Ohio Bid Award No. 248-10 Odot Inspection Sheet

OHIO BID AWARD NO. 248-10 ODOT INSPECTION SHEET

Vendor: Myers Equipment TESCO _____ Whitworth __

(LTN 10,500) (LTV 12,500 -14,500) (LTV 12, 500 or 14,500)

ODOT Inspection Date:_____ by ______

1. / Agency Name / ODOT P.O.
2. / ODOT Project Number
3. / State Term Invitation/Award No. / 248-10 / Light Transit Narrow Body
4. / Vehicle Manufacturer / Ford / Model / F-350 / Color / Year
5. / Vehicle Serial Number
Does serial number on door and VIN number in window match? Yes No
Does serial number begin with a 1? Yes No - Do not accept vehicle
Does vehicle have FMVSS sticker: Yes No, do not accept vehicle.
Vehicle Weight ______
6. / Mileage ______

Inspection Instructions: Place a check (√) next to all items that are in satisfactory condition. Place an “x” next to items that are deficient and explain problems further in the "Comments” section.

LIGHTING
____ Headlights / Turn signals
____ High beam
____ Low beam / ____ Front Right
____ Front Left / ____ Rear right
____ Rear left / ____ Backup lights
____ Brake lights
____ Hazard lights
____ Rear lights / ____ Rear warning signal / ____ 12 Volt outlet
____ Four ceiling lights in interior of building
_____ Horn
____ Automatic Transmission
____ Cruise Control
____ Vehicle height sign
COMMENTS:
MIRRORS
____ Interior Rearview mirror / ____ Left exterior review adjustable/remote heated mirror / ____ Right exterior rearview adjustable/remote heated mirror / ____ Right adj convex mirror
____ Left adj convex mirror
CLIMATE CONTROL
Windshield / Air Conditioning / Heating
____ Wipers
____ Intermittent feature
____ Washer / ____ Front A/C
____ Rear AC / ____ Front heater
____ Rear heater
____ High speed
____Low speed / ____ Radio/CD Player
____ Driver’s side sun visor
COMMENTS:
SEATS / Driver’s Seat
____ All seats same color / ____ Adjustable forward and backward
____” Seat Belt length / ____ Adjustable back seat
____Seats at least 25.5” between / ____ Seatbelt
____ Securely fastened to vehicle / ____ Left Armrest
_____ Aisle seats have armrests / ____ Right Armrest
____ Jump seats working properly
____ Three Step Fold-away Seats working properly
COMMENTS:
WINDOWS
____ Curbside Emergency Exit window _____ Opens / ____ Emergency Exit Window Sticker
____Street side Emergency Exit Window _____ Opens / ____Emergency Exit Window Sticker
____ Rear Emergency Exit Window or Door _____ Opens / ____ Emergency Exit Window Sticker
____ All windows open and close
COMMENT:
VEHICLE INTERIOR
_____ Interior panels composed of a uniform, easily cleanable, scuff resistant material
_____ Coved molding at junction of floor and sidewall panels
_____” Aisle width (Must be at least 12”)
_____” Floor to ceiling, (Must be at least 72”)
_____ Standee line in contrasting color
_____ Vertical Stanchion behind driver
_____ Rubber floor covering ______Nonskid floor covering
COMMENT:
TRANSIT ENTRYWAY
____ Door opens and closes
____ Two Steps / ____ Three steps (Flat Floor Vehicle)
____ Left hand rail / ___ Right hand rail / ____ 32” Clear entryway
___Width of Stairs30” / ___Height of Stairs 9” / ___First step12” off of ground
____ Rubber covered steps / ____ Slip Resistant
____ Lighted steps / _____ Contrast marking on edge of steps
____ Outer edges of door weather stripped / ___ Padded to protect passengers heads
____ Stanchion behind driver / ____ Modesty panel on curb side _
COMMENT:

