Forms
Instructions for Filling Out Online Forms
The following official forms are used by Caltrans personnel while administering construction projects. They are also used by contractors, subcontractors, and suppliers to meet contract requirements. All forms listed on this page are linked to Caltrans Electronic Forms System (CEFS).
CEFS requires a specific plug-in that makes the PDF documents dynamic (enables expanding and scripting features).
Microsoft Edge Settings:
- Go to the Microsoft Edge settings and select "Cookies and site permissions."
- Under "Site permissions," click on "PDF documents."
- Turn on "Always download PDF files." Note: You may need to restart Edge (close and open the browser) to see results.
Note: If you cannot download pdf securely: Click ⋯ (Settings and more) > Settings > Cookies and site permissions and scroll down to and click on "Insecure content" in the list of permissions. Use the Add button to enter the URL of the site you're trying to download from.
Windows Settings:
- In the Start menu type in "Default apps."
- Open the "Default apps" page and go to "Choose default apps by file type."
- Scroll down to ".pdf" and change the default to "Adobe Acrobat DC" or "Adobe Acrobat Reader DC" (whichever is listed on computer).
For further information about the application of specific forms, please refer to Section 5-1, "Project Records and Reports," of the Construction Manual (PDF)
Accessibility Assistance: Caltrans makes every attempt to ensure our documents are accessible. Due to variances between assistive technologies, there may be portions of this document which are not accessible. Where documents cannot be made accessible, we are committed to providing alternative access to the content. Should you need additional assistance, please contact us at (916) 654-2852 (and/or a division contact) or visit https://dot.ca.gov/request-ada-compliant-documents.
Division of Construction Forms
If you are looking for a form that doesn't appear on this page, visit CEFS.
- Form DOT CEM-0101, Resident Engineer’s Report of Assignment (PDF)
- Form DOT CEM-0501, Relief from Maintenance (PDF)
- Form DOT CEM-0602, Project Safety Program Statement (PDF)
- Form DOT CEM-0603, Major Construction Incident Notification (PDF)
- Form DOT CEM-0604, Project Safety Review or Meeting (PDF)
- Form DOT CEM-0606, Construction Safety Checklist (PDF)
- Form DOT CEM-1201, Subcontracting Request (PDF)
- Form DOT CEM-1202A, Contractor Action Request-Change of Name/Address (PDF)
- Form DOT CEM-1202B, Contractor Action Request-Assignment of Contract Monies, Assignee Change of Name/Address (PDF)
- Form DOT CEM-1203, Contractor Action Request-Assignment of Contract Performance (PDF)
- Form DOT CEM-1211, Renewable Diesel Report (PDF)
- Form DOT CEM-1301, Construction Work Zone Speed Limit Reduction Determination (PDF)
- Form DOT CEM-1302, Construction Work Zone Positive Protection Determination (PDF)
- Form DOT CEM-1303, Positive Work Zone Protection Supplement (PDF)
- Form DOT CEM-1901, Burial Location of Soil Containing Aerially Deposited Lead (PDF)
- Form DOT CEM-1902, Burial Location of Soil Containing Naturally Occurring Asbestos (PDF)
- Form DOT CEM-1903, Burial Location of Soil Containing Aerially Deposited Lead (Topographic Survey) (PDF)
- Form DOT CEM-1904, Agreement Between a Contractor Working on State Facilities and a Real Property Owner for Disposing Construction Related Material on Commercial Zoned Property Owner’s Property (PDF)
