Agency Contract for Aerial Platform Lift 62 FT Working Height for the Mississippi Department of Transportation (MDOT). RFX 3160008182

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 1 OF 10
Aerial Platform Lift-62-Foot Working Height-Truck Mounted
Aerial platform lift (Lift), truck mounted, 62-foot working height, new and of current model, equipped as advertised
by the manufacturer, to meet or exceed the following MINIMUM specifications:
Aerial Platform Proposed: Make: _____________________________ Model: _____________________________
Cab Chassis Truck Proposed: Make: ___________________________ Model: ___________________________
Proposed Flat-Bed Body: Make: _____________________________ Model: _____________________________
Non-Restrictive Clause: Any use of brand name or equal within this specification is to be considered a reference
for the purpose of describing the standard of quality, performance, and characteristics desired. It is not intended to
limit or restrict competition.
The vendor must respond to each of the following statements. Specifications listed are minimum requirements
that must be met for a vendor to qualify for an award. A "YES" response means the vendor guarantees that they
meet this requirement. A "NO" response means the vendor cannot meet the requirement and will not be considered.
The vendor must supply printed literature that shows compliance with each requirement of the Equipment
Specifications and, if on inspection, an item is found not to comply, the machine(s) will be rejected.
Descriptive literature shall be furnished to substantiate EACH of the details specified herein.
SPECIFICATIONS
General: The Aerial Platform shall have an attainable height as measured from ground level to the bottom of the
platform of not less than 57 feet and a horizontal reach as measured from the centerline of rotation to the centerline
of the platform of not less than 54 feet. All applicable components shall be built to ANSI/SAIA A92.2 standards
(latest version at time of build, currently 2021 version).
Height from ground level to the bottom of the platform (feet):____________________________________________
Horizontal reach as measured from the centerline of rotation to the centerline of the platform (feet): _____________
The Aerial Platform shall be provided with one rotating platform manufactured of steel with a rated capacity of not
less than 600 pounds in any boom position.
Platform Weight Rating (pounds): _________________
Comply Yes/No:
Aerial Platform Lift:
Platform: One (1) removable steel platform measuring 40-inches deep (front to back) x 60-inches wide (left to right)
x 42-inches tall (top to bottom) with a hydraulic rotator capable of allowing the operator to rotate the platform up to
+/- 45 degrees from the centerline of the boom. The platform shall be equipped with a safety chain at the opening
and shall be equipped with a minimum of two (2) safety lanyard attachments.
Platform Dimensions (inches): Depth: ________________ Width: ________________ Height: ________________
Platform Rotation from centerline of boom both directions (degrees): _____________________________________
Comply Yes/No: _________________
Boom Configuration: The boom shall consist of three (3) individual telescopic sections extended hydraulically.
The boom shall have an arc of travel no less than 75 degrees above horizontal to 20 degrees below horizontal, 95
degrees total. All edges of the aerial device and boom(s) shall be rounded off for safety.

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 2 OF 10
Boom Arc of Travel (degrees above/below horizontal, highest to lowest): ________________________________
Comply Yes/No: _________________
Boom Construction: The boom shall be constructed of high-strength, 46,000 psi, steel sections. The assembly
shall include cylinder fittings, pivot pins and replaceable, ultra-high molecular weight polyethylene wear plates. The
boom shall be equipped with a steel cable carrier mounted externally on the boom. The boom pedestal shall be
mounted on the rear of the chassis with the platform at the front of the truck when in the rested position.
High-Strength Steel Boom Rating (psi): ___________________________________________________________
Comply Yes/No: _________________
Boom Function: The boom lifting function shall be accomplished with One (1) 6-inch I.D. double-acting, 57-inch
stroke cylinder. The lift cylinder shall be equipped with a holding valve to prevent boom from falling in event of hose
failure.
Boom Lifting Cylinder: Make: _______________________________ Model: _______________________________
Stroke Length (inches): ______________________________ Cylinder ID: _______________________________
The telescoping boom extensions shall be accomplished by using two opposing "piggyback" double acting 2 12-inch
I.D. cylinders (minimum), 1 12 -inch diameter rod, and interconnecting the three boom sections (no cables). The
cylinder shall be pinned in place and equipped with holding valves for both in and out.
