I just installed one of these on my 2009 cab. I backed up on some ramps for a little more room. I can recommend actually having the recommended tools on-hand, as there ends up being a reason for them!

I found I had to enlarge the holes more than the instructions called for to be able to get the carriage bolt heads in. I was apprehensive about the fishwire techniques in the instructions, but found it VERY easy.
Overview- this hitch has three bolts/side. The back bolts are already there.... need to be removed and reinstalled (12 point socket MUST be used!). One of the middle holes is there, but the other needs to be drilled and both enlarged sufficiently to wiggle in carriage bolts and backing plates. The front holes are already there. Once the holes are prepared, you use the fish wires supplied to pull carriage bolts from the enlarged middle holes to the front holes (easier than it sounds). Then you fish-wire carriage bolts into the middle holes.... and you're ready to hang the hitch!
Haven't wired it up yet, though.
Mike