- Form DOT CEM-1906, Agreement Between a Contractor Working on State Facilities and a Real Property Owner for Disposing Construction-Related Material Suitable for Use on Residential Zoned Property (PDF)
- Form DOT CEM-2101, COZEEP Daily Report (PDF)
- Form DOT CEM-2102, COZEEP/MAZEEP Task Order (PDF)
- Form DOT CEM-2103, COZEEP/MAZEEP Cancellation Form (PDF)
- Form DOT CEM-2210, Traffic Control Daily Report (PDF)
- Form DOT CEM-2301, Temporary Pedestrian Access Route Compliance Inspection Report (PDF)
- Form DOT CEM-2302, Temporary Pedestrian Access Route Weekly Inspection Report (PDF)
- Form DOT CEM-2303, Temporary Pedestrian Access Route Sidewalk Detour Inspection Report (PDF)
- Form DOT CEM-2311, Temporary Pedestrian Access Route Contractor Compliance Report (PDF)
- Form DOT CEM-2312, Temporary Pedestrian Access Route Contractor Weekly Report (PDF)
- Form DOT CEM-2402F, Final Report—Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subcontractors (PDF)
- Form DOT CEM-2402S, Final Report—Utilization of Disabled Veteran Business Enterprises (DVBE), State-Funded Projects Only (PDF)
- Form DOT CEM-2403(F), Disadvantaged Business Enterprises (DBE) Certification Status Change (PDF)
- Form DOT CEM-2404(F), Monthly DBE/UDBE Trucking Verification (PDF)
- Form DOT CEM-2406, Monthly Disadvantaged Business Enterprise (DBE) Payment (PDF)
- Form DOT CEM-2407, Disadvantaged Business Enterprises (DBE) Joint Check Agreement Request (PDF)
- Form DOT CEM-2410, Disadvantaged Business Enterprise Commercially Useful Function Evaluation (PDF)
- Form DOT CEM-2411, Disadvantaged Business Enterprise Commercially Useful Function Corrective Action Plan (PDF)
- Form DOT CEM-2415, Commercially Useful Function Monitoring Review Contractor, Subcontractor, Trucker (PDF)
- Form DOT CEM-2416, Commercially Useful Function Monitoring Review Regular Dealer / Manufacturer / Broker (PDF)
- Form DOT CEM-2417, Commercially Useful Function Monitoring Review Professional Services (PDF)
- Form DOT CEM-2421, Disadvantaged Business Enterprise (DBE) Replacement Plan (PDF)
- Form DOT CEM-2500, LCPtracker Vendor Request (PDF)
- Form DOT CEM-2501, Fringe Benefit Statement (PDF)
- Form DOT CEM-2502, Contractor or Subcontractor Payroll (PDF)
- Form DOT CEM-2503, Statement of Compliance (PDF)
- Form DOT CEM-2504, Employee Interview: Labor Compliance / EEO (PDF)
- Form DOT CEM-2504SP, Entrevista de Empleado: Cumplimiento Laboral /IOE (PDF)
- Form DOT CEM-2506, Labor Compliance Wage Violation (PDF)
- Form DOT CEM-2507, Labor Violation: Case Summary (PDF)
- Form DOT CEM-2508, Contractor Payroll Source Document Audit Summary (PDF)
- Form DOT CEM-2509, Checklist—Source Document Audit (PDF)
- Form DOT CEM-2513, Weekly Report of Job Site Labor (PDF)
- Form DOT CEM-2601, Construction Progress Chart (Oversight Projects) (PDF)
- Form DOT CEM-2701, Weekly Statement of Working Days (PDF)
- Form DOT CEM-2702, Overrun in Contract Time (PDF)
- Form DOT CEM-3006, Mix Design for Partial Depth Recycling (PDF)
- Form DOT CEM-3101, Notice of Materials to Be Used (PDF)
- Form DOT CEM-3102, Contractor-Property Owner Material Acquisition Agreement (PDF)
- Form DOT CEM-3501, Hot Mix Asphalt Production Report (PDF)
- Form DOT CEM-3502, Hot Mix Asphalt Placement Report (PDF)
- Form DOT CEM-3503, Post Plant Gradation Correction Factor for Hot Mix Asphalt (PDF)
- Form DOT CEM-3504, Post Plant Gradation Correction Factor for Hot Mix Asphalt with Recycled Asphalt Pavement (PDF)
