P r o d u c t  S u b m i s s i o n  F o r m
To be completed by Suppliers

Transportation and Civil Engineering Division
Technical Standards Branch
2nd Floor, Twin Atria Building
4999 - 98 Avenue
Edmonton, Alberta T6B 2X3

New Product Evaluation Standing Committee
PRODUCT SUBMISSION FORM

This form must accompany all new product submissions to Alberta Transportation. Applicants should make every effort to provide the requested information as this data will be used by the New Product Evaluation Committee to assist in the initial review of the product. A letter of receipt will be issued as well as a status report following the initial appraisal.

* All Fields Are Required

1) Supplier Name:
Address:
City:
Province/State:
Postal/Zip Code:
Contact:
Telephone No.:
Facsimile No.:
       
2) Manufacturer Name
(if different supplier):  
Address:
City:
     
3) Product Name:
  
4) Briefly state the intended purpose of use of this product:
  
5) Is this product currently being used or under review by any other transportation agency? Yes No
 If Yes, explain:
  
6) Has this product been evaluated for environmental impact? Yes No N/A
If Yes, attach environmental studies (max. 5120 KB filesize).
  
7) Is this product WHMIS controlled? Yes No N/A
If Yes, attach MSDS (note: MSDS must conform to WHMIS standards) (max. 5120 KB filesize).
  
8) Does this product meet the requirements of a recognized specification agency (i.e., CSA, ASTM, CGSB, AASHTO)?  Yes No N/A
If so, state agency and specification number:
  
9) Have you attached all other information that you feel is relevant and will assist the Committee to appraise this product? Yes No N/A
    
    
Name:
Date:




After submitting this online form a confirmation screen will appear.
If it does not please contact Joe Filice at (780) 415-1022.