½” tolerance on all measurements

MOBILITY SYSTEM
_____ Ricon ____ Count / Model______/ _____ Braun ___ Cnt / Model______
_____ Installed on curb side of vehicle
_____ Lift door has window
_____ Lights below lift / _____ Lights on right and left of lift
_____ Lift equipped with two handrails which move in tandem with lift
_____ Lift deploys / _____ Lift folds
_____ Padded to protect passengers heads
_____ All components of lift mechanism inside vehicle when lift door is closed.
_____ Control Box / _____ Place to store control box
_____ Four point attachment system
_____ Tracks flush with floor
_____ Track distance (minimum 32”)
_____ Mobility aid positions 30” x 48”
_____ Provision for storage of belts and buckles when not in use
COMMENT:
EXTERIOR
_____ Front bumper / _____Rear Bumper / _____ Fuel tank outside passenger compartment
_____ Front license plate bracket / _____Rear tow hooks / _____ No rust on dents on any part of vehicle
_____ Driver’s side running board / _____ Rear license plate bracket / _____ Protective guard over driveshaft
_____ Vehicle accessibility symbol / _____ Exhaust discharges within 6” of rear of vehicle / _____ Dual batteries
Tires (Brand name and size) ______
_____Matching full size spare tire
_____ Standard driver’s door
_____ Heavy duty mud flaps on all tires
COMMENT:
SAFETY EQUIPMENT
_____ Triangles / _____ Metal First Aid Kit / _____ 5 lb fire extinguisher
_____ Two seatbelt cutters / ____ Bloodborne pathogens spill kit
COMMENT:
FLUIDS
_____ Oil / _____ Brake Fluid
_____ Transmission Fluid / _____ Antifreeze
_____ Windshield Fluid / _____ Power Steering Fluid
WARRANTIES
_____ Lift Warranty / _____ Tire Warranty / _____ Chassis Warranty / _____Rear AC Warranty
_____ Rear Heater Warranty / _____ Seat Warranty / _____ Securement System Video
COMMENT:

OHIO BID AWARD 248-10

Vendor: Myers Equipment TESCO _____ Whitworth __

Agency:

Items to be repaired before vehicle delivery

Agency:

Vin #

Items that need to be repaired before delivery:

______
______
______
______
______
______

OHIO BID AWARD 248-10

AGENCY DELIVERY RECEIPT

Received by Date

This paper should be delivered with agency delivery receipt. Sheet should be returned to ODOT with delivery receipt insuring all items have been repaired.

______

Receiving Agency Signature Date

OHIO BID AWARD 248-10

Agency: Brown County Senior Citizens

AGENCY DELIVERY RECEIPT

Received by Date Completed

Phone Number

1. / Agency Name / ODOT P.O.
2. / ODOT Project Number
3. / State Term Invitation/Award No. / 248-08
4 / Vendor Name / TESCO
5. / Vehicle Manufacturer / Ford / Model / F-350 / Color / Year
6. / Vehicle Serial Number
Does serial number on door and vin number in window match? Yes No
Does serial number begin with a 1? Yes No - Do not accept vehicle
Does vehicle have FMVSS sticker: Yes No, do not accept vehicle.
Vehicle Weight ______
7. / Company Delivering Vehicle / Driver’s Name
8. / Date Notified of Delivery / Delivery Date / Delivery Mileage

