Pantry statewide form changes

Last updated: 2024-12-03

Refer to this page to see a list of the changes made to the Construction documentation used to administer a construction contract.

File name

Description of change(s)
QMP Template Forms  
Form changes and new form

The following form updates were made:

  • BADSmallQntySum.docx replaces BADSmallQtySum.docx

  • BADSum.docx updated with no name change.

  • BGQVSum.docx updated with no name change for Beam Guard Acceptance Testing & Heat No. Summary (155 report)

  • ConcAncSum.docx replaces ConcAncQVSum.docx

  • ConcPvmtSum.docx updated with no name change.

  • ConcStrucSum.docx updated with no name change.

  • IRISum.docx updated with no name change.

  • MSEWallSum.docs replaces MSEWallNucDensitySum.docx.

New forms:

AncillaryPrePlacementDepth.docs for ancillary pre-placement depth checks (sidewalk & driveways)

CIRSum.docx for Cold In-Place Recycling Summary (155 report).

ConcBarrSum.docx for QMP Concrete Barrier Testing Summary (155 report).

Removed HMAMixDensitySum.docx. Replaced with:

  • HMAPWLSum.docx for PWL HMA Mix and Density Testing Summary (155 report).
  • HMAQMPSum.docx for QMP HMA Mix and Density Testing Summary (155 report).

MillRelay_PulbRelayCmpctSum.docx for QMP Mill and Relay Compaction and Pulverize and Relay Compaction Summary (155 report).

SubgradeSum.docx for QMP Subgrade Summary (155 report).
NonConformance_NonPerformanceAddendum.docx
  • Updated form posted 1/17/2024
  • NC/NP Justification Write-Up Addendum updated to reflect the credit criteria requiring Chief’s signature.
    • NonPerformance_NonConformanceConcurrence.docx
  • Updated form posted 1/17/2024
  • NC/NP Justification Write-Up Addendum updated to reflect the credit criteria requiring Chief’s signature.
    • A-Z Forms  
       
    WS Forms  
    BuyAmericaExemptionTrackingTool.xls Posted an updated Buy American Exemption Tracking Tool on 10/09/2024 for determining allowable exemption amounts and for tracking of materials in accordance with Buy America requirements.
       
    CurbRampComplianceForm.pdf Updated Curb Ramp Compliance Form
    WeeklyProgressMeetingAgenda.docx Weekly Progress Meeting Agenda updated to include Buy America certifications under the Materials section
    Utility Relocation Claim Assessment Notice.docx New Utility Relocation Claim Assessment Notice
    Utility Relocation Claim Documentation Checklist.docx New Utility Relocation Claim Documentation Checklist
    Utility Relocation Claim Notice of Receipt of Claim.docx New Utility Relocation Claim Notice of Receipt of Claim
    LineOfCommunication.docx

    Removed the FAX line from the Line of Communication form.

    Replaced LineOfCommunication.dotm with LineOfCommunication.docx
      Removed the outdated Utility Conflict Documentation Report and the Utility Conflict Documentation Report Instruction Presentation from 2021.
    GuardrailPostSamplingDataForm.xlsx An updated version of the Guardrail Post Sampling Data form has been posted.
    HMA_PWL_PrePaveAgenda.docm Added Statewide IRI Ride contact Chris Norton to the Region DOT Pavement & Material Contacts table at the bottom of the agenda.
    HMAPrePaveAgenda.docm Added Statewide IRI Ride contact Chris Norton to the Region DOT Pavement & Material Contacts table at the bottom of the agenda.
    DT Forms  
    DT1011 - DBE Commercially Useful Function Review and Certification The DT1011 - DBE Commercially Useful Function Review and Certification has been reposted on the Authorized WisDOT forms site. There is a link to this DT form on the Statewide Forms page.
    DT1668 - Sales to Others Invoice For the new Utility Relocation Claim process, added the DT1668 - Sales to Others Invoice under DT Forms.
       

     

    File name

    Description of change(s)
    QMP Template Forms  
       
    A-Z Forms  
    Form changes from the Wisconsin Department of Natural Resources - Handling Waste from Demolished Structures web page Posted an updated copy of the Notification for Demolition and/or Renovation (Form 4500-113)
    CurbRampComplianceForm.pdf. Posted an updated copy of the form.
    IRIRideProfileNotificationTemplate.docx Used by contractors to notify WisDOT staff when IRI ride Profiling is taking place on a contract.
    DT Forms  
       

     

    File name

    Description of change(s)
    All Statewide Forms  
    QMP Template Forms  
       
    A-Z Forms  
    CurbRampComplianceForm.pdf Updated in 2022, Curb Ramp Compliance Post Construction Report Instructions
    Form changes Moved the HMA PWL Pre-Pave Meeting and the HMA Pre-Pave Meeting forms from QMP Template Forms to Forms beginning with G-L.
    DT Forms  
      Posted the Buy America Certification (Contracts let prior to the November 2022 letting)

     

    File name

    Description of change(s)
    All Statewide Forms  
    QMP Template Forms  
       
    A-Z Forms  
    BenchMarks.docm Updated in 2021, new format
    DT2075 - Final Construction Project Record Checklist

    DT2075 form updated for AWP Construction.

