Fillable Massachusetts Department of Transport Request to Increase Single Class of Work Limit

Fill Online, Printable, Fillable, Blank Massachusetts Department of Transport Request to Increase Single Class of Work Limit Form

Use Fill to complete blank online COMMONWEALTH OF MASSACHUSETTS (MA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Massachusetts Department of Transport Request to Increase Single Class of Work Limit

On average this form takes 16 minutes to complete

The Massachusetts Department of Transport Request to Increase Single Class of Work Limit form is 2 pages long and contains:

  • 1 signature
  • 42 check-boxes
  • 42 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
_____________________________________________ ___________________________________________
Request to Increase Single Class of Work Limit
Submit one completed project per class of work
Date:_________________________
Name of Company:__________________________________________________________________________
Address:__________________________________________________________________________________
City:____________________________________________________ State:_______Zip:__________________
Contact Person:___________________________________________ Vendor Code:______________________
Phone Number:___________________________________E-mail Address:_____________________________
Original Signature, Title, Date Print Name, Title
Select Class of Work
Bridge - Construction Highway - Bike Paths Salt Marsh and Wetland
Restoration
Bridge - Culverts Highway - Construction Sewer and Water
Bridge - Deck Repairs Highway - Lighting Signing - Non Structural
Bridge - Joints Highway - Sidewalk and Curbing Signing - Structural
Catch Basin Cleaning Impact Attenuators Street Sweeping
Chemical Storage Sheds Intelligent Transportation Systems Traffic Signals
Crack Sealing Landscaping Including Tree Planting Tree Trimming - Maintenance
and Removal
Dam Construction Marine Construction Waterways
Demolition Mowing and Spraying
Drainage Painting - Structural
Drawbridge Maintenance Pavement Markings
Dredging Pavement - Milling and Cold Planing
Drilling & Boring Pavement - Reclamation
Electrical - All Types - Including
Electrical Maintenance
Pavement - Surfacing
Guard Rail & Fencing Pump Stations
Hazardous Waste Remediation &
Transportation
Recreational Facilities
FOR OFFICIAL USE ONLY
Approved_________ Denied__________
Comments___________________________
Email: prequal.r109@dot.state.ma.us
Phone: 857-368-8660
____________________________________
Rev 12/2018 1
click to sign
signature
click to edit
Request to Increase Single Class of Work Limit
Submit one completed project per class of work
Duplicate the project information template as needed to list project experience
Please provide a detailed scope of work for each project. Project listed should be $50K and over.
Do not list contracts completed more than 10 years ago.
1. Class of work:
1a. Other Classes of work performed: Dollar Value:
Project Title:
Location:
Owner:
Owner’s rep:
Telephone#: Email:
Architect / Engineer:
A/ E contact person:
Telephone#: Email:
Original contract amount: $ Original completion date:
Final contract amount: $ Final completion date:
Were you the Prime Contractor or Subcontractor for this project?
Percentage of work completed with own forces:
Value of work completed with own forces: $
Detailed Scope of Work:
Email to: prequal.r109@dot.state.ma.us Phone: 857-368-8660
MASSDOT, Highway Division
Prequalification Department
10 Park Plaza, Room 6260, Boston, MA 02116
Rev 12/2018 2
Select from drop down menu...
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Massachusetts Department of Transport Request to Increase Single Class of Work Limit

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 May 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document