- Form DOT CEM-3511, Contractor Job Mix Formula Proposal (PDF)
- Form DOT CEM-3512, Contractor Hot Mix Asphalt Design Data (PDF)
- Form DOT CEM-3512P, Contractor Hot Mix Asphalt Design Data—PILOT (PDF)
- Form DOT CEM-3513, Caltrans Hot Mix Asphalt Verification (PDF)
- Form DOT CEM-3513P, Caltrans Hot Mix Asphalt Verification—PILOT (PDF)
- Form DOT CEM-3514, Contractor Job Mix Formula Renewal (PDF)
- Form DOT CEM-3514P, Contractor Job Mix Formula Renewal—PILOT(PDF)
- Form DOT CEM-3701, Test Result Summary (PDF)
- Form DOT CEM-3702, Relative Compaction Summary (PDF)
- From DOT CEM-3703, Caltrans Production Start-Up Evaluation (PDF)
- Form DOT CEM-3736, Pavement Smoothness Inertial Profiler Submittal Record (PDF)
- Form DOT CEM-3736AC, Asphalt Concrete Pavement Smoothness Corrections Information (PDF)
- Form DOT CEM-3736C, Concrete Pavement Smoothness Corrections Information (PDF)
- Form DOT CEM-3801, Request for Assignment of Inspectors, Samplers, and Testers (PDF)
- Form DOT CEM-3802, Quality Control Inspector Affidavit of Proficiency (PDF)
- Form DOT CEM-3803, Daily Summary of Quality Control Testing (PDF)
- Form DOT CEM-3803P, Daily Summary of Quality Control Testing - PILOT (PDF)
- Form DOT CEM-3804, Hot Mix Asphalt Inspection and Testing Summary (PDF)
- Form DOT CEM-3804P, Hot Mix Asphalt Inspection and Testing Summary - PILOT (PDF)
- Form DOT CEM-3810, Construction Grade Checking Report (PDF)
- Form DOT CEM-4101, Materials Release Summary (PDF)
- Form DOT CEM-4102, Material Inspected and Released on Job (PDF)
- Form DOT CEM-4201, Material Plant Quality Program Certification Request (PDF)
- Form DOT CEM-4202, Material Plant Safety Checklist (PDF)
- Form DOT CEM-4204S, Material Plant Quality Program Sticker (PDF)
- Form DOT CEM-4401, Solid Waste Disposal and Recycling Report (PDF)
- Form DOT CEM-4403, Recycled Materials Report (PDF)
- Form DOT CEM-4410, Crumb Rubber Usage Report (PDF)
- Form DOT CEM-4501, Resident Engineer’s Daily Report or Assistant Resident Engineer’s Daily Report (PDF)
- Form DOT CEM-4601, Assistant Resident Engineer’s Daily Report (PDF)
- Form CEM-4701, Drainage System Summary (PDF)
- Form DOT CEM-4801, Quantity Calculations (PDF)
- Form CEM-4900, Change Order (PDF)
- Form DOT CEM-4901, Change Order Input (PDF)
- Form DOT CEM-4902, Extra Work Bill (Short Form) (PDF)
- Form DOT CEM-4902A, Extra Work Bill—Title Page (PDF)
- Form DOT CEM-4902B, Extra Work Bill—Labor Charges (PDF)
- Form DOT CEM-4902C, Extra Work Bill—Equipment Charges (PDF)
- Form DOT CEM-4902D, Extra Work Bill—Material Charges (PDF)
- Form CEM-4903, Change Order Memorandum (PDF)
- Form DOT CEM-4904, Caltrans Authorization for Using Internet Extra Work Bill System (PDF)
- Form DOT CEM-4905, Contractor Authorization for Using Internet Extra Work Bill System (PDF)
- Form DOT CEM-4906, Internet Extra Work Bill (iEWB) User Account Request Form (PDF)
- Form DOT CEM-4907, Tentative Daily Extra Work Agreement (PDF)
- Form DOT CEM-4910, Value Engineering Change Proposal Submittal (PDF)
- Form DOT CEM-4911, Value Engineering Change Proposal Acceptance / Rejection (PDF)
- Form DOT CEM-5101, Request for Payment for Materials on Hand (PDF)
- Form DOT CEM-5105, Materials on Hand Summary (PDF)
- Form DOT CEM-5500, Partnering Facilitator Registration (PDF)
- Form DOT CEM-5501, Partnering Facilitator Evaluation - Kick-off (PDF)