Comply Yes/No: _________________
Mounting: The aerial turret box shall be mounted to the chassis sub-frame of the vehicle by bolting at the rear of
the vehicle so that the platform will stow at the front of the vehicle. The vehicle shall have a permanently installed
boom rest at the front of the bed and be of adequate design to withstand stow loads. The unit, when mounted on
the vehicle and in the stowed position, shall not exceed a 13-foot travel height (as measured from the highest point
of the unit to ground level).
Maximum Travel Height (feet and inches): _________________
The torque frame from main to rear outriggers shall be a box structure 6-inches tall x 34 12-inches wide.
Torque Frame Measurements (inches): _________________
Comply Yes/No: _________________
Turret and Turret Bearing: The turret shall be a one-piece weldment with reverse offset design. The turret shall
rotate on a ball bearing and shall provide continuous rotation with no stops.
Comply Yes/No: _________________
Rotation The turret shall rotate 360 degrees continuously without stops. A hydraulic motor, driving the turret through
a self-locking worm gearbox (no brake) shall accomplish rotation. The gearbox shall be mounted on the turret above
the rotation. The rotation system shall be capable of rotating the maximum rated load capacity of the unit at the
maximum attainable horizontal distance away from the pedestal upwards on a five-degree incline.
Comply Yes/No: _________________
Platform Leveling: The platform shall be maintained in a level position relative to the chassis frame in all operating
positions by a "closed" hydraulic system comprised of twin 2 12-inch platform cylinders interacting with a boom-
actuated 4-inch master cylinder mounted in the boom support turret. In lieu of the 4-inch master cylinder, an
electronic leveling sensor will also be acceptable for leveling. The leveling system shall be provided with factory-

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 3 OF 10
set relief valves to compensate for oil expansion or overload during platform leveling operation. A leveling valve
shall be provided and be permanently connected to the boom valve bank. It shall be capable of being remotely re-
leveled with an electrical switch in the platform.
Comply Yes/No: _________________
Stability: The completed aerial device shall be tested prior to delivery for compliance with ANSI A92.2.
Comply Yes/No: _________________
Emergency Lowering: The aerial device shall be provided with a 12-volt emergency lowering system with switches
located at both the lower and upper controls.
Comply Yes/No: _________________
Hydraulic System: The hydraulic system shall be of open center design with 2,500 PSI design pressure. The
hydraulic pump shall have a rating of 14 GPM at 1,200 engine RPM. The pump shall be of domestic manufacture.
The hydraulic pump shall be driven by a hot-shift PTO mounted to the transmission by means of an SAE type flange
mount. The PTO shall include an indicator/warning light. The load bearing ends of all hydraulic cylinders shall be
equipped with check or counterbalance valves capable of hydraulically locking the cylinder and preventing
movement of the cylinder in the event of loss of hydraulic power or line failure. The reservoir filler shall be easily
accessible and have a removable strainer. The filler opening shall be of such design as to prevent oil from splashing
out of the reservoir. The reservoir shall have sight level gauge and thermometer. The hydraulic oil shall be supplied
to the turret-mounted control valve through a rotary manifold. All cylinders, control valves, hoses and hydraulic
fittings shall be domestic convention (no metric adapters permitted).
Hoses: All high-pressure hoses shall be wire braid reinforced with a minimum safety factor of 4:1.
Cylinders: All cylinders must have micro-honed I. D. cylinder tubing, chrome shafts, top grade packing and
protective rod wipers.
Filtration: The hydraulic filtration system shall consist of a suction strainer, return line filter, capable of providing 10-
micron nominal filtration, and a pressure filter capable of providing 10-micron nominal filtration.
Comply Yes/No: _________________
Outriggers: The aerial platform shall be stabilized by two (2), independently operated hydraulic outrigger
assemblies. The secondary front outriggers and main rear outriggers shall all be out-and-down design. Minimum
14-foot spread required for main outriggers. The vertical legs shall telescope under the bed floor. The horizontal
and vertical movement of the outriggers shall be individually controlled. The system shall have an automatic rotation
lockout which will allow operation of the boom and platform to the side of the truck that the outriggers are fully
extended.
