CDOT Form 595 "Pre-approved Product Evaluation Request & Summary" - Colorado

What Is CDOT Form 595?

This is a legal form that was released by the Colorado Department of Transportation - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the Colorado Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CDOT Form 595 by clicking the link below or browse more documents and templates provided by the Colorado Department of Transportation.

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Download CDOT Form 595 "Pre-approved Product Evaluation Request & Summary" - Colorado

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APL Reference No.
COLORADO DEPARTMENT OF TRANSPORTATION
PRE-APPROVED PRODUCT EVALUATION REQUEST & SUMMARY
Material code:
Product Evaluation Coordinator
Colorado Department of Transportation
FOR INTERNAL CDOT USE
Material code description full name:
4670 North Holly Street, Unit A
Denver, Colorado 80216
PART 1
Product name:
Product category:
Product Representative (name & address):
Manufacturer (name & address):
Attn:
Attn:
E-mail:
E-mail:
Phone:
Phone:
Web-site address:
Web-site address:
Description of the product:
(Include specific quantifiable details from tech data sheet. Advertising generalities are not appropriate.)
Restrictions, (installation and/or use):
Use of the product, (be specific to CDOT highway activities only):
Benefits to CDOT, (how will your product enhance quality, improve safety, save money, be a better value then other manufacturer’s products):
Specifications: (listing those applicable is required)
K
CDOT
:
K
ASTM
:
K
AASHTO :
K
FHWA
:
K
other
:
ONLY
Certificate of Verification (COV) provided for select categories
K
Certificate of Compliance (COC) provided
Product Testing: (National/independent laboratories or universities with Report Date.) Certified Test Report (CTR) provided to validate all claims.
K
NTPEP-AASHTO :
K
FHWA
:
K
:
other
K
other
:
K
K
other
:
Expiration Date
State DOT Approvals, (current documentation required):
K
K
K
K
K
yes
K
yes
no
n/a
Safety Data Sheets (SDS):
no
Sample submitted:
n/a
Alternate Product Category:
Additional Comments:
CDOT Form #595 11/19
Page 1 of 2
APL Reference No.
COLORADO DEPARTMENT OF TRANSPORTATION
PRE-APPROVED PRODUCT EVALUATION REQUEST & SUMMARY
Material code:
Product Evaluation Coordinator
Colorado Department of Transportation
FOR INTERNAL CDOT USE
Material code description full name:
4670 North Holly Street, Unit A
Denver, Colorado 80216
PART 1
Product name:
Product category:
Product Representative (name & address):
Manufacturer (name & address):
Attn:
Attn:
E-mail:
E-mail:
Phone:
Phone:
Web-site address:
Web-site address:
Description of the product:
(Include specific quantifiable details from tech data sheet. Advertising generalities are not appropriate.)
Restrictions, (installation and/or use):
Use of the product, (be specific to CDOT highway activities only):
Benefits to CDOT, (how will your product enhance quality, improve safety, save money, be a better value then other manufacturer’s products):
Specifications: (listing those applicable is required)
K
CDOT
:
K
ASTM
:
K
AASHTO :
K
FHWA
:
K
other
:
ONLY
Certificate of Verification (COV) provided for select categories
K
Certificate of Compliance (COC) provided
Product Testing: (National/independent laboratories or universities with Report Date.) Certified Test Report (CTR) provided to validate all claims.
K
NTPEP-AASHTO :
K
FHWA
:
K
:
other
K
other
:
K
K
other
:
Expiration Date
State DOT Approvals, (current documentation required):
K
K
K
K
K
yes
K
yes
no
n/a
Safety Data Sheets (SDS):
no
Sample submitted:
n/a
Alternate Product Category:
Additional Comments:
CDOT Form #595 11/19
Page 1 of 2
PART 2
Form #595 (date entered):
Form #595 (date to evaluator):
APL Reference Number:
Product Evaluation Coordinator’s review:
K
PART 1 - Completed
K
Standard Product - Forwarded to the appropriate CDOT Expert Product Evaluator (EPE) / Subject Matter Expert (SME).
Experimental Feature - Forwarded to Research Director, SME, CDOT Technical Committee or Branch Head. (PD 1401.1)
K
Returned from the appropriate CDOT EPE/SME, Research Director or CDOT Technical Committee.
K
K
Accepted - Product acceptable for pre-approval and meets CDOT’s Specifications.
K
Rejected - Product unacceptable for pre-approval or contrary to CDOT specifications.
PART 3
The CDOT Evaluator is to complete this portion. Attach references and/or additional sheets as necessary. Do not perform
any work until product is accepted for evaluation in PART 2, and a product reference number is assigned.
Evaluation methods and procedures. (Evaluattor should document intended evaluation procedure.)
Findings and recommendations. (Evaluator should write the exact specification(s) that the product complies with. Document the evaluation performed and
therecommendation toward APL approval. Conclude with your signature, title and date):
Per PEC: comments and/or post-approval requirements (if applicable):
:(Expiration Date (YYYY-MM-DD
PART 4
K
Acceptable for use. Add to the Approved Products List (APL).
[The evaluation and acceptance of this product is intended for CDOT use. DO NOT USE for Advertising.]
K
Rejected for use. Reason for rejection:
CDOT Materials Engineer, Printed Name
CDOT Materials Engineer Signature
Date
Page 2 of 2
CDOT Form #595
11/19
Page of 2