LIGHTING
____ Headlights / Turn Signals
____ High Beam
____ Low Beam / ____ Front Right
____ Front Left / ____ Rear Right
____ Rear Left / ____ Backup lights
____ Brake lights
____ Hazard Lights
____ Rear lights / ____ Rear warning signal / ____ 12 Volt outlet
____ Four ceiling lights in interior of building
_____ Horn
_____ Cruise control
____ Automatic Transmission
____ Vehicle height sign
COMMENTS:
MIRRORS
____ Interior Rearview mirror / ____ Left exterior review adjustable/remote heated mirror / ____ Right exterior rearview adjustable/remote heated mirror / ____ Right convex mirror
____ Left convex mirror
CLIMATE CONTROL
Windshield / Air Conditioning / Heating
____ Wipers
____ Washer
____ Intermittent Feature / ____ Front A/C
____ Rear AC / ____ Front Heater
____ Rear Heater
____ High Speed
____Low speed / ____ Radio/CD Player
____ Driver’s Side Sun Visor
COMMENTS:
SEATS / Driver’s Seat
____ All seats same Color / ____ Adjustable forward and backward
____ Jump Seats working properly / ____ Three Step Fold-away Seats working properly
COMMENTS:
WINDOWS
____ Curbside Emergency Exit window _____ Opens / ____ Emergency Exit Window Sticker
____Street side Emergency Exit Window _____ Opens / ____Emergency Exit Window Sticker
____ Rear Emergency Exit Window or Door _____ Opens / ____ Emergency Exit Window Sticker
____ All windows open and close
COMMENT:
MOBILITY SYSTEM
_____ Ricon Model ______/ _____ Braun Model ______
_____ Vendor demonstrated use of lift.
_____ Securement system video delivered
_____ Number of cycles on lift
_____ Storage system for securement devices
COMMENT:
EXTERIOR
_____ Accessibility symbol
_____ No rust on dents on any part of vehicle
_____ Full size spare tire
COMMENT:
SAFETY EQUIPMENT
_____ Triangles / _____ Metal First Aid Kit / _____ 5 lb fire extinguisher
_____ Two Seat belt cutters / ____ Bloodborne pathogens spill kit
COMMENT:
FLUIDS
_____ Oil / _____ Brake Fluid
_____ Transmission Fluid / _____ Antifreeze
_____ Windshield Fluid / _____ Power Steering Fluid
_____ ½ tank of fuel when delivered
TEST DRIVE
_____ Test Drive Completed Date ______
COMMENT:
WARRANTIES
_____ Lift Warranty / _____ Tire Warranty / _____ Chassis Warranty / _____Rear AC Warranty
_____ Rear Heater Warranty / _____ Seat Warranty
COMMENT:

OHIOBID AWARD NO. 248-10 ODOT VENDOR PERFORMANCE FORM

Vendor: Myers Equipment TESCO _____ Whitworth __

Agency Name______

ODOT Inspection Date: Inspector ______

OHIO DEPARTMENT OF TRANSPORTATION

OFFICE OF TRANSIT

Please Note: ODOT wants to meet the needs of its customers. This form will help us provide you with quality vehicles and serve you with quality, customer oriented vendors. Please complete and return this form to ODOT.

Please check all items that apply and sign. Use the comment section; positive comments are as valuable to us as your concerns. This is your chance to voice your opinions regarding the Vendor as well as ODOT.

VENDOR:
TESCO / Vehicle Type:
State Term Invitation/Award No. / ODOT Purchase Order: / Vehicle Serial Number:
Agency Name:
Contact Person: / Signature:
Title: / Phone:
Address:
Yes / No / N/A / Yes / No / N/A
DELIVERY – Did the vendor….
Contact you at least three weeks in advance to determine title language and delivery date?
Contact you at least three days in advance of delivery to set a specific time and location?
WARRANTIES/MANUALS - Did the Vendor provide the following?
Operator’s Manual / Wheelchair Lift Warranty
Vehicle Maintenance/Inspection Schedules
Vehicle Chassis Warranty / Vehicle Body Warranty
Tire Warranty
List of service representatives for vehicle and related equipment
Was an explanation provided for any other warranties? If yes, please list:
Yes / No / N/A
DEMONSTATIONS – Did the Vendor demonstrate use of the following?
Wheelchair Lift
Wheelchair Tie-Down System
Emergency Exit Windows/Hatch
Other Special Equipment (Please List):
Did the Vendor assist you in inspecting and test driving the vehicle?
TITLE WORK – Did the Vendor….
Obtain the needed signatures to process the title?
Provide you with a memorandum title?
Provide you with 30 day temporary tags?
Did the Vendor answer any and all questions regarding the vehicle and related equipment to your satisfaction? If not, please address in the comment section below.
COMMENTS: All comments negative and positive, long or short regarding the Vendor and/or ODOT. Attach additional sheets if needed.

Please submit to Pat Pikula, ODOT, Office of Transit, 1980 W. Broad Street, 2nd Floor, Columbus, OH43223.