Material Source List Forms (501)-Processing and Approval Procedure

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2012 STANDARD SPECIFICATIONS FOR CONSTRUCTION - SECTION 105
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Material Source List Forms (501)-Processing and Approval Procedure

This revised process is not affecting the method of verifying and documenting material when the basis of acceptance is “test” or “tested stock”. Also, the requirements for documenting aggregate, bituminous, and concrete delivery tickets are not affected.

The processes outlined in this article can apply to active projects, as well as, projects yet to be audited; if reasonable assurance can be made that the certified material used with the pay items is as specified on the certification document.

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Process for Documenting Certified Materials in FieldManager

The following process remains in effect for documenting certified materials in FieldManager:

  1. When all components making up a pay item are certified from the same source, each component of the pay item is not required to be listed and associated in FieldManager and FieldBook. The relationship of the material to the pay item will be one to one, whenever this is the case. Example: If Guardrail Type B is the pay item, Guardrail Type B would also be the material associated with it, and would include the steel beams, posts, hardware, etc.
  2. When additional material components are certified from other sources, these components will be associated to the pay item, and only the sources will be verified and documented. The quantity approved of each of these certified material components will no longer need to be documented in FieldManager and FieldBook.
  3. Using the above guardrail example, if the wood products are certified from a different source than the steel products, the wood products would be associated with the pay item Guardrail Type B, and the source certifying the wood products would be identified. The assumption is then made that if the guardrail was completed according to the plans, then the proper quantities of all associated components were supplied.
  4. This does not relieve the construction/project engineer from verifying in the field that material quantities used are as specified by MDOT plans and procedures. This verification should be documented accordingly by means of IDR, or other project documentation.
  5. The construction/project engineer will check the material delivered to the project against the materials source list and/or FieldBook associations.
  6. When the basis of acceptance is “general certification” or “test data certification,” the construction/project engineer will verify that a signed certification has been sent to the project office, and document the source in FieldManager.
  7. When the basis of acceptance is “certification from an approved manufacturer/supplier,” the construction/project engineer will verify the source is listed in the Materials Source Guide and document in FieldManager. If the sources on the certification document provided to the project office does not agree with the materials source list submitted by the contractor, the construction/project engineer will require a revised materials source list.
  8. All materials certifications require a signature.
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Changes to the material Source List, Form 501, and Processing Procedures

The following changes were made to the Materials Source List and processing procedures:

  1. The Materials Source List, Form 501, was consolidated from seven forms into one generic form to be used for all types of materials.
  2. The certification statement by the paving contractor (currently on Form 501B), states that “The materials used in the hot mix asphalt (HMA) mixtures for this project are from the same sources as the materials used in developing the mix design and the bond coat is from an approved source”, has been removed from the revised form. After the approved mix design received from Lansing, the paving contractor is still required to provide the construction/project engineer with the same certification on a separate document along with signature.
  3. Signed materials source lists will be accepted by the construction/project engineer via regular mail, hand delivered, email, fax, or other electronic methods. Hand written original signatures are no longer required on Form 501 for the project files.
  4. The certification statement on the old Form 501 has been changed to read, “I understand that all materials to be incorporated in the work, when the basis is other than test, must be supplied by an approved source”, on the new Form 501.

Changes to Quality Assurance Procedures Manual

Section A-6 of the MDOT Materials Quality Assurance Procedures Manual is hereby deleted and replaced with the following: The manual will be revised at the next printing to reflect these changes:

Processing of Materials Source list (Form 501)

1. A completed and signed Materials Source List (Form 501) is a required project documentation, and required for payment of associated items of work. The Materials Source List is not a substitute for other required material quality control and quality assurance documentation.

1.1. The contractor must provide a completed and signed Materials Source List to the construction/project engineer in accordance with subsection 105.01 of the Standard Specification for Construction. The materials source list may be submitted at, or prior to the pre-construction meeting.
1.2. The contractor may submit the signed Materials Source List via regular mail, email, fax, or other electronic method.
1.3. The Materials Source List will include the following information as applicable:
  • Material name (general)
  • Specific product name (for specialty and/or QPL materials)
  • Specification reference (from Materials Source Guide)
  • Approximate quantity
  • Material type, size, class, etc.
  • Source of material including:
    • Name of manufacturer and /or supplier
    • Contanct information
    • Pit number (if applicable)
    • Location
1.4. If the source of material changes, the contractor must provide a revised Materials Source List to the construction/project engineer prior to the material being incorporated into the project.
1.5. Prime contractors are responsible for submission of the Materials Source Lists for all materials including their subcontractors.

2. The materials staff in the region may assist the engineer in determining the following:

2.1 Which items originate locally. Acceptance instructions will be referenced in the last column.
2.2 Whch items originated elsewhere will be sampled or inspected on the project.
2.3 Which items are to be supplied by sources with certification, QPL, or tested stock privileges, as listed in the current Materials Source Guide.

Procedural Changes in the Project Office

The same emphasis will be placed on the required use of the revised materials source list for materials documentation, and the sources listed there by the contractor as in the past. The construction/project engineer will follow the revised Section A-6 of the MDOT Materials Quality Assurance Procedures Manual, Processing of Materials Source List (Form 501). The revised materials source list forms will be the only form accepted by the construction/project engineer. The contractor must sign the Materials Source List acknowledging they understand that all materials to be incorporated in the work, when the basis is other than test, must be supplied by an approved source. A copy is attached, and also available on MDOT’s forms page.


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