    Go to Statewide Manuals and Guides for the FieldManager version of this checklist.

     

    File name

    Description of change(s)
    All Statewide Forms Reformatted using tables and added a description to each form to help staff using the AWPKB search feature to locate forms.
    QMP Template Forms  
    BADCmpctSum.docx This form replaces BaseAggCompactionTemplate.dotm
    BaseAggEx.pdf Removed form
    BadSmallQtySum.docx New form
    BADSum.docx This form replaces BaseAggTemplate.pdf
    BGQVSum.docx This form replaces BeamGuardQVSum.dotm
    BeamGuardSumEx.pdf Removed form
    ConcAncQVSum.docx This form replaces PCCAncSumTemplate.dotm
    ConcPvmtSum.docx This form replaces PCCPvmtSumTemplate.dotm
    ConcPvmtThickSum.docx New form
    ConcStrucSum.docx This form replaces PCCStrucSumTemplate.dotm
    HMAMixtureSumEx.pdf Removed form
    HMAMixDensitySum.docx This form replaces HMAMixtureSumTemplate.dotm
    HMANucDensitySumTemplate.dotm Removed form
    IRISummary.ex.pdf Removed form
    IRISum.docx This form replaces IRISummaryTemplate.dotm
    MSEWallNucDensitySum.docx New form
    NonConformance_NonPerformanceAddendum.docx and NonPerformance_NonConformanceConcurrence.docx These forms replace NonPerformanceQMP.docm
    PCCAncSumEx.pdf Removed form
    PCCPvmtSumEx.pdf Removed form
    PCCStrucSumEx.pdf Removed form
    A-Z Forms  
    DT4567 - Buy America Certification

    Removed link to the Buy America Cert form - WS4567 replacing with the new Buy America Certification form - DT4567.
    ConcBrdgDeckPrePourAgenda.docm This form replaces ConcBrdgDeckPrePourMtg.dotm
    ConcBrdgSubStrucPrePourAgenda.docm This form replaces ConcBrdgStructurePrePourMtg.dotm
    ConcreteDeckPourAuthorization(StructureNo).doc Updated form
    CurbRampComplianceForm.pdf Updated form
    RandNoBAD1.xlsx New form
    RecycledAsphalticBinderChangeRequest.xlsx New form
    Yield Calc&Asphalt Paving Diary Example.xlsx New form
    DT2337 - Contractor's Field Welding Plan This form has been posted on the Pantry Statewide forms page under DT Forms.
    DT2320 - Field Welding Inspection Checklist

    This form has been posted on the Pantry Statewide forms page under DT Forms.
    DT1072 - Erosion And Sediment Inspection The DT1072 Erosion And Sediment Inspection form has been updated for the 2020 construction season and is posted on the Pantry Statewide forms page under DT Forms.
    DT1074 - Erosion Control Order The DT1074 Erosion Control Order form has been updated for the 2020 construction season and is posted on the Pantry Statewide forms page under DT Forms.
    DT2075 - Finals Construction Project Checklist The DT2075 Finals Construction Project Checklist has been updated for the 2020 construction season and is posted on the Pantry Statewide forms page under DT Forms.
    DT2355 - Contract Modification Justification The Pantry CMJ form has been replaced with the new DT2355 Contract Modification Justification and is posted on the Pantry Statewide forms page under DT Forms.
    Damaged Girder Incident Report

    This form has been posted on the Pantry Statewide forms page under A-F Forms.
    DT1011- DBE Commercially Userful Function Review and Certification This form has been posted on the Pantry Statewide forms page under DT Forms.

     

    File name

    Description of change(s)
    DT Forms

    Note: All DT form links updated to the official WisDOT Forms page on the Wisconsin Department of Transportation web site.
    New Erosion Control Implementation Plan (ECIP) - DT1073 Replaced the Erosion Control Implementation Plan (ECIP) Worksheet - WS1073.dotm with the new Erosion Control Implementation Plan (ECIP) - DT1073
    FaxTransmittalDT1455.dotm

    Removed from AWPKB Pantry Statewide Forms DT Forms - Folks don't fax anymore, regions have their own if needed.
    ConstrPermitREDT1732.dotm

