Att.1_Exhibit_E_-_Van_Inspection_Form.docx

This is a Van Inspection Approval Form attachment for the State of California's ADA Wheelchair Lift Van Conversion procurement opportunity. The form serves as the inspection documentation required for wheelchair lift van conversions performed under Purchase Order 5225-XXXX. The inspection process evaluates conversion installations by certified technicians and verifies compliance with California state regulations and federal ADA standards. The form captures essential vehicle information including make, model, year, VIN, license plate number, and shipping address, along with the state inspector's name, inspection location, and date. The inspection checklist comprises seven major categories: general lift installation compliance, lift operational functionality, passenger safety features, ADA compliance specifications, vehicle modifications related to the conversion, documentation and labeling requirements, and required attachments. Specific ADA requirements verified include platform dimensions of 30" x 48", minimum weight capacity of 600 lbs, minimum head clearance of 56" when entering or exiting the vehicle, and controls accessible to individuals with disabilities.

The form requires comprehensive documentation including the manufacturer's installation certificate, ADA compliance documentation, and proof of insurance updated post-conversion. The inspection outcome is marked as pass or fail, with any deficiencies or required repairs documented accordingly. Both the state inspector and vehicle owner/operator must sign and date the form to certify compliance. The document references compliance with California Highway Patrol (CHP) and Federal Motor Vehicle Safety Standards (FMVSS). Bid submissions for this opportunity must be sent to ota@dgs.com with the Business Unit number, Event/Solicitation number, title, due date, and Procurement Official name clearly stated in the subject line. Phebe Lapinig serves as the primary Procurement Official, with Jennifer Maier as the backup contact for inquiries.