You must have JavaScript enabled to use this form. Applicant Information Trade name: Patented: - Select -YesNoApplied for Manufacture: Representative: Street Address Street Address Address 2 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP code Email: Materials Information Will samples be furnished for evaluation?: Yes No Can demonstration be provided?: Yes No Availability: Seasonal Non-Seasonal Delivery at site: For example: 5 days after approval. Are quantities limited?: Yes No Estimated cost per unit of application: For example: $1.00 per brick. Are you a registered metro vendor?: Yes No Can the product only be purchased by you?: Yes No Has another Metro department been contacted?: Yes No Explain: Has this product been evaluated, or is it currently being evaluated, by the National Transportation Product Evaluation Program (NTPEP)?: Yes No NTPEP Submittal and Report Number (if applicable): Product, materials, equipment or process identification: Recommended use and requested designation: General composition of material: Email Laboratory Report Where Applicable, and MSDS to [email protected] Does this product contain asbestos as defined in OSHA regulations 29 CFR 1926.1101?: Yes No List applicable specification which product, material, equipment, or process meets (select all that apply): AASHTO ASTM Federal Specification(s) TDOT Other List all agencies presently using or evaluating this product, include contact information: Additional Information If you have the following applicable information and materials available to substantiate, verify, or clarify the materials contents, submit the documents to [email protected] after submitting this application.SpecificationsDrawings, Sketches, PicturesWarrantyInstallation InstructionsMaterial Safety Data Sheet (MSDS)Product/Material LiteratureTest DataCertifications DISCLAIMER: This Approved Materials List assumes no liability on the part of Metro for the products included nor is it intended to promote any product, supplier, or manufacturer over another. This list does not guarantee that NDOT, or a NDOT contractor, will purchase or use the material, product, or engineered system. All applicable local, state, and federal laws still apply to procurement and purchasing of any product. Purchasing and Procurement: The list of approved materials, products, and engineered systems are subject to Metro Nashville procurement guidelines and regulations before purchase. These local guidelines can be found at Metro Finance Procurement website. Leave this field blank