General Information. Location Information. Location Use. Colorado VSPC/Drop-off/Drop-box Accessibility Survey Form. For SOS office use only

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Colorado VSPC/Drop-off/Drop-box Accessibility Survey Form Complete all sections of the survey below if you are using the site as a full VSPC and/or a drop off site. If you are using the site as a Drop Box only site, complete the information below up to Entering the VSPC. Indicate and describe any accessibility barriers and note continual or new barrier removal plans. To assist in recognizing and evaluating changes in accessibility, surveyors should also reference the initial ADA Checklist for Polling Places assessment for this location when completing this survey. Survey results must be filed with the Colorado Secretary of State s office no later than 90 days before the election. Scan and email the complete and signed survey to the Elections Division: State.ElectionDivision@sos.state.co.us For SOS office use only Date received: Comments: General Information Assessment date (mm/dd/yyyy): County: Surveyor s full name: Surveyor s signature: Location Information Location name: Street address (including city, zip code): Building owner/management company: Building representative name: Type of building: School Church Government Private Business Clubhouse Other (describe) Location Use Election Type : Primary General Coordinated Special Location Type (check more than one if applicable) Voter Service Polling Center Drop-off Site Drop-box Site SOS Election Rule 7.10 Page 1 of 5 Updated February 2018

Getting to the Polling Place/Drop-Box A. Parking Spaces t Applicable 1. Accessible spaces must connect to the shortest possible accessible route to the accessible building entrance or facility they serve. Is the minimum number of accessible parking spaces provided, based on the total number of available parking spaces? For your records, please record the following: Total number of spaces: Number of accessible parking spaces: Total Number of Parking Spaces for Polling Place Minimum Number of Required Accessible Parking Spaces 1-25 1 van-accessible space 26-50 1 space + 1 van-accessible space 51-75 2 spaces + 1 van-accessible space Total Number of Parking Spaces Provided in Parking Facility Minimum Number of Required Accessible Parking Spaces 76 to 100 4 101 to 150 5 151 to 200 6 201 to 300 7 301 to 400 8 401 to 500 9 501 to 1000 2 percent of total 1001 and over 20, plus 1 for each 100 over 1000 One of every six accessible parking spaces, or fraction thereof, must be vanaccessible. 2. If there is only one accessible parking space required, it must meet van accessible standards. Do van accessible spaces meet the minimum standard requirement? (132 minimum) 3. Are all-accessible parking spaces, including the access aisle, relatively level in all directions? 4. Is each accessible parking space marked with a parking sign displaying the International Symbol of Accessibility? 5. Do all accessibility signs identifying van parking spaces contain the designation van accessible? 6. Are all accessibility signs at least 60 inches above the finish floor or ground surface measured to the bottom of the sign? 7. If there is a curb between the access aisle and the accessible route to the building, is there a curb ramp that meets the minimum of 36? 8. Are the accessible parking spaces serving the voting area on the shortest accessible route to the accessible entrance? 9. Do all accessible parking spaces have adjacent access aisles that are a minimum of 60 wide, run the full length of the parking space(s) and are marked so as to discourage parking in them? B. Passenger Drop-off Areas. t Applicable 1. Is the passenger drop-off and loading area relatively level? 2. Is a 36 wide curb ramp provided between the vehicle pull up area and the access aisle or the access aisle and the accessible route to the accessible entrance? 3. Does an accessible route connect the curb ramp to the accessible entrance? C. Path of Travel SOS Election Rule 7.10 Page 2 of 5 Updated February 2018

