Traffic Operations Approved Product Evaluation Form

PRODUCT TRADE NAME

Product Trade Name *

BUILD AMERICA BUY AMERICA

Is this product BABA compliant?

Yes
No

MANUFACTURER

Manufacturer *

Subsidiary of

Manufacturer Corporate Address *

Manufacturing Location *

Address to be listed on the TOAPL *

Corporate
Manufacturing Facility

Manufacturer Phone Number *

Manufacturer E-Mail Address *

Manufacturer Contact Person *

Contact's Phone *

Contact Person's Title *

Contact's Location *

PRODUCT REPRESENTATIVE

Product Representative *

Distributor
Manufacturer's Employee
Other

If Other

Representative's Company Name *

Representative's Name and Title *

Representative's Address *

Representative's Email *

Representative's Phone Number *

PATENT

Product Patented *

Yes
No

Patent Applied For *

Yes
No

EXISTING PRODUCT UPDATE

Will this product replace an existing approved product from your company listed on this TOAPL? *

Yes
No

If yes, existing product name(s)

Why is product being replaced?

Discontinued
New Version/Update
Other

If Other

DOCUMENTATION

Documentation

DATA CONSENT

Consent for storing submitted data *

Yes, I give permission to store and process my data