Statewide forms

Last updated: 2026-02-25

Statewide form changes

Reference these statewide forms when administering a construction contract.

Description DT Form
Ancillary Structures Pre-Installation Verification of High Strength Bolts DT2322

Buy America Certification (effective with November 14, 2023 letting through the September 9, 2025 letting)

 N/A

Buy America Certification (effective with November 8, 2022 letting through the October 10, 2023 letting)

 N/A
Buy America Certification (effective through the October 11, 2022 letting) N/A
Contract Items Review DT2076
Contract Modification Justification DT2355
Contract Requests for Information Log DT2501
Contractor's Field Welding Plan DT2337
Domestic Materials Certification (effective with October 14, 2025 letting) DT4567
DBE Commercially Useful Function Review and Certification DT1011
Erosion And Sediment Inspection DT1072
Erosion Control Order DT1074
Erosion Control Implementation Plan (ECIP) Templates & Guidance (formerly DT1073) N/A
Field Welding Inspection Checklist DT2320

Final Construction Project Record Checklist for AWP Construction

DT2075
General Material Sample Tag DT1499
High Strength Steel Anchor Rod Installation Tensioning Record DT2321
HMA Sample Tag DT1352
Pile Driving Data DT1924
Pile Driving System DT3550
Piling Record DT1315
Pre-Installation Verification Test of High Strength Bolts DT2114

Project Team’s Evaluation of the Contractor (To be completed for construction contracts administered in FieldManager only. Go to Contractor Evaluations for the new process for construction contracts administered in AWP Construction. Updated 01/20/2021)

 DT2510
Request for Information (RFI) DT2502
Sales to Others Invoice DT1668
Source of Materials Report DT1349
Sublet Request and DBE Sublet Purchase Report DT1925
File Name Description
AncillaryPrePlacementDepth.docx Ancillary pre-placement depth checks (sidewalk & driveways)
BADCmpctSum.docx QMP Base Aggregate 1 1/4" Compaction Testing Summary (155 report)
BADSmallQntySum.docx QMP Small Quantity Base Aggregate Testing Summary (155 report)
BADSum.docx QMP Base Aggregate Testing Summary (155 report)
BGQVSum.docx Beam Guard Acceptance Testing Summary (155 report)
CIRSum.docx Cold In-Place Recycling Summary (155 report)
ConcAncSum.docx QMP Concrete AncillaryTesting Summary (155 report)
ConcBarrSum.docx QMP Concrete Barrier Testing Summary (155 report)
ConcPvmtSum.docx QMP Class I Concrete Pavement Testing Summary (155 report)
ConcPvmtThickSum.docx Concrete Pavement Thickness Testing Summary (155 report)
ConcStrucSum.docx QMP Class I Concrete Structures Testing Summary (155 report)
HMAPWLSum.docx PWL HMA Mix and Density Testing Summary (155 report)
HMAQMPSum.docx QMP HMA Mix and Density Testing Summary (155 report)
IRISum.docx QMP IRI Ride Testing Summary (155 report)
MillRelay_PulvRelayCmpctSum.docx QMP Mill and Relay Compaction and Pulverize and Relay Compaction Summary (155 report)
MSEWallSum.docx QMP MSE Wall Testing Summary (155 report)
NonConformance_NonPerformanceAddendum.docx NC/NP Justification Write-Up Addendum
NonPerformance_NonConformanceConcurrence.docx NC/NP Justification Write-Up
SubgradeSum.docx QMP Subgrade Summary (155 report)
Description WS Form
Aggregate Gradation Chart WS3014
Aggregate Gradation Control Chart WS3017
Aggregate Moisture Content Combined P200 Water Cement Ratio WS3010
Air Content Ctrl Chart For Concrete Pavement WS5016
Air Content Ctrl Chart Masonry Bridge WS5017
Anc Conc Daily Test Report WS5013
Anc Conc Daily Test Report WS5013
Atterberg Limits Worksheet WS3050
Base Aggregate Fractured Particle Ctrl Chart WS3019
BuyAmericaExemptionTrackingTool.xls (10-09-2024) N/A
Combined Concrete Aggregate Gradation WS3012
Combined P200 Ctrl Chart WS3016
Compress Strength Cylinder Fab Sum For Concrete Pavement WS5018
Concrete Mix Design WS5014
Daily Nuclear Reference Check Record For CPN WS4605
Daily Nuclear Reference Check Record For Seaman WS4603
Daily Nuclear Reference Check Record For Troxler And Humbolt WS4604
Density Sublot Random Test Locations WS4611
Design Issue Notice DIN WS2503
Field Density Control Chart WS2079
Field Moisture Control Chart WS2078
GradingAreaDesignations WS2073
MovingAvgForFieldDensityAndMoisture WS2076
NucHMADensityQCQVSublotTestRec WS4613
NucHMADensityTestRec WS4602
NucSoilsDensityTestRec WS4601
NucSoilTestRec WS2074
PreconMtgAgenda WS1030
ProdSampleLocations WS3011
ProgressMtgNotes WS1050
RunningAvgCalcs WS3015
SieveAnalysisForConcAgg WS5015
SoilMoistureDensity WS2071
WisDOTBlockCalibrations WS7011
File Name Description
ApplForPermitToInstallTempBusSignOnHwyRW.dotm Application for Permit to Install Temporary Business Sign(s) on Highway Right-of-Way During Improvement Project
BenchMarks.docm Bench Marks Location and Elevation
Bridge Geometry Field Measurements_Revision 8-6-2025.pdf Bridge Vertical and Horizontal Clearance
ConcBrdgDeckPrePourAgenda.docm Concrete Deck Pre-Pour Meeting
ConcBrdgSubStrucPrePourAgenda.docm Concrete Substructure Pre-Pour Meeting
ConcPavingPrePourMtg.dotm Concrete Paving Pre-Pour Meeting
ConcreteDeckPourAuthorization(StructureNo).doc Concrete Deck Pour Authorization Form
ConcreteSampleTag.xlsx Replaces DT1308 Concrete Cylinder Test Data – 28 Day Break
ConstrPermit.dotm Construction Permit Recommendation and Approval
CRIConceptEvaluation.docx Cost Reduction Incentive (CRI) Concept Evaluation
CulvertPlacement.pdf Culvert Replacement
CurbRampComplianceForm2025V2.pdf Curb Ramp Compliance Post Construction Report Instructions
CurbRampComplianceForm_LocalProgram.pdf Curb Ramp Compliance Form for Local Program projects
DamagedGirderReport.pdf Bureau of Structures Damaged Girder Incident Report & Proposed Response
ElastoExpDeviceInstallData.dotm Elastomeric Expansion Device Installation Data
File Name Description
GuardrailPostSamplingDataForm.xlsx Guardrail Post Sampling Data Form
HMA_PWL_PrePaveAgenda.docm HMA PWL Pre-Pave Meeting
HMAPrePaveAgenda.docm HMA Pre-Pave Meeting
IRIRideProfileNotificationTemplate.docx Used by contractors to notify WisDOT staff when IRI ride Profiling is taking place on a contract.
Large Pipe Culvert Form.docx Form to be completed for form standard culvert pipes 7’ and greater diameter.
LettertoPropOwner.dotm Letter to Property Owner
LineOfCommunication.docx Line of Communication (Associated levels of decision making)
File Name Description
MailboxRemoval.dotm Mailbox Removal During Highway Construction
MtgNotes.dotm Meeting Notes
NLEBBridgeInspectionForm.pdf Appendix C: Bridge/Structure Inspection Form
NLEBBridgeInspectionGuidance.pdf Appendix B: Bridge Inspection Guidance Preliminary Bat Inspection Guidelines for Bridges/Structures