    Removed DT1732 which is now RE1732 (Real Estate form), use ConstrPermit.dotm in A-F (PDS PM/PE use in Constr)
    General Material Sample Tag - DT1499 Added DT1499 per Chris Fredrick; This is a general sample tag used in construction when submitting materials to be tested. BTS is no longer printing these tags for projects to use and requires each project to print them.
    QMP Forms (All TSS Forms - Matls/Labs)  
    NonPerformanceQMP.docm Added NonPerformanceQMP form
    HMA_PWL_PrePaveAgenda.docm Updated form from Anne Wallace provided with statewide approval
    HMAPrePaveAgenda.docm Updated form from Anne Wallace provided with statewide approval
    WS Forms  
    Erosion Control Implementation Plan (ECIP) Worksheet replacement Replaced the Erosion Control Implementation Plan (ECIP) Worksheet - WS1073.dotm with the new Erosion Control Implementation Plan (ECIP) - DT1073
    All WS forms Renamed using the Construction & Materials Manual naming standard of WS#### where #### is the form number.
    BuyAmericaExcemption.xls Added BuyAmericaExcemption form, Change PL to PM on form
    ConcPvmtThicknessLogWS5019.xltm Removed form
    PlacementTestSiteSampleLocationsWS3013.dotm Removed form
    PreconMtgAgendaWS1030.dotm Added one more agenda topic regarding curb ramps to the Precon Meeting agenda
    Statewide Forms beginning with A-F  
    BenchMarks.dotm Updated for 2019
    CMJ.dotm Updated for 2019
    CorrespondenceMemo.dotm Removed form
    ClaimSubmittalForm.dotm Removed form
    CRIConceptEvaluation.docx Added this new form for Cost Reduction Incentive (CRI) validation process for review of all CRI concepts submitted by contractors. Updated 5/29/2019
    CurbRampComplianceForm.pdf New form added May 2019; Updated 5/22/2019; Updated 9/14/2020; Updated 11/25/2020

    Statewide Forms beginning with G-L

    		 
    GuardrailPostSamplingDataForm.xlsx Added the Guardrail Post Sampling sheet to align with SS 614.3.2.1(4) to sample guardrail posts after installation.
    Statewide Forms beginning with M-R  
    RRPreconChecklist.docx Updated form from SWR Matls Supr Anne Wallce with statewide approval
    SuspensionofWork.dotm Removed form
    Statewide Forms beginning with S-Z  
    WPDESNoticeofTerminationForm3400162

    Replaced form with link to new DNR process on their website
    WPDESNoticeofTerminationInstructions Replaced with link to new DNR guidance
    WisDOT HMA PWL Guide This guide was added on the Statewide Manual and Guides page to accompany the HMA PWL spreadsheets posted on the site.

     

    File name

    Description of change(s)
    Statewide Forms  
    BrdgVertHrzClear

    Project Leader to Project Engineer & revision date
    BrdgVertHrzClearDividedHwy Project Leader to Project Engineer & revision date
    ClaimSubmittalForm Project Leader to Project Engineer & revision date
    CMJ Project Leader to Project Engineer & revision date
    ConcBrdgDeckPrePourMtg Project Leader to Project Engineer & revision date
    ConcBrdgSubStructurePrePourMtg Project Leader to Project Engineer & revision date
    ConcPavingPrePourMtg Project Leader to Project Engineer & revision date
    ElastoExpDeviceInstallData Project Leader to Project Engineer & revision date
    HMAPrePaveMtg Spelled out engineer vs eng. & revision date
    LineOfCommunication Project Leader to Project Engineer & fixed formatting & revision date
    MtgNotes Project Leader to Project Engineer & revision date
    RRChklst Project Leader to Project Engineer & revision date
    SignBrdgVertClear Project Leader to Project Engineer & reversed cantilever structure picture & revision date
    SignStrucSignalLeftVertClear Project Leader to Project Engineer & revision date
    SignStrucSignalRightVertClear Project Leader to Project Engineer & revision date
    UtilConflictRptProjMgr Project Leader to Project Engineer & revision date
    UtilConflictRptUtilCo Project Leader to Project Engineer & revision date
    WeeklyProgressMtgAgenda Project Leader to Project Engineer & removed highighting & revision date
    WPDESNoticeofTerminationForm3400162

    New form added
    WPDESNoticeofTerminationInstructions Instructions for new form added
       
    DT Forms  
    AncStrucPreInstallVerifTestOfHighStrengthBoltsDT2322

    File opened as a blank document, replaced with file from DOTNET
    ConcCylinderTestData28DayBreakCardDT1308 Requested owner to fix formatting, no issues found. Had others try, no issues. Not sure why 3 of us statewide in different regions had issues when we tried? Left as is.
    ConstrPermitREDT1732 NO longer a DT form - removed
    ContRFILogDT2501 Project Leader to Project Engineer & revision date
    FinalConstrProjRecChklstDT2075 Project Leader to Project Engineer & revision date
    HMASampleTagDT1352 New version
    ProjTeamsEvalOfTheContrDT2510 Project Leader to Project Engineer & revision date
    RFIDT2502 Project Leader to Project Engineer & revision date
    SubletRequesteDBESubletPurchaseRepDT1925 Removed
       
    WS Forms  
    BuyAmericaCertWS4567 Project Leader to Project Engineer & revision date
    ConcMixDesignWS5014 Project Leader to Project Engineer & revision date
    ECDiaryInspectionFormWS1072 Spelled out engineer vs eng. & revision date
    ECIPWkstWS1073 Project Leader to Project Engineer & revision date
    PlacementTestSiteSampleLocationsWS3013 Form came up blank - replaced with an older version
    PreconMtgAgendaWS1030 Project Leader to Project Engineer & added reminder to enter production rates & revision date
    ProdSampleLocationsWS3011 Form came up blank - replaced with an older version
    ProgressMtgNotesWS1050 Fixed formatting
    SieveAnalysisForConcAggWS5015 Changed Ws to Ww and #16 1.16 to 1.18