Measurement between main out riggers (feet and inches ): _________________
Vertical outrigger cylinders shall be of the double acting type equipped with integral pilot operated check valves
capable of preventing drift from both the retracted and the extended positions even in the event of loss of hydraulic
power or line failure.
Main and secondary outrigger assemblies shall be solidly mounted to the sub-frame assembly.
Comply Yes/No: _________________
Operator Control System: The medium for transmitting control signals from the platform to the lower control station
shall be by means of electric cable or a Controller Area Network (CAN bus) system.
Lower controls style (electric or CAN bus): _________________

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 4 OF 10
The controls located at the aerial platform shall consist of the following: Three (3) control handles for operating
boom extension, lift, and rotation. In lieu of separate control handles a single, multi-directional, proportional control
handle/joystick will be acceptable. One (1) engine speed switch/button and One (1) engine start/stop switch/button,
, and One (1) winch control handle will also be inlcuded. The lower boom controls shall be mounted on the roadside
of the turret above rotation. The master control switch with indicator lights shall be installed in the truck cab. The
main and rear outrigger controls shall be mounted at the rear on each side, with roadside valve controlling roadside
outriggers and curbside valve controlling curbside outriggers. The outrigger controls shall include a truck level bull's
eye. All controls and switches shall be clearly labeled to define function and direction of operation.
Comply Yes/No: _________________
Body: The bed shall be equipped with a 3/16" tread plate floor, and a standard DOT type bumper installed at the
rear of bed with taillights. The bed shall have white anti-spray suppressant, splashguards.
Floor thickness (inches) : _________________
A step shall be provided on each side at the rear of the body to provide access to the walk-around control platform
with non-slip steps and grab handles.
Comply Yes/No: _________________
Heavy-Duty Hydraulic Boom Winch: The winch shall be high-efficiency planetary type with integral load-holding.
The winch shall have a lifting rating of 600 lbs. at 45-ft radius and 5,900 lbs. at 3-ft radius with platform removed.
Winch weight rating at 45-foot radius (pounds): _________________
Winch weight rating at 3-foot radius (pounds): _________________
The winch shall be controlled from an additional valve section on the lower control valve. It shall be pressure
compensated to allow feathering the winch and one boom section simultaneously. The winch shall be mounted at
the base of the boom for a long fleet angle and flat, level spooling of cable. The winch shall have 180-feet of 3/8-
inch diameter 6 x37 Improved Plow Steel Iron Wire Rope Core cable and a weighted swivel hook.
Length of wire rope spooled on to winch (feet and inches): _________________
Winch weight rating at 45-foot radius (pounds): _________________
The winch shall be provided with a three-ton dead end snatch block to operate with 2-part line and a 50-pound
down haul ball. The main boom section shall be equipped with a retainer at platform end to stow cable when not in
use.
Comply Yes/No: _________________
Platform Tool Circuits: The aerial platform shall have a 110-volt duplex receptacle in the platform for using electric
tools. The aerial platform shall have an air supply line with quick-disconnect in the platform for using air tools. The
aerial platform shall have welding lead connections in the platform with 15-foot leads (see Welder/Generator section
below).
Comply Yes/No: _________________
Platform Access: The aerial platform shall be equipped with a walkway to allow for access to the platform while
the boom is in boom rest. Walkway frame shall be constructed of steel and include a non-slip walking surface.
Comply Yes/No: _________________

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 5 OF 10
Toolboxes: There shall be three (3) toolboxes mounted to the truck bed as follows:
One (1) toolbox: 24-inches deep (front to back) x 36-inches tall (top to bottom) x 98-inches wide (left to right) with
two (2) locking doors, mounted immediately behind the cab.
Toolbox included: Make: _________________ Model: _________________
Measurements (Depth x Width x Height in inches): __________________________________
Two (2) toolboxes: 18-inches deep (front to back) x 18-inches tall (top to bottom) x 48-inches wide (left to right)
under bed toolboxes with locking doors, mounted between the rear axle and back of the truck on each side.
