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)
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 CEM-2402(F), 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 CEM-2403(F), Disadvantaged Business Enterprises (DBE) Certification Status Change (PDF)
- Form CEM-2404(F), Monthly DBE/UDBE Trucking Verification (PDF)
- Form CEM-2405, Disabled Veteran Business Enterprise (DVBE) Substitution Request to the Department of General Services (DGS) (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 CEM-2500, LCPtracker Vendor Request (PDF)
- Form CEM-2501, Fringe Benefit Statement (PDF)
- Form CEM-2502, Contractor or Subcontractor Payroll (PDF)
- Form 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 CEM-2507, Labor Violation: Case Summary (PDF)
- Form CEM-2508, Contractor Payroll Source Document Audit Summary (PDF)
- Form DOT CEM-2509, Checklist—Source Document Audit (PDF)
- Form CEM-2513, Weekly Report of Job Site Labor (PDF)
- Form 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-3101, Notice of Materials to Be Used (PDF)
- Form DOT CEM-3102, Contractor-Property Owner Material Acquisition Agreement (PDF)
- Form 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-3513, Caltrans Hot Mix Asphalt Verification (PDF)
- Form CEM-3514, Contractor Job Mix Formula Renewal (PDF)
- Form 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 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 CEM-3802, Quality Control Inspector Affidavit of Proficiency (PDF)
- Form CEM-3803, Daily Summary of Quality Control Testing (PDF)
- Form CEM-3804, Hot Mix Asphalt Inspection and Testing Summary (PDF)
- Form CEM-3810, Construction Grade Checking Report (PDF)
- Form CEM-4101, Materials Release Summary (PDF)
- Form DOT CEM-4102, Material Inspected and Released on Job (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 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 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 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 CEM-4904, Caltrans Authorization for Using Internet Extra Work Bill System (PDF)
- Form CEM-4905, Contractor Authorization To Use 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 CEM-4910, Value Engineering Change Proposal Submittal (PDF)
- Form CEM-4911, Value Engineering Change Proposal Acceptance / Rejection (PDF)
- Form DOT CEM-5101, Request for Payment for Materials on Hand (PDF)
- Form CEM-5105, Materials on Hand Summary (PDF)
- Form 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 CEM-5773B, Curb Ramp (Case B) Americans with Disabilities (ADA) Compliance Inspection Report (PDF)
- Form CEM-5773C, Curb Ramp (Case C) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form CEM-5773CH, Curb Ramp (Case CH) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form CEM-5773CM, Curb Ramp (Case CM) Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form 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 CEM-5773SW, Sidewalk Americans with Disabilities Act (ADA) Compliance Inspection Report (PDF)
- Form DOT CEM-5803A, Electrical System Inspection Checklist (PDF)
- Form CEM-5803B, Detector Loop Inspection Checklist (PDF)
- Form CEM-5819A, Cable Verification Worksheet (PDF)
- Form CEM-5819B, Segment Verification Worksheet (PDF)
- Form CEM-5819C, Link Loss Budget Worksheet (PDF)
- Form DOT CEM-6004, Contract Transactions Input (PDF)
- Form CEM-6200, Candidate Application for Dispute Resolution Board (DRB) Member/Dispute Resolution Advisor (DRA) (PDF)
- Form CEM-6201D, Initial Potential Claim Record (PDF)
- Form CEM-6201E, Supplemental Potential Claim Record (PDF)
- Form CEM-6201F, Full and Final Potential Claim Record (PDF)
- Form CEM-6202, Dispute Resolution Board (DRB)—Establishment Report (PDF)
- Form CEM-6203, Dispute Review Board Update Report (PDF)
- Form CEM-6204, Dispute Resolution Board (DRB)—Dispute Meeting Report (PDF)
- Form 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 CEM-6209, Elevation of a Dispute (PDF)
- Form DOT CEM-6210, Alternative Dispute Resolution - Progress Meeting Report (PDF)
- Form CEM-6214, Dispute Resolution Chargeable Hours Authorization (PDF)
- Form CEM-6220, Dispute Resolution Board (DRB) Member/Dispute Resolution Advisor (DRA) Resume
- Form CEM-6301, Contract Acceptance (PDF)
- Form CEM-6302, Final Materials Certification (PDF)
- Form CEM-9001, Construction Manual Proposed Change (PDF)
- Form LA-17, Report of Chemical Spray Operations (PDF)
- Form OFG-1, Oversight Engineer's Preconstruction Checklist (PDF)
- Form OFG-2, Local Agency and Oversight Engineer PreConstruction Conference Checklist (PDF)
- Form OFG-3, Local Agency Resident Engineer Contract Provisions Checklist (PDF)
- Form OFG-4, Oversight Engineer's Construction Contract Administration Verification Checklist (PDF)
- Form OFG-5, Federal-Aid Projects of Division Interest (PDF)
- Form OFG-6, Final Acceptance Checklist for Caltrans Oversight Projects (PDF)
- Form STD-204, Payee Data Record (PDF)