Qualified Traffic Control Equipment Submission Form for
Sign Supports and Mounting Harware
Submission Instructions: Please submit one application per product. Catalogue cuts shall be included as
attachments. FHWA Federal-aid eligibility letters, if applicable shall be included with submittal and test results
from an independent test lab shall be submitted to ensure compliance. Other testing results or certifications
which may assist in evaluation may also be included. All equipment shall comply with the latest edition of
Section 840 - Sign Supports of the Standard Specifications
, including Supplemental and Interim editions. Upon
evaluation MassDOT Highway Division will contact you.
Part A. Applicant Information
Today's Date
Name
Company
Address
City, State ZIP
Phone
Email
Part B. Basic Product Information
Name or Model #
Description
Link to product cutsheet
Product Type
Square Post U-
Channel Post
Breakaway System Sign Mounting Bracket
Other:
Part C. Technical Product Information
Product Material(s)
Available Finishes
Dimensions
Please complete this section for Sign Supports and Breakaway Systems, only.
Test Level n/a TL-2 TL-3 TL-4 TL-5
Methodology NCHRP 350 MASH
FHWA Acceptance Letter(s):
FHWA Limits on Use
Application Revision: November 13, 2014 Sign Supports and Hardware Application
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