Toolbox included: Make: _________________ Model: _________________
Measurements (Depth x Width x Height in inches): __________________________________
All toolboxes shall be keyed alike and of the same color, either manufacture's standard color or black.
Comply Yes/No: _________________
Retractable Reels: There shall Two (2) retractable reels, One (1) each for both electrical and air lines. One (1)
retractable reel with 100-feet of 14-gauge, 3-wire, electric extension cord to be mounted and connected to
generator. Reel shall be mounted under control box on passenger side behind truck cab.
Length of 14 AWG, 3-wire, extension cord included on reel (feet): _________________
One (1) retractable reel with 100-feet of 3/8-inch I.D. air hose to be mounted and connected, using quick disconnect
couplings (male/female), to the truck air feed located under control box on passenger side next to the electric reel.
Length of 3/8-inch ID airline included on reel (feet): _________________
Comply Yes/No: _________________
Accessories: Two (2) safety harnesses and two (2) 72-inch lanyards shall be delivered with the unit.
Platform-mounted sign forks.
Comply Yes/No: _________________
Cab Chassis Truck:
GVWR: 37,000 pounds
GVWR: _______________________
Comply Yes/No: _________________
CA Dimension: 144 inches
CA dimension: _______________________
Comply Yes/No: _________________
Engine: 9-liter minimum, 360-horsepower minimum, water-cooled, diesel, minimum torque of 1,000 lb.-ft., meeting all
current federal and EPA requirements
Make: _________________________________ Model: _________________________________

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 6 OF 10
Displacement (liters): _____________________ Power (horsepower): ______________________
Torque (pound feet): ______________________
Comply Yes/No: _________________
Engine Protection: Unit shall have automatic shutdown system to include oil pressure, oil temperature, and coolant
temperature.
Comply Yes/No: _________________
Transmission: Vocational-duty, fully automatic, 6-speed with overdrive designed for on-road/off-road operations,
geared for highway speeds up to a minimum top speed of 75 MPH with fully loaded truck.
Make: ___________________________________ Model: _________________________________
Type (automatic/manual): _____________________________ Speeds: __________________________
Comply Yes/No: _________________
Brakes: Full air, disc, ABS with 4 channel/4 sensor/4 modulator configuration for front and rear axle compatibility,
sized to meet all applicable state and federal safety standards for size, weight and application of truck. Mechanical
spring-set rear axle parking brakes.
Manufacturer: __________________________ Type (air/hydraulic/etc.): ___________________
Style (disc/drum/etc.): ____________________ ABS configuration (4S/4M, etc.): _____________
Comply Yes/No: _________________
Axle Rating and Suspension: Front: 14,000-pound minimum, multi-leaf springs with shock absorbers - setback
configuration, disc brake compatible hubs.
Manufacturer: ____________________
Axle Type: ________________________ Weight Rating (pounds): ___________________
Suspension Type: __________________ Weight Rating (pounds): ___________________
Rear: 26,000-pound minimum, multi-leaf springs with 4500-pound auxiliary rubber spring, single-speed, with full
locking differential (driver operated), disc brake compatible hubs.
Manufacturer: ____________________
Axle Type: ________________________ Weight Rating (pounds): ___________________
Suspension Type: __________________ Weight Rating (pounds): ___________________
Comply Yes/No: _________________
Cooling System: Heavy-duty, high-capacity radiator, silicone hoses.
Comply Yes/No: _________________
Electrical: One (1) 12-volt, 160-amp alternator. Two (2) 12-volt maintenance free batteries, 1100 CCA.

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 7 OF 10
Comply Yes/No: _________________
Frame: All grade 8 bolts and hardware (preferred) or Huck bolts for assembly. Minimum 80,000 PSI high strength,
low alloy steel section modulus-20.1, minimum 2,000,000 RBM.
Section Modulus: ____________________ RBM: ___________________
Comply Yes/No: _________________
Fuel System: 100-gallon tank capacity (any configuration) dual stage fuel filters.
