DMS Form MP6301 "Request for Acquisition of Motor Vehicle(S) and Mobile Equipment" - Florida

DMS Form MP6301 is a Florida Department of Management Services form also known as the "Request For Acquisition Of Motor Vehicle(s) And Mobile Equipment". The latest edition of the form was released in January 1, 2016 and is available for digital filing.

Download a PDF version of the DMS Form MP6301 down below or find it on Florida Department of Management Services Forms website.

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Download DMS Form MP6301 "Request for Acquisition of Motor Vehicle(S) and Mobile Equipment" - Florida

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CLEAR FORM
DMS Fleet Management
Request for Acquisition of Motor Vehicle(s) and Mobile Equipment
PRIOR to completion of DMS Form MP6301, review Chapter 287
Part II
F.S., Means of Transport.
Reference guidelines are provided in DMS Fleet Management Procedure Number FMP1; Fleet Acquisition:
Purchase, Lease, Rental, Donation & Transfer of Motor Vehicles and Mobile Equipment
A. REQUESTOR
Department:
Request #:
CHOOSE AGENCY/DEPARTMENT
Division:
Date:
Name:
Title:
Address:
City:
Zip:
Phone:
Fax:
Email:
B. DESCRIPTION OF MOTOR VEHICLE(S) AND MOBILE EQUIPMENT TO BE ACQUIRED
Requesting agency is encouraged to review the operating expenses associated with the requested representative model
equipment. U.S. Department of Energy:
www.fueleconomy.com
State Commodity Code: ___________________________
Color: _____________________
DOT Fleet Code: ____________________ (
)
For Department of Transportation Use Only
Representative Model Description
(As stated on the contract price sheet):
Method or Type of Acquisition Requirements.
Please select the Method or Type of Acquisition.
The following selections require the completion of Sections A-G:
State Term Contract Purchase of Motor Vehicle(s)
Invitation To Bid Purchase (Requires ITB#
)
Used Motor Vehicle Purchase
GSA 1122 “Counter-drug” Program Purchase (Requires GSA#
)
Alternate Contract Source Purchase
(Also requires completed authorization from DMS
State Purchasing)
The following selections require the completion of ALL Sections, except F:
State Term Contract Purchase of Mobile Equipment
Used Mobile Equipment Purchase
( e.g., Commercial Trucks
Donation
(Class 4-8), Heavy Equipment and other related equipment.)
Transfer
(Requires all sections except F unless agency exchange of equipment)
Lease
Other; Requires further explanation:
The following information is required if you selected - Used, Lease, Donation or Transfer:
Year: ________________ Make:
Model: _________________________________________
VIN or S/N: _____________________________
Odometer/Hour Meter: ______________________
1
DMS FORM MP6301
Revised 2016
CLEAR FORM
DMS Fleet Management
Request for Acquisition of Motor Vehicle(s) and Mobile Equipment
PRIOR to completion of DMS Form MP6301, review Chapter 287
Part II
F.S., Means of Transport.
Reference guidelines are provided in DMS Fleet Management Procedure Number FMP1; Fleet Acquisition:
Purchase, Lease, Rental, Donation & Transfer of Motor Vehicles and Mobile Equipment
A. REQUESTOR
Department:
Request #:
CHOOSE AGENCY/DEPARTMENT
Division:
Date:
Name:
Title:
Address:
City:
Zip:
Phone:
Fax:
Email:
B. DESCRIPTION OF MOTOR VEHICLE(S) AND MOBILE EQUIPMENT TO BE ACQUIRED
Requesting agency is encouraged to review the operating expenses associated with the requested representative model
equipment. U.S. Department of Energy:
www.fueleconomy.com
State Commodity Code: ___________________________
Color: _____________________
DOT Fleet Code: ____________________ (
)
For Department of Transportation Use Only
Representative Model Description
(As stated on the contract price sheet):
Method or Type of Acquisition Requirements.
Please select the Method or Type of Acquisition.
