VEHICLE PACKET
FOR
MODIFIED MINIVANWITH RAMP
AND
PURPOSE BUILD VEHICLE (MV-1)
STATE OF MICHIGAN
Passenger Transportation
Version Date: 12/18/2018
Table of Contents
I. Introduction 3
II. Ordering Information 4
III. Accessible Passenger Floor Plans 5
IV. Title/Delivery Information & Post Delivery Audit 7
V. Acceptance/Inspection Checklist14
I. Introduction
Purpose
This packet contains vehicle ordering information and related forms for purchasing from the State Vehicle Purchasing Program.
Instructions
- Please read the Guidelines for State Vehicle Purchasing Program (available on the MDOT website) before ordering any vehicle. These Guidelines provide information, procedures, and a checklist to assist with a vehicle purchase.
- Contact the dealer under “Ordering Information” (section II)to order a vehicle.
- After receiving the vehicle, complete the Post Delivery Audit Work Sheets (section IV).
II. Ordering and Service Information
To order a vehicle, complete the separate New Vehicle Order Form (found on the MDOT State Vehicles & Contracts website under “Accessible Passenger Vehicles”. The form is a Microsoft Excel file and allows agencies to enter data while calculating costs.
Vehicle Type / Minivan with RampVendor / Mobility Transportation Services
Minivan State Vehicle Purchasing Program Contract No. / 071B5500138
Contract Period / 09/14/2015 - 09/13/2017
Funding Sources / 100% paid State and Federal except optional equipment purchased outside of the contract.
Order Contact / Dave Brown
42000 Koppernick, A3
Canton, MI 48187
(800) 496-4280
Fax: (734) 453-6708
Manufacturer / Braun
Vehicle Type / Purpose Build Vehicle (MV-1)
Vendor / Hoekstra Transportation Inc.
MV-1State Vehicle Purchasing Program Contract No. / 071B5500137
Contract Period / 09/14/2015 - 09/13/2017
Funding Sources / 100% paid State and Federal except optional equipment purchased outside of the contract.
Order Contact / Steve Bollin
3741 Roger B. Chaffee Memorial Drive
Grand Rapids, MI 49548
(616)389-1130
Fax: (616) 245-7736
Manufacturer / Mobility Ventures
State of Michigan Contacts
Department of Technology, Management and Budget / Yvon DufourPurchasing Operations
(517) 284-6996
E-mail:
MDOT / Jeff Turner
Office of Passenger Transportation
(517) 335-3282
Fax: (517) 373-7997
E-mail:
III. Accessible Passenger Vehicle Floor Plans
ModifiedMinivan
3+2 Modified Chassis Vehiclewith ramp and onedouble fold-awayseat (vinyl).
3+2 Modified Chassis Vehiclewith ramp –vinyl (less doublefold- awayseat).
Purpose Built Vehicle (MV-1)
- 3+2 PurposeBuilt Vehiclewith ramp – vinyl(less singlerearfacing seat).
- 3+2 PurposeBuilt Vehiclewith ramp – vinyl(with single rearfacing seat).
IV.TITLE/DELIVERY INFORMATION AND
POST DELIVERY AUDIT WORKSHEETS
DATE______
TRANSIT AGENCY______
CONTRACT NO.______FED I.D. # ______
TITLE INFORMATIONName of City, County, or Agency
Street Address (Post Office Box Not Acceptable)
City Zip Code
DELIVERY ADDRESS
Name of Operating Transit Agency
Street Address (Post Office Box Not Acceptable)
City Zip Code County
Contact Person Telephone Number
1
1
ATTACHMENT A-7
CHECKLIST
Contract # / VehicleDescriptionDealer / Manufacturer
Contract Term / Contract Admin.
Post DeliveryAudit
Item / CompletionDate / Initials
1 / Buy America Certification stating regulations are still being
met.
2 / BidCertification
2.1 / Vehiclesight inspection
2.2 / Vehicle road test
2.3 / Werethere11 ormorevehicles purchased? YesNo
2.4 / Ifyes obtainInspectors report
2.5 / Certification vehiclemeets bid specifications
2.5 / Federal MotorVehicleSafetyStandard'scertification
To be completed by transit agency
1
ATTACHMENTA-8
FEDERALMOTOR VEHICLE SAFETY STANDARDSCERTIFICATIONS
Check onethat applies:
The vehiclesproposedunder thiscontractaresubjecttothe FederalMotor Vehicle Safety Standards(FMVSS)issuedby theNationalHighwayTrafficSafety Administration (NHTSA)in part 571 ofthis title.
The vehiclesproposedunder thiscontractare notsubjecttothe FederalMotor Vehicle Safety Standards(FMVSS)issuedby theNationalHighwayTrafficSafety Administration (NHTSA)in part 571 ofthis title.
Asrequired by Title49oftheCFR,Part663–SubpartD,Ihavereceivedacopy ofthe manufacturer's self-certification information concerning these vehicles compliance with relevant Federal Motor Vehicle Safety Standards. I havehadthiscertificationinmy possession at both thepre-award and post-deliverystages oftheprocurement.
Post-DeliveryVehicleDescription
Manufacturer
AgencyContactName
Date
To be completed by transit agency
Vendor to provide Post-delivery FMVSS Certification
1
ATTACHMENTA-9
BUY AMERICA CERTIFICATION Post-Delivery
InAccordancewiththe"Buy America"regulationsadopted by theFederalTransit AdministrationonJanuary9,1991,Icertifythatthevehiclesdeliveredunderthiscontractare incompliance withthe requirementsof section165(b)(3),of the Surface Transportation AssistanceAct of1982,as amended,and theregulations of49 CFR661.11.
DateVehicleDescription
Dealer
Manufacturer
AgencyContact
Name
Position Title
To be complete by transit agency
1
ATTACHMENT A-10
BUY AMERICA POST-DELIVERY AUDIT
ComponentParts
Component / Supplier/Manufacturer / Address / Country ofOrigin / Costor%of Domestic Origin1
2
3
4
5
6
7
8
9
10
Vendor:
Vendor’s Signature:
PLEASEMAKEADDITIONALCOPIESIFNECESSARY
Completed by vendor – vendor can provide actual domestic content worksheet
1
ATTACHMENT A-11
BUY AMERICA POST-DELIVERY AUDIT
Sub-componentParts
Subcomponent / Supplier/Manufacturer / Address / Country ofOrigin / Costor%of Domestic Origin1
2
3
4
5
6
7
8
9
10
Vendor:
Vendor’s Signature:
PLEASEMAKEADDITIONALCOPIESIFNECESSARY
Completed by vendor – vendor can provide actual domestic content worksheet
1
ATTACHMENTA-12
BID SPECIFICATION AUDITCERTIFICATION Post-Delivery
Ihaveroadtestedandvisuallyinspectedthevehiclepurchased. Icertifythatthevehicle delivered underthis contract meets thecontract specifications usedforthis solicitation.
Therewerefewerthaneleven vehicles procured underthis solicitation.
Therewere eleven ormorevehicles procuredunderthis solicitation. Acopyof theinspector's report is attached.
DateVehicleDescription
Dealer
Manufacturer
Agency
ContactName
Position Title
To be completed by transit agency
1
1
V. Acceptance/Inspection Checklist
Accessible Passenger Vehicle Acceptance/Inspection Checklist can be found on Office of Passenger Transportation web site:
1