612501 AWRF.pdf
PDF 749 KB Posted
- Attached to
- 612501 - DISTRICT 6
- Solicitation number
- BD-22-1030-0H100-0H002-76584
- Issued by
- Suffolk County, Massachusetts
About this file
The document provided is an Access Work Request Form from the Massachusetts Department of Transportation (MassDOT) District 6 Highway Division. The form details the requirements and approvals necessary for contractors to perform work on MassDOT facilities or roadways. The form captures information such as the date, time, location, and description of the work, as well as the contract/permit number, permittee, contractor, and MassDOT representatives involved. It also addresses traffic control setup, state police details, billing information, and special instructions or conditions.
The related state and local contract opportunity is for Project #612501 - DISTRICT 6, which is being solicited by MassDOT. This project does not use the COMMBUYS system, and there are two addenda attached. The project location is in Massachusetts, but no further details on the scope of work, quantities, response dates, or contract term are provided in the materials submitted.
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Other files
| File | Type | Posted |
|---|---|---|
| 612501 RFAC.pdf | ||
| 612501 NTC.pdf | ||
| 612501 DFAR.pdf | ||
| 612501 A2.pdf | ||
| 612501 BidTabs.pdf | ||
| 612501 WZS.pdf | ||
| 612501 SP.pdf | ||
| 612501 BidResults.pdf | ||
| BIL 612501.txt | TXT text file | |
| 612501 A1.pdf | ||
| 612501 PHL~1.pdf |
Show all 11
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Text version
District 6 Highway Division 185 Kneeland Street, Boston, MA 02111
Tel: 857-368-6300, FAX: 857-368-0106/0105 www.mass.gov/massdot
ACCESS WORK REQUEST FORM
Document Number: ____________________ (MassDOT Use Only)
S M T W Th F S Day(s): Date(s): ________________ Time (0-24 HR):_______________
Area/Location of Work: _______________________________________________________________
Description of Work: _________________________________________________________________
Contract/Permit #:____________ Permittee: _________________ Contractor: ________________
Contractor Representative: ____________________ Cell: ________________ Tel: _______________
MassDOT Representative: _____________________ Cell: ________________ Tel: _______________
Traffic Control Setup: None Required by MassDOT by Permittee
Traffic setup Description: _____________________________________________________________
(MassDOT Use Only)
State Police Details: No Yes Number:____________ MassDOT Setup: M7 M8
Detail Sign In Location: __________________________________ Time (0-24 HR): ______________
Billing Information: Permittee:__________________________ MassDOT Billing No: ______________
Trust Fund Reimbursable: No Yes ______________________________________________
Special Instructions/Conditions
* Contractor responsible to ensure all secured doors be closed and locked at the end of each shift
Approvals
Access Work Coordinator Division Engineering
Confined Space entry See Attached Lockout/Tagout
FAILURE TO NOTIFY THE HOC (617-946-3150) BEFORE THE START OF WORK WILL RESULT IN REVOCATION OF THIS WORK REQUEST.
E-Mail Completed Form at Robert.hutcheon@state.ma.us or Fax at 857-368-0106
Proposal No. 612501 - 118550
A00816 - 1
THIS PAGE IS INTENTIONALLY LEFT BLANK
Proposal No. 612501 - 118550
A00816 - 2
A00816-Access Work Request Form-2018
File details come from the government source that posted it. Updated .