The following selections require the completion of Sections A-G:
State Term Contract Purchase of Motor Vehicle(s)
Invitation To Bid Purchase (Requires ITB#
)
Used Motor Vehicle Purchase
GSA 1122 “Counter-drug” Program Purchase (Requires GSA#
)
Alternate Contract Source Purchase
(Also requires completed authorization from DMS
State Purchasing)
The following selections require the completion of ALL Sections, except F:
State Term Contract Purchase of Mobile Equipment
Used Mobile Equipment Purchase
( e.g., Commercial Trucks
Donation
(Class 4-8), Heavy Equipment and other related equipment.)
Transfer
(Requires all sections except F unless agency exchange of equipment)
Lease
Other; Requires further explanation:
The following information is required if you selected - Used, Lease, Donation or Transfer:
Year: ________________ Make:
Model: _________________________________________
VIN or S/N: _____________________________
Odometer/Hour Meter: ______________________
1
DMS FORM MP6301
Revised 2016
DMS Fleet Management
Request for Acquisition of Motor Vehicle(s) and Mobile Equipment
Essential Options Requested to Support Agency Mission:
Agency approver indicates no options were selected
Original Equipment Manufacturer (OEM) Option Codes and Description(s) with detailed justification:
Identified Aftermarket Option Description(s) with detailed justification:
Non-Identified Aftermarket Option Description(s) with detailed justification:
Other State Term Contract Option, Order or Product Codes and Descriptions with detailed justification:
See attached awarded Contract Price Quote (PQF)
By selecting this box, Agency approver certifies they have approved the requested representative model and options (if applicable).
C. STATUS OF MOTOR VEHICLE(S) AND MOBILE EQUIPMENT IN AGENCY FLEET
Does your agency have specific Legislative approved funding authority to purchase additional fleet vehicle(s) and
equipment?
Yes
Requires copy of the specific funding authority (e.g., D3A; Legislative Budget Request Approval; Grant; Designated Federal or
Trust Funding Appropriation for Acquisition of Motor Vehicles and Mobile Equipment; or, Equipment & Furniture Document, Etc.)
attached to the purchase requisition.
No
Requires completed entries in section F. Description of Replaced Equipment for Automobiles, Light Trucks, Buses, Motorcycles
and other vehicles designed primarily for transporting persons, Watercraft and Aircraft. Exemptions include Mobile Equipment: (e. g.,
Commercial Trucks (Class 4-8), Heavy Equipment and other related equipment.)
D. ASSIGNMENT OF MOTOR VEHICLE(S) AND MOBILE EQUIPMENT
Assignee: ____________________________
Title: _________________________________
DOT Cost Center: ______________________
Estimated Annual Miles/Hours: ________________
(For Department of Transportation Use Only)
Note: Projected entries less than 10,000 miles require agency head annually written justification for the need of the
assignment of a motor vehicle. Reference Florida Statutes 287.17 Limitation on use of motor vehicles and aircraft (4),(a).
A-1 POOL ASSIGNMENT:
Pool vehicles for general use by employees that do not have a vehicle assigned to them.
B-1 LIMITED USE PASSENGER CARRYING VEHICLES:
Employee has requirements for a full-time use of a vehicle during regular
working hours, but vehicle remains parked at office overnight and when not in use.
B-2 LIMITED USE NON-PASSENGER CARRYING VEHICLES:
Employee has requirement for full-time use of vehicle during regular
working hours but vehicle remains parked at office overnight and when not in use.
C-1 PERQUISITE:
Employee is entitled to use of vehicle by virtue of his position and is so approved and authorized as a perquisite
by the Department of Management Services.
C-2 LAW ENFORCEMENT:
Employee is subject to special emergency calls from his residence for law enforcement.
C-3 EMERGENCY SERVICE:
Employee is subject to emergency calls from his residence for the protection of life or property.
2
DMS FORM MP6301
Revised 2016
DMS Fleet Management
Request for Acquisition of Motor Vehicle(s) and Mobile Equipment
C-4 EMPLOYEE’S HOME IS OFFICE:
Employee’s home is his official base of operation and vehicle is parked at home when not in
use.
Not Applicable for requested equipment
E. DETAILED JUSTIFICATION OF MOTOR VEHICLE(S) AND MOBILE EQUIPMENT
Include specific applications for this size, options and type of equipment.
