Attachment A-II - Forms.docx
DOCX document 176 KB Posted
- Solicitation number
- RFP 591 260000002219 1
- Issued by
- Wayne County, Detroit City, Michigan
About this file
This file is Attachment A-II to RFP No. 260000002219 for Movable Bridges Operational and Custodial Services issued by the State of Michigan Department of Transportation. The attachment provides standardized forms and checklists that contractors and bridge operators must utilize during the performance of operational and custodial services. The document includes five primary forms: the Bridge Operator's Report (Form 0406), an Unnecessary Bridge Openings report, a Contractor/Operator's Inspection evaluation form, an Equipment Checklist, and an Accident/Incident Report form. These forms establish uniform documentation and performance standards for all movable bridge operations throughout Michigan's waterways.
The forms detailed in this attachment serve as quality assurance and compliance mechanisms for contract performance. The Contractor/Operator's Inspection form requires evaluations of bridge operator knowledge, operational ability, navigation and safety conditions, operator appearance, housekeeping standards, and overall bridge condition, with ratings of Good, Fair, or Poor. The Equipment Checklist mandates verification of required safety equipment including first-aid kits, life jackets, life rings, rope, fire extinguishers, emergency flags, flashlights, cones, reflectorized vests, and functional amenities such as commodes, communication systems, and climate control. The Unnecessary Bridge Openings and Accident/Incident Report forms require detailed documentation of specific incidents, vessel information, weather conditions, property damage, and police reports. All forms must be completed by project managers, inspectors, or bridge operators as applicable to ensure operational compliance and safety standards throughout the contract term.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A-V- BO Qualifications.docx | DOCX document | |
| RFP 26.2219 CT Form.docx | DOCX document | |
| RFP 26.2219 2026 Moveable Bridges SOW.docx | DOCX document | |
| RFP 26.2219 Proposal Instructions.docx | DOCX document | |
| Attachment A-VI - GB Operating Manual.docx | DOCX document | |
| RFP 26.2219 Standard Contract Terms.docx | DOCX document | |
| RFP 26.2219 Schedule B - Pricing Sheets.xlsx | XLSX spreadsheet | |
| RFP 26.2219 Schedule B - Pricing Terms.docx | DOCX document | |
| Attachment A-III - Custodial Duties.docx | DOCX document | |
| Attachment A-I - Materials List.docx | DOCX document | |
| Attachment A-IV Drug Alcohol Testing.docx | DOCX document | |
| RFP 26.2219 VQ Worksheet.docx | DOCX document |
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Text version
ATTACHMENT A-II
RFP No.: 260000002219 Movable Bridges Operational and Custodial Services
Forms
1. BRIDGE OPERATOR’S REPORT (Form 0406) Fillable PDF available: https://mdotcfintra.state.mi.us/interchange/forms/Allforms.cfm
2. UNNECESSARY BRIDGE OPENINGS
3. CONTRACTOR/OPERATOR’S INSPECTION
4. EQUIPMENT CHECK LIST
5. ACCIDENT INCIDENT
UNNECESSARY BRIDGE OPENINGS
BRIDGE NAME: BRIDGE No.
BRIDGE LOCATION:
· NUMBER OF VESSEL (IF NUMBERED):
· NAME OF VESSEL:
· HOME PORT (IF SHOWN):
· NAME & ADDRESS OF OWNER:
| MONTH: | DAY: YEAR: | TIME: AM: | PM: |
| DIRECTION OF PASSAGE: UP STREAM: | DOWN STREAM: |
CAUSE OF UNNECESSARY BRIDGE OPENING
APPURTENANCES UNESSENTIAL TO NAVIGATION:
ANTENNA: OUTRIGGER: DECORATIVE MAST:
FLAGPOLE: FALSE STACK: CANVAS TOP:
OTHER:
CLEARANCE GAUGE: FEET
ESTIMATED CLEARANCE OF VESSEL’S HIGHEST FIXED POINT: FEET
REMARKS:
BRIDGE OPERATOR:
(VIOLATION CANNOT PROCEED WITHOUT THIS INFORMATION)
CONTRACTOR/OPERATOR’S EVALUATION
BRIDGE NAME:
INSPECTOR: TIME: DATE:
| EVALUATION |
| GOOD |
| FAIR |
| POOR |
A. Bridge Operators Overall Knowledge Of Functions
1. Knowledge of routine operations procedures
2. Knowledge of emergency operating procedures
3. Knowledge of administrative requirements
4. Knowledge of Coast Guard Regulations
B. Bridge Operators Overall Operational Ability
1. Ability to operate bridge
2. Bridge logs (Completeness)
C. Bridge Navigation And Safety Conditions
1. Navigation lights (daily checks)
2. Fender systems
3. Other safety devices
D. Bridge Operators Appearance
E. Housekeeping Overall
1. Operators bridge house floors
2. Bridge house windows
3. Control console and switchgear
4. Walkways and platforms
5. Commode
F. Overall Bridge Condition
EQUIPMENT CHECK LIST
BRIDGE NAME:
| 1. | FIRST-AID KIT – (2 required) | |
| a. | In a readily accessible place? | |
| b. | Has it been used? | |
| c. | Has it been replenished? |
| 2. | LIFE JACKETS – (2 required) and LIFE RINGS – (2 required) | |
| a. | Is the required number accounted for? | |
| b. | Ripped, torn, or cracked? | |
| c. | General Condition: New Good Fair Poor |
| 3. | ROPE, 150 linear feet 1/4 inch (plus vertical distance of the draw span to water) | |
| a. | Is it in a readily accessible condition? | |
| b. | General Condition: New Good Fair Poor |
| 4. | FIRE EXTINGUISHERS (6 required) | |
| a. | Are there 4 ABC, 10 lbs.? | |
| b. | Are there 2 BC, 10 lbs.? | |
| c. | Date filled? | |
| d. | Has the pin been broken? |
| 5. | BIG RED FLAG FOR EMERGENCY SHIP WARNING | |
| a. | Is the required number accounted for? | |
| b. | Are they properly stored? |
| 6. | FLASHLIGHTS – (2 required) | |
| a. | Is the required number accounted for? | |
| b. | Are they in working condition? | |
| c. | Are the batteries good? |
| 7. | ARE THE FOLLOWING AVAILABLE? | |
| a. | Cones – (6 required) | |
| b. | Vests (Reflectorized) – (2 required) |
| 8. | ARE THE FOLLOWING WORKING SATISFACTORILY? | |
| a. | Commode | |
| b. | Fan/air conditioner | |
| c. | Door locks | |
| d. | Telephone |
e. Intercom (if available)
9. COMMENTS:
PROJECT MANAGER DATE
ACCIDENT/INCIDENT REPORT
LOCATION:
TIME OF ACCIDENT: ____________ DATE: ____________ HOUR: ______ AM: PM:
WEATHER CONDITIONS: ______________________________ (CLEAR, RAIN, FOG, ETC.)
| OPERATOR’S NAME, ADDRESS & PHONE NUMBER |
| VEHICLE / BOAT IDENTIFICATION NUMBER |
| DRIVERS LICENSE NUMBER |
| INSURANCE COMPANY |
MDOT PROPERTY DAMAGED:
DESCRIPTION OF ACCIDENT:
POLICE AGENCY REPORT NUMBER:
SKETCH IF NECESSARY
RFP 260000002219 – Movable Bridges Operational and Custodial Services 1 image1.png image2.png
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