Florida Department of Transportation

Approved Product List (APL)

Request for Product Consideration

This completed application and attached product literature serves to request that the Florida Department of Transportation consider the product described herein for use on the streets and highways of the state. Submit one application for each product series.

Date Submitted:	PATH Application ID:

PRODUCT INFORMATION

Product Name:	Part#/Model/Series:

Company (to be listed on the APL):	Applicant:

E-mail:	Phone:

Proposed Use:

Benefits to FDOT:

Major Components of Device:

Unit Retail Price: $

Does product have current end of life schedule? If yes, please provide schedule.

For modifications to a product currently listed on the APL, provide the approval number:

For modified APL products, list and summarize all changes:

MANUFACTURING FACILITY INFORMATION

Manufacturer Name: _

Is manufacturing facility currently ISO 9001 certified?

Contact Person:	E-mail:

Manufacturer Address:	Phone:

City:	State/Province:

Zip:	Country:

Manufacturer Website:

The following product literature MUST be included with the submittal:

Manufacturer’s product specifications
Drawings and cut sheets
Product design change documents (for modifications to existing approved products)

By submitting this application, the applicant certifies that he or she has reviewed and agrees to comply with requirements of the Product Certification Handbook (https://www.fdot.gov/traffic/traf-sys/terl-pch.shtm).

Please submit this application via the Product Application Tracking History (PATH) website at https://fdotwp1.dot.state.fl.us/ApprovedProductList/Specifications