ADA Inspection Checklist |
4860kb 6 pages) |
| ARRA Coding Instructions |
(12.6kb 2 pages) |
| FHWA Form 1589 Contractor Employment Report |
Link to FHWA website |
| Electronic Documentation Choice Request Form |
(25kb 1pages) |
| SiteManager Contractor Payment Schedule Form |
(27kb 1pages) |
| Discrimination
in Employment is Prohibited By Law |
(131kb 1page) |
| Equal Employment Opportunity (EEO)
Policy - Example |
(8 kb, 1 page) |
| Equal
Employment Opportunity is the Law (also available in
Spanish) |
(24 kb, 1 page) (
Spanish 15 kb, 1 page) |
| Wage Rate Info FHWA-1495 (also available
in Spanish) |
(72 kb, 1 page) ( Spanish
53 kb, 1 page) |
| Job
Safety & Health Protection (OSHA) (also available
in Spanish) |
(41 kb, 1 page) (
Spanish 99 kb, 1 page) |
| Letter
Appt EEO Officer |
(8 kb, 1 page) |
| Your Rights Federal Minimum
Wage 1088 (also available in Spanish) |
(25 kb, 1 page) (
Spanish 46 kb, 1 page) |
| Notice
FHWA 1022 |
(18 kb, 1 page) |
| Notice
to Employees Polygraph Protection Act WH 1462 (also available in Spanish) |
(34 kb, 2 pages) ( Spanish
158 kb, 2 pages) |
| Notice
to Employees Davis Bacon 1321 |
(67 kb, 2 pages) |
| Notice
to Workers Disability Paid at Special Minimum Wage WH 1284 |
(100 kb, 2 pages) |
| Your
Rights Family Medical Leave Act (FMLA) WH 1420 (also available in Spanish) |
(62 kb, 1 page) |
| ARRA-Know your Rights Under the Recovery Act! Revised 10-29-09 |
(34 kb, 1 page) |
| Employee Rights Under the National Labor Relations Act (also available in Spanish) |
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| Storm Water Permit "Sign" |
(50 kb 1 pages) |
Job Site Bulletin Board Checklist
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Transfer Request of Inspected Material |
(65 kb, 1 page) |
| New
Product Evaluation Form
(Type-In
format) |
(46 kb, 4 pages .pdf ) (Type-In
36kb, 4 pages .doc) |
| PAL
Shippers Transmittal Form |
(37 kb, 1 page) |
| PAL
Fabricators Receival Form |
(42 kb, 1 page) |
| PAL
Program Inclusion Certifications and Guarantee Statement |
(122 kb, 1 page) |
| Concrete
Mix Design Submittal Form |
(76 kb, 1 page) |
| Pipe
Shipping Submittal Form: CMP, RCP, Precast Drainage Unit & Precast Box Culvert |
(21 kb, 1 page) |
| Pipe
Shipping Submittal Form: PVC and HDPE |
(22 kb, 1 page) |
| Producer
Supplier Listing Form |
(148 kb, 4 page) |
| Asphalt
Inspectors Worksheets: Payfactor v6.20 |
(376
kb, multiple page) |
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Asphalt
Inspectors Worksheets: Plant Inspection
v4.50 |
(913 kb, multiple page) |
| Corelok Aggregate Workbook |
(56 kb, 1 page) |
| Durable Aggregate Calculation |
(25 kb, 1 page Excel) |
| Aggregate
Quality Control Plan |
(20 kb, 1 page) |
| Recycle Binder Contribution 2.1 |
((112 kb, 1 page) |
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