1. Is an accessible route (36 minimum width) provided from accessible parking spaces to the accessible entrance of the building? 2. Is an accessible route free of breaks and edges and is clear of debris such as snow, ice and leaves, and lowhanging objects such as tree branches? 3. Where an accessible route crosses a curb, is a 36 curb ramp provided? 4. If part of the accessible route is on a slope, is an accessible ramp provided and in good condition? 5. If an accessible ramp is provided, is the slope no greater than 1 :12 or 8.3% grade? 6. If an accessible ramp is provided, is there a hand rail along the walking slope with 12 extensions at the beginning and end of the railing? 7. Are wall-mounted objects, that project into a pedestrian route from the side or that are overhead, located so that people who are blind or who have low vision will either detect the objects before they run into them or safely pass under them? (e.g., wall-mounted boxes, signs, handrail extension, trees, drinking fountains) 8. Are the undersides of exterior stairs enclosed or protected with a cane detectable barrier so that people who are blind or have low vision will not hit their heads on the underside? Drop-Box Accessibility D. Depositing the Ballot 1. n/a n/a n/a n/a Is there at least a 30 x 48 inch clear floor space for a side approach on the opening to the ballot box? 2. Is the opening/door/slot on the ballot box no higher than 48 inches from the ground? 3. Is the opening/door/slot on the ballot box within 10 inches of the accessible vehicular or pedestrian route? 4. If the ballot box has a door, does it take no more than 5 pound of force to operate? 5. If the ballot box has a door, can it be opened/closed or manipulated with one hand - without tight grasping, pinching, or twisting of the wrist? Or in other words can it be operated with a closed fist? SOS Election Rule 7.10 Page 3 of 5 Updated February 2018

Entering the VSPC E. Building Entrance 1. Is there at least one accessible entrance connected to an accessible route? 2. Is the door to the accessible entrance a minimum of 32 wide 2. Is the door hardware (e.g., lever, pull, panic bar) usable with one hand without tight grasping, pinching, or twisting of the wrist? Examples of handles and door hardware that can be used without tight grasping, pinching, or twisting. 3. Does it take more than 5# of push or pull to open the accessible door? 4. If there is an accessible door opener is it turned on and working properly? 5. If there is a threshold is it smooth and less than or equal to ½ high? F. Hallways, Corridors and Elevators 1. Is there an accessible route that connects the accessible entrance to the voting area? 2. If there are stairs to get to the voting area, is there an accessible elevator or lift available? 3. Is the elevator accessible? (The entrance to the elevator must be a minimum of 36 wide, the interior of the elevator must be a minimum of 54 wide and 80 deep. If the elevator is a minimum of 60 wide, an acceptable depth may be a minimum of 60. There may be other acceptable width and depth combinations, please review the 2010 ADA Standards Chapter 4 Section 407.4 or contact the Secretary of State s office.) 4. Are call buttons for the elevator a minimum of 54 above ground and a minimum of ¾ in diameter? 5. Are visible and audible signals provided at the entrance of the elevator car? The visible signals must be a minimum of 72 above the ground? (up and down arrows/indicators) 6. Are floor designations provided on the jambs of the elevator doorways entrances in 2 tactile characters and braille? These should be located below the visible floor designation. 7. At each location on the way to the voting area where the accessible route passes through any door, does at least one door meet the following requirements? n/a a. Is the door a minimum of 32 wide? b. Is the door hardware (e.g., lever, pull, push, panic bar) usable with one hand, without tight grasping, pinching, or twisting of the wrist? c. Is there clear maneuvering floor space in front and on the pull side of each accessible door? 8. Are pedestrian routes leading to or serving the voting area, smooth, free of objects that protrude from the side or overhead into the route? 9. If provided, are the interior stairs along these routes built so that people who are blind or visually impaired cannot hit their heads on the underside? n/a SOS Election Rule 7.10 Page 4 of 5 Updated February 2018

Using the Polling Place G. Voting Area 1. Is there an accessible entrance to the voting area that is a minimum of 32? 2. Within the voting area, is there a 36 inch path of travel for check-in tables, a voting demonstration (if provided), and at least one accessible voting station? 3. Is the voting area free of objects that protrude from the side or overhead? 4. Is the flooring smooth and slip resistant? (no carpet ripples, electrical cords, gaps or tripping hazards) Indicate and describe any changes in accessibility (improvements/barriers): Barrier removal solutions: SOS Election Rule 7.10 Page 5 of 5 Updated February 2018