- Form DOT CEM-5502, Partnering Facilitator Evaluation - Closeout (PDF)
- Form DOT CEM-5773, Americans with Disabilities Act (ADA) Project Compliance Certification (PDF)
- Form DOT CEM-5773ADE, Curb Ramp (Case A, D, or E) Americans with Disabilities (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773B, Curb Ramp (Case B) Americans with Disabilities (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773C, Curb Ramp (Case C) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773CH, Curb Ramp (Case CH) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773CM, Curb Ramp (Case CM) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773DW, Sidewalk at Driveway Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773FG, Curb Ramp (Case F or G) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773NSPL, Curb Ramp (Non-Standard Plan - Parallel) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773NSPP, Curb Ramp (Non-Standard Plan - Perpendicular) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773P Parking Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773PW Passageway Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5773SW, Sidewalk Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5803A, Electrical System Inspection Checklist (PDF)
- Form DOT CEM-5803B, Detector Loop Inspection Checklist (PDF)
- Form DOT CEM-5819A, Cable Verification Worksheet (PDF)
- Form DOT CEM-5819B, Segment Verification Worksheet (PDF)
- Form DOT CEM-5819C, Link Loss Budget Worksheet (PDF)
- Form DOT CEM-6004, Contract Transactions Input (PDF)
- Form DOT CEM-6200, Candidate Application for Dispute Resolution Board (DRB) Member/Dispute Resolution Advisor (DRA) (PDF)
- Form DOT CEM-6201D, Initial Potential Claim Record (PDF)
- Form DOT CEM-6201E, Supplemental Potential Claim Record (PDF)
- Form DOT CEM-6201F, Full and Final Potential Claim Record (PDF)
- Form DOT CEM-6202, Dispute Resolution Board (DRB)—Establishment Report (PDF)
- Form DOT CEM-6203, Dispute Review Board Update Report (PDF)
- Form DOT CEM-6204, Dispute Resolution Board (DRB)—Dispute Meeting Report (PDF)
- Form DOT CEM-6205, Dispute Resolution Board (DRB)—Completion Report (PDF)
- Form DOT CEM-6206, Dispute Resolution Advisor (DRA)—Establishment Report (PDF)
- Form DOT CEM-6207, Dispute Resolution Advisor (DRA)—Dispute Meeting Report (PDF)
- Form DOT CEM-6208, Dispute Resolution Ladder Establishment (PDF)
- Form DOT CEM-6209, Elevation of a Dispute (PDF)
- Form DOT CEM-6210, Alternative Dispute Resolution - Progress Meeting Report (PDF)
- Form DOT CEM-6214, Dispute Resolution Chargeable Hours Authorization (PDF)
- Form CEM-6220, Dispute Resolution Board (DRB) Member/Dispute Resolution Advisor (DRA) Resume
- Form DOT CEM-6301, Contract Acceptance (PDF)
- Form DOT CEM-6302, Final Materials Certification (PDF)
- Form CEM-9001, Construction Manual Proposed Change (PDF)
- Form DOT LA-17, Report of Chemical Spray Operations (PDF)
- Form DOT OFG-1, Oversight Engineer's Preconstruction Checklist (PDF)
- Form DOT OFG-2, Local Agency and Oversight Engineer PreConstruction Conference Checklist (PDF)
- Form DOT OFG-3, Local Agency Resident Engineer Contract Provisions Checklist (PDF)
- Form DOT OFG-4, Oversight Engineer's Construction Contract Administration Verification Checklist (PDF)
- Form DOT OFG-5, Federal-Aid Projects of Division Interest (PDF)
- Form DOT OFG-6, Final Acceptance Checklist for Caltrans Oversight Projects (PDF)
- Form STD-204, Payee Data Record (PDF)