Number of tanks: ____________________________
Capacity per tank (gallons): ____________________________
Comply Yes/No: _________________
DEF Tank: 6-gallon, frame-mounted
Number of tanks: ____________________________
Capacity per tank (gallons): ____________________________
Comply Yes/No: _________________
Steering: Power-integral
Comply Yes/No: _________________
Driveline: U joint.
Comply Yes/No: _________________
Tires: All tires must be rated equal to or higher than axle and suspension weight specifications.
Front: Two (2) 12R22.5 or 295/80R22.5
Manufacturer: ______________________ Size: ___________________________________
Rear: Four (4) 11R22.5
Manufacturer: ______________________ Size: ___________________________________
Comply Yes/No: _________________
Wheels: Must be rated equal to or higher than axle and suspension weight specifications, disc brake compatible.
Front: Pilot 22.5 x 9, 10-hole disc, steel, hub piloted
Manufacturer: ______________________ Size: ___________________________________
Rear: Pilot 22.5 x 8.25, 10-hole disc, steel, hub piloted
Manufacturer: ______________________ Size: ___________________________________
Comply Yes/No: _________________

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 8 OF 10
Back-up Alarm: Smart, self-adjusting alarm system which is activated upon engagement of the reverse gear of the
vehicle, is audible above normal outdoor sounds, and meets FMVSS requirements. The back-up warning alarm shall
be mounted on the rearmost part of the vehicle, be protected from water and road spray, and meet a minimum 82 dB
up to 107 dB depending on surrounding ambient noise levels.
Alarm Volume (decibels): __________ Alarm Frequency (hertz): ___________
Comply Yes/No: _________________
Back-up Camera: Complete, fully functional, and operational back-up camera system providing a clear view of the
area directly behind the vehicle to allow safe reverse travel of vehicle.
Comply Yes/No: _________________
Cab and Equipment: Conventional-type, steel or aluminum construction with fiberglass front hood and fender
assembly, equipped with door pads and back of cab pads for sound deadening and insulation.
All standard equipment including, but not limited to: five (5) cab-mounted marker lights, deluxe high-back air
suspended driver and passenger seats with armrests, two (2) cup holders, stainless steel sun visor, power windows,
power mirrors, power locks, high-visibility orange safety belts, factory air conditioning and heater with defroster, outside
assist handles both sides (if exhaust is in the way then an inside assist handle will be acceptable for the side affected),
12-volt dash-mounted accessory power outlet, direct reading gauges for oil pressure, water temperature and air
pressure, tachometer, AM/FM Bluetooth stereo radio with hands-free option, air horn(s), warning lights and buzzers
for air pressure, oil pressure and water temperature, RH and LH west coast mirrors, RH and LH convex auxiliary
mirrors, tinted glass all around, multi-speed electric windshield wipers and washers with intermittent mode, tilt steering
column, front tow hooks, heavy-duty front bumper, 7-pin electrical connector with enough harness to terminate at end
of frame; to be hung on rear of cab. Four-wheel trailer air brake connections with enough hose to terminate at end of
frame; to be hung on rear of cab.
There shall be a holder for the operator's manuals.
Comply Yes/No: _________________
Pintle Hitch: A 30-ton capacity forged pintle hitch mounted on 34-inch plate with two (2) 5/8-inch forged "D" rings for
safety chains. Mounting height to be 26-inches from ground to center of pintle hitch. Pintle hitch plate must be
gusseted to frame. Pintle hitch shall be bolted on for a permanent connection to vehicle.
Pintle Hitch supplied: Make: _________________Model: _________________
Weight Rating (pounds): _________________
Comply Yes/No: _________________
Miscellaneous Accessories: Black undercoating applied to underside of body, Triangle reflector kit, A U/L
approved 2 12 pounds BC dry chemical fire extinguisher shall be installed in the truck cab.
Comply Yes/No: _________________
Paint: Truck chassis to be manufacturer's standard white, all other to be manufacturer's standard color.