Notification for Demolition and/or Renovation (Form 4500-113)


This form can be found on the DNR Handling Waste from Demolished Structures web page by following the steps below:

  1. Click the hyperlink noted above.
  2. Scroll down and select the Landfill tab.
  3. In the second paragraph under the Landfill tab, select the hyperlink for the Notification of Demolition and/or Renovation (Form 4500-113) and download the form.

Wisconsin Department of Natural Resources Handling Waste from Demolished Structures web page.

  1. If you are unable to download Form 4500-113, go to Google Chrome settings , search for and select "PDF".
  2. Select Site settings.

  3. Scroll down and select "Additional content settings".

  4. Scroll down and select "PDF documents".

  5. Select the "Download PDFs" checkbox.
PromptPymtToPrimeF2.dotm Prompt Payment to Prime to Pay Subcontractors F2
PromptPymtToPrimeF3.dotm Prompt Payment to Prime to Pay Subcontractors F3
PromptPymtToSubF1.dotm Prompt Payment to Subcontractors F1
RandNoBAD1.xlsx Random Numbers: Location Base Aggregates Dense
RecycledAsphalticBinderChangeRequest.xlsx Recycled Asphaltic Binder Change Request
RRChklst.dotm Railroad Checklist
File Name Description
SignBrdgVertClear.dotm Sign Bridge Vertical Clearance
SignStrucSignalLeftVertClear.dotm Sign Structure (Signal-Left Side) Vertical Clearance
SignStrucSignalRightVertClear.dotm Sign Structure (Signal-Right Side) Vertical Clearance
SiteHealthAndSafetyChklst.dotm Site Health and Safety Checklist
StrucVertClearInstructionOnly.pdf Record Critical Vertical Clearance
TrafficCtrlInspectionChklst.dotm Traffic Control Inspection Checklist
Utility Relocation Claim Assessment Notice.docx Utility Relocation Claim Assessment Notice
Utility Relocation Claim Documentation Checklist.docx Utility Relocation Claim Documentation Checklist
Utility Relocation Claim Notice of Receipt of Claim.docx

Utility Relocation Claim Notice of Receipt of Claim
Utility Non-Assessment Closing Letter .docx Utility Non-Assessment Closing Letter
WeeklyProgressMtgAgenda.docx Weekly Progress Meeting Agenda
WDNR Notice of Termination (NOT) Website Requires WAMS ID to log on
WDNR Notice of Termination (NOT) Guidance Construction General Permit (TCGP) Guidance
Yield Calc&Asphalt Paving Diary Example.xlsx HMA Paving Diary Worksheet

 

Pantry Forms Committee Members (Chairperson denoted with an *)

Member Representing Email address Telephone Number
Chad Hayes* DTSD Bureau of Project Development chad.hayes@dot.wi.gov 608-246-5391
Korey Boehm NC Region - Wisconsin Rapids korey.boehm@dot.wi.gov 715-459-2943 (M)
Rebecca C Frank SW Region - Madison rebeccac.frank@dot.wi.gov  
Eric Hanson SE Region ericd.hanson@dot.wi.gov 414-840-9341
Vacancy NW Region    
Stacy Lehmann NW Region stacy.lehmann@dot.wi.gov 715 855-7668
Lisa Koca NC Region - Rhinelander lisa.koca@dot.wi.gov 715-365-5708
Callum O’Connor NE Region - Green Bay callum.oconnor@dot.wi.gov

920-492-4128