Facilities Project Request Form Date(Required) MM slash DD slash YYYY School/Department(Required) Applicant(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Primary Contact/Designee for Project(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Contact/Designee Phone #Contact/Designee Email(Required) Project ExpensesIs the Total Cost of the Project Known?(Required) Yes No Enter the Project Total:(Required)Please enter a number from 1 to 500000.Approximate Project Cost:(Required) $1,000 or Less $5,000 or Less Cost Exceeds $10,000 Funding Source(Required) Grant/Bond Bill Budgeted Expense Capital Expense Other Specify funding source:(Required) Project DetailsProject Type(Required) Alter Existing Space/Area Construction of New Space/Area Installation of New or Upgraded Equipment Landscaping or Playground Other Specify project type:(Required) Project Description (Please provide a short description along with justification for the requested project. Please include any attachments pertaining to the proposed project.)(Required)Attachments (Please attach additional information that would assist the review of the proposed project, including: proposals quotes site plans, drawings, sketches, notices, ect.)Max. file size: 50 MB.Estimated Project Start Date(Required) MM slash DD slash YYYY Estimated Project End Date(Required) MM slash DD slash YYYY STOP: REMAINDER COMPLETED ADMINISTRATIVE OFFICE ONLY -- Scroll down to the end of the form and select "SUBMIT".Select to Begin Project Request Review Managing Director of Applicant Program/DepartmentDate(Required) MM slash DD slash YYYY Reviewing Managing Director -- By signing, the program/department's Managing Director is endorsing this project and certifying, that if approved, the project will be implemented in accordance with the final approval plan.(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Post Title Facilities ReviewSelect to Begin Facilities Project Request Review Director or Managing Director of FacilitiesFacility Approval(Required) Approved as Proposed, No Changes Needed Approved with Modifications Resubmit Proposal with Modifications Denied Review Comments:(Required) Additional Required Documents (If Needed) See attachment if checked. Document Attached Reviewer's Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Date Reviewed(Required) MM slash DD slash YYYY Finance ReviewSelect to Begin Finance Project Request Review Controller, Director, or Managing Director of FinanceFinance Approval(Required) Approved as Proposed, No Changes Needed Approved with Notifications Inclusion in Future Capital Projects Resubmit Proposal with Modifications Denied Review Comments:(Required) Additional Required Documents (If Needed) See attachment if checked. Document Attached Reviewer's Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Title(Required) Date Reviewed(Required) MM slash DD slash YYYY SLT ReviewSelect to Begin SLT Project Request Review CFO, CEO, and/or Chief overseeing applicant program/department.SLT Approval(Required) Approved as Proposed, No Changes Needed Approved with Notifications Inclusion in Future Capital Projects Resubmit Proposal with Modifications Denied Review Comments:(Required) Additional Required Documents (If Needed) See attachment if checked. Document Attached Reviewer's Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Suffix Title(Required) Date Reviewed(Required) MM slash DD slash YYYY Project Request VerdictVerdict(Required) Approved Denied Resubmit with Modifications Δ
