EMPLOYEE'S NAME (Printed)

U S Department of Agriculture

Food Safety and Inspection Service

SEVERE WEATHER AND/OR TERRAIN NON-STANDARD GOVERNMENT OWNED VEHICLE (GOV) EQUIPMENT REQUEST

Introduction: In areas that experience long periods of severe weather and/or extreme terrain, FSIS will try to accommodate GOV drivers by approving non-standard 

GOV equipment. The approved equipment will be the most cost-effective option. The primary option is snow tires for the GOV. All-wheel and 4-wheel drive GOV's 

may be considered as a final resort.

Please provide a detailed description of your assignment and a justification of why non-standard GOV equipment is needed. The criteria for requesting snow tires or 

all-wheel /4 wheel drive vehicles can be found on the reverse side of this form. Please attach your justification to the completed form and provide it to your immediate 

supervisor. They will provide it to the District Office for review/approval/disapproval.

Note: Privately Owned Vehicles (POVs) may be utilized during occasional severe weather which does not meet the criteria for continued use of snow tires or non-standard 

GOV equipment. Reimbursement will be at the current mileage rate. Supervisors should be notified and approval received for each event.

TYPE OF NON-STANDARD EQUIPMENT BEING REQUESTED

I have reviewed the criteria set forth for requesting snow tires and meet the criteria. 

I have provided a justification with this request.

I have reviewed the criteria set forth for requesting an all-wheel/ 4-wheel drive vehicle and meet the criteria.

I understand that I will be responsible for storing the all weather tires/snow tires (off season) at my own expense. 

I have reviewed the criteria set forth for requesting snow tires and meet the criteria. 

I understand that the installation and removal will be done by a GSA approved tire vendor and that I will be reimbursed for the 

installation/removal of the tires by submitting the expense to the District Office on a SF-1164 for reimbursement if they do not 

accept the WEX Fleet credit card.

I am aware of all local, city, county and state laws regarding use of studded tires permitted on all parts of my assignment. 

http://drivinglaws.aaa.com/laws/studded-tires/

I have provided a justification with this request. 

A. I am requesting snow tires for use on my GOV. 

B. I am requesting studded snow tires for use on my GOV. 

C. I am requesting an All-Wheel drive or 4-Wheel drive GOV. Snow tires will not be effective in the area that I am assigned. 

EMPLOYEE'S SIGNATURE

SUPERVISOR'S NAME (Printed)

SUPERVISOR'S SIGNATURE

EXPLANATION / COMMENTS

CONCUR DO NOT CONCUR

DATE

DATE

DISTRICT MANAGER'S SIGNATURE

DISTRICT MANAGER'S NAME (Printed)

APPROVE DO NOT APPROVE

DATE

FSIS FORM 2450-10 (7/23/2012) 

I have provided a justification with this request. 

I understand that I will be responsible for providing inside storage for the all weather tires/snow tires (off season) at my 

own expense.

I understand that the installation and removal will be done by a GSA approved tire vendor and that I will be reimbursed 

for the installation/removal of the tires by submitting the expense to the District Office on a SF-1164 for reimbursement if 

they do not accept the WEX Fleet credit card.
Snow Tire Criteria: 

 

Snow is predicted in your immediate area on a regular basis (at least 2 weeks per month). 

Snow fall accumulation is over 3 inches per event.

Studded Tire Criteria: 

 

Severe weather is predicted on a recurring basis which includes severe icing (at least 2 weeks 

per month). Snow fall accumulations are over 6 inches per event. Mountainous or treacherous 

roads are used on a daily basis.

All Wheel / 4-Wheel Drive Vehicle Request Criteria: 

 

Severe weather is predicted on a daily basis during the winter season. Mountainous passages 

and severe terrain are utilized on a daily basis during the winter season.

FSIS 2450-10 (7/23/2012) REVERSE

CRITERIA FOR NON-STANDARD REQUESTS