Towing Package
(standard or optional equipment) ALL trucks and SUVs require entries in section E (Max. Load Carried (Payload), %
of Time Load Carried, Max. Towed Load and % of Time Towed) or detailed explanation for frame mounted receiver hitch, fifth wheel
or gooseneck to accommodate essential accessory mounts and trailering options. Original Equipment Manufacturer (OEM) Towing
Package options, to include dealer installation of OEM parts, are recommended for all representative model towing needs.
Detailed explanation for frame mounted receiver hitch, fifth wheel or gooseneck as required:
Enter Gross Vehicle Weight Rating (GVWR) as provided by trailer manufacturer: ____________
(Required when towing package is acquired (standard or optional) for trailer towing)
Is trailer equipped with electric brakes?
Yes
No
(Trailer brake controller is recommended for trailers weighing more than 1500 lbs. when loaded)
Towing Utilization:
Local
Statewide
Vehicle Utilization Environment: Paved road:
Yes
No
Off-road:
Yes
No
(Requires detailed Off-road utilization description)
Detailed Off-road utilization description:
Enter agency performance needs in the categories identified below.
Max. Load
% of Time Load
Max Number of
% of Time
Carried
Max Towed Load % of Time Towed
Carried
People Carried
People Carried
(Payload)
• Payload = Cargo Weight (Includes Optional Equipment and Trailer Tongue Weight (10-15% of loaded trailer if applicable), +
Passenger Weight. 5
th
-wheel trailers, king pin weight is 15-25% of loaded trailer weight. Note: Payload is always deducted from
Manufacturers stated Maximum Towing Capacity to ensure safe trailering.
• All Manufacturers stated Maximum Towing Capacity can only be achieved with a weight distribution hitch supporting
manufacturer tongue weight limitations.
• Weight Carrying Hitches have limitations. Refer to manufacturers towing guide for specifications.
• Gross Vehicle Weight Rating (GVWR) is the maximum allowable weight of the fully-loaded vehicle (including passengers and
cargo).
3
DMS FORM MP6301
Revised 2016
DMS Fleet Management
Request for Acquisition of Motor Vehicle(s) and Mobile Equipment
• The Gross Vehicle Weight (GVW must never exceed the GVWR). Stated on Safety Compliance Certification Label on inside of
vehicle driver door jam.
• Gross Vehicle Weight (GVW) = Base Curb Weight + Cargo Weight + Passenger Weight + Trailer Tongue Weight
F. DESCRIPTION OF REPLACED MOTOR VEHICLE(S) AND MOBILE EQUIPMENT
All applicable fields must be completed. FLEET
Equipment Number: _______________________
Year: ________________
Make: __________________
Type
Model: __________________________________
: ___________________
(Sedan, SUV, Van, Pickup, etc.)
VIN or S/N: ___________________________ Odometer: ___________
Hour Meter: _____________
Supporting documentation must be attached to the purchase requisition for needed mechanical or body repair damage
that exceeds the fair market value for replaced equipment which doesn’t meet the DMS Minimum Equipment Replacement
Criteria for Automobiles, Light Trucks =<1TON, Buses, Motorcycles, Watercraft, Aircraft and other vehicles designed
primarily for transporting persons.
Wrecked vehicles not meeting the DMS Minimum Equipment Replacement Criteria require a copy of the law enforcement
accident report, body repair estimate or insurance letter validating vehicle condition as (Totaled) unless already approved
for surplus as disposed in FLEET.
G. AUTHORIZATION INFORMATION OF APPROVER OR DELEGATE
Contact Name: ___________________________________
Phone: ________________________
Address: ________________________________________
City: _______________________
Zip: ______________
Authorized Signature:
Authorized signature certifies that the above information is true and correct.
FAILURE TO COMPLETE ALL APPLICABLE SECTIONS AND INPUT CURRENT FLORIDA EQUIPMENT ELECTRONIC TRACKING (FLEET)
SYSTEM DATA WILL DELAY PROCESSING OF THIS REQUEST.
4
DMS FORM MP6301
Revised 2016
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