Revised 08/22/14
“USE ON MANUFACTURER’S LETTERHEAD”
MATERIAL CERTIFICATION
FLORIDA D.O.T.
BRIDGE BEARING PADS
Material Number (535)
Lot Number:
Bearings in Lot:
Plain, Fiber Reinforced, or Elastomeric:
Manufacturer:
D.O.T. Project Number (FIN):
D.O.T. Contract Number:
Project Location:
We certify that the product listed above meets the requirements of the Florida D.O.T. and
Section 932-2.6 of the Contract Specifications. Each of the bearings in this lot was
manufactured in a reasonably continuous manner from the same batch of elastomer and
cured under the same conditions. In addition, a certified copy of the independent
laboratory’s complete test results are attached to this certification.
Manufacturer Officer or
Designee:_____________________________
Signature:_________________________________
Date:_____________________________________
(Notarized)