Material: Polycarbonate Other________________ □ □ Color: Black Yellow □ □ Illuminated Street Name Signs Manufacturer: Southern Mfg Other ___________________ □ □ Black Other ___________________ □ □ Blank Out Message Signs Manufacturer: M-Systems Inc. Other ___________________ □ □ Color: Black Other ___________________ □ □ Signal Pole Information: Type: Decorative Signal Pole Only Decorative Signal/Light Pole □ □ Standard Signal Pole Only Standard Signal/Light Pole □ □ Manufacturer: Union Metal Valmont Other________________ □ □ □ Material: Steel □ Shape: Round Fluted □ □ Finish: Galvanized Black Dk Green Dk Bronze □ □ □ □ Other ____________________ □ Mounting Height Choices: (No Lum), 30’, 35’, or 40’ Pole Length Choices: 20.5’ (No Lum), 27’ (for 30’ MH), 32’ (for 35’ MH) or 37’ (for 40’ MH) Pole Mounting Pole Length Bolt Circle Base Square Plate No. Height Diameter Dimensions Signal Pole Base Information: Type: Contour None □ □ □ □ Finish: Black Dk Green Dk Bronze □ □ □
Material: □ Polycarbonate □ Other________________ Color: □ Black □ Yellow Illuminated Street Name Signs Manufacturer: □ Southern Mfg □ Other ___________________ □ Black □ Other ___________________ Blank Out Message Signs Manufacturer: □ M-Systems Inc. □ Other ___________________ Color: □ Black □ Other ___________________ Signal Pole Information: Type: □ Decorative Signal Pole Only □ Decorative Signal/Light Pole □ Standard Signal Pole Only □ Standard Signal/Light Pole Manufacturer: □ Union Metal □ Valmont □ Other________________ Material: □ Steel Shape: □ Round □ Fluted Finish: □ Galvanized □ Black □ Dk Green □ Dk Bronze □ Other ____________________ Mounting Height Choices: (No Lum), 30’, 35’, or 40’ Pole Length Choices: 20.5’ (No Lum), 27’ (for 30’ MH), 32’ (for 35’ MH) or 37’ (for 40’ MH) Pole No. Mounting Height Pole Length Bolt Circle Diameter Base Square Plate Dimensions Signal Pole Base Information: Type: □ □ □ Contour □ None Finish: □ Black □ Dk Green □ Dk Bronze
V-19a.docx