Comply Yes/No: _________________
ADDITIONAL REQUIREMENTS
Service: The Lift shall be delivered fully assembled and ready to operate. Factory-trained dealer representative is to
inspect the Lift upon delivery and provide receiving MDOT equipment manager with information on operational,
service, and maintenance requirements.

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 9 OF 10
Bidder shall maintain a representative inventory of replacement parts and service facilities as well as all necessary
diagnostic tools/equipment/software and software licenses needed for diagnosis, repair, service, and maintenance.
Acknowledge Yes/No: _______________
Warranty: Clearly stated terms and conditions of all manufacturer warranties shall be included with the bid package.
All materials, specialty equipment, or accessories that prove defective in normal operation within the warranty period
shall be replaced or repaired by the manufacturer free of all cost to MDOT, including all material, labor, and
transportation costs. Warranty replacement and/or repairs shall be furnished promptly by the successful bidder within
a time not to exceed thirty (30) calendar days. The bidder shall provide written assurance with the bid package
regarding warranty repairs.
The delivering dealer will have sole warranty responsibility (all components) for the first ninety (90) calendar days
after acceptance of equipment.
The manufacturer shall provide, with the bid package, a list of warranty service locations within the State of Mississippi
for all components of the Lift (body, chassis, electrical, etc.) which may need warranty repair beyond the first ninety
(90) calendar days.
Acknowledge Yes/No: _______________
Workmanship: Workmanship throughout shall conform to the highest standard of commercially accepted practice for
the class of work and shall result in a neat and finished appearance. The design which the manufacturer proposes
must be of substantial and durable construction in all respects.
All parts shall be new. Used, reconditioned, or obsolete parts will not be accepted.
Acknowledge Yes/No: _______________
Parts Availability: Dealer name and contact information located closest to the point of delivery:
Dealer Name: _________________________________________________________________________
Telephone: ___________________________________________________________________________
Street Address: _______________________________________________________________________
City, State, ZIP: _______________________________________________________________________
Acknowledge Yes/No: _______________
Tests and Testing: The complete Lift and all working and moving parts and operating devices shall be thoroughly
tested and put in operating condition by the manufacturer.
Prior to acceptance by MDOT, the manufacturer shall service and adjust the unit for operation.
Acknowledge Yes/No: _______________
Literature:
Technical manuals: Operator's manual, service/maintenance manual, and parts book are to be made available in
both hard copy and electronic (PDF file format on USB flash drive) versions. One set of technical manuals shall be
provided with each Lift upon delivery. Additional manuals may be ordered later.

MISSISSIPPI DEPARTMENT OF TRANSPORTATION
AMD SPECIFICATION NUMBER 807-APTM-62WH-DAT-76-1032/101
DATE: Amended 9/2/2025 (492-0713) PAGE 10 OF 10
Technical service bulletins: Successful bidder shall provide TSBs (technical service bulletins) for all Lift(s)
delivered to MDOT as they are published, regardless of the date of delivery. TSBs may be furnished in paper or
electronic format and shall be updated regularly.
The following additional information shall be provided by the vendor at time of delivery (electronically if possible):
* Manufacturer's recommended service/preventive maintenance intervals
* Recommended fluids, lubricants, and their SAE equivalents
Two (2) copies of descriptive literature shall be furnished to substantiate the details specified in the bid.
Acknowledge Yes/No: _______________
Certification: The manufacturer(s) shall furnish certification that the Lift meets or surpasses current U.S.
Department of Labor Occupational Safety and Health Administration (OSHA) Regulations, U.S. Department of
Transportation Federal Motor Vehicle Safety Standards (FMVSS), and any other applicable Federal regulations.
Acknowledge Yes/No: _______________
Vehicle Title or Certificate of Origin:
Assignment: State of Mississippi/DFA - 941
Mailing address: Mississippi Department of Transportation, 9301
P.O. Box 1850
Jackson, MS 39215
Acknowledge Yes/No: _______________
Lienholder: Upon award, if MDOT issues a Notice to Proceed instead of a Purchase Order, the Lift is being
purchased through the State's Master Lease Purchase Program.
Acknowledge Yes/No: _______________