Proposed Project Title: _

Transcription

1 REQUEST FOR CAPITAL PROJECT OR FEASIBILITY STUDY UNIVERSITY OF ILLINOIS SPRINGFIELD CAMPUS Proposed Project Title: _ Building Name and Number: Room Number(s): Project Description/Scope of Work/Floorplan (add additional pages if required): Approximate Square Footage affected by project Scope of Work: Will this project add gross square footage to the facility: No Yes How much added square footage? Proposed CFOP (Line of Accounting): Feasibility Cost Estimate (See Feasibility Rate Scale per GSF): Project Cost Estimate (See Total Project Budget/GSF Rate Scale): Project Type (Select from Options Below): New Building Building Addition Master Plan Proposed Schedule (month, year): Campus Approval Site Work Utilities Improvements Remodeling Start Finish Other Construction Feasibility Study Planning Project Approval Architect / Engineer Selection Feasibility / Conceptualization Design Bid / Award Construction

2 Proposed Source of Funds (select all that apply): Dept./Institutional Funds AFS R & R Federal State Funds Gift/Grant Funds Other (please specify) Required Attachments: a. Academic Program Statement (need and expected contribution to educational services) b. Relationship to Mission and Long Range Planning (relevance to Campus Strategic Compass) c. Alternatives considered d. Existing and projected: (1) Personnel; (2) Student Enrollment; (3) Student Contact Hours; (4) Research Funding e. Summary of existing space inventory f. Donor feasibility (Associate Chancellor for Advancement) Requesting Individual: Dept.: Phone: Approved by: Department Head (signature) Dean/Director/Division Head (signature) $80k-$250k Vice Chancellor or Provost (signature) $250k+ Delegated Authority Limits, Definitions, Instructions, and Rate Guidelines Capital Projects have a Total Project Budget of $80K or greater. Non Capital Projects should be submitted through SchoolDude at Campus Approval: By obtaining the required signatures, per the levels noted above, the requesting Unit may proceed with the project development process through the campus construction unit headed by the Associate Chancellor of Administrative Affairs, Facilities and Services. New Buildings, Major Additions, or Total Renovations will require additional campus review and approval prior to proceeding with project development. Electronically forward completed form and required attachments to the Director of Construction at: kstew6@uis.edu Project Approval: Board of Trustee (BOT) delegated approval will proceed following project development, acceptance of prepared Program Statement and receipt of executed funding commitment.

3 INDIVIDUAL SPACE CRITERIA SHEET Space Name: Typical Occupancy (Head count): Space Requirements 1. Primary Function/Utilization of the space: 2. Size of the Space: a. Ceiling Height (minimum): i. b. Minimum Dimensions: i. Length: ii. Width: 3. Finish Materials: a. Floor: b. Walls: c. Ceiling: d. Acoustics: e. Signage: f. Door Size (minimum): 4. Special Heating/Cooling and Ventilating Requirements: a. Heating/Cooling (e.g. must maintain X temp): b. Ventilating (Min # of air changes per hour or exhaust hood CFM): c. Humidity (50% is typical): d. Plumbing (Water, sewer, compressed air, etc.): 5. Utility Requirements: a. Special Drains or Traps: b. Uninterrupted Power Supply Required (Y/N): 6. Fire Protection: a. Required (Y/N): b. Proposed System type (Dry/Wet/Halon):

4 7. Electrical: c. Fire Alarm: d. Fire Rated Partitions or Walls: a. Proposed # of Power Outlets: b. Special Power Requirements: i. Dedicated ground outlet required: ii. Isolated ground outlet required: iii. 220V/480V or Other Power required: iv. Special Lighting Controls Warranted: v. Daylight required: 8. Communications: a. LAN: b. Telephone: c. PA System: d. TV/Monitor: e. CCTV: 9. Security: f. Projector/Screen: g. Other: a. Key Lock: b. Key Pad (Electric): c. Access Control System (icard): d. Intrusion Detection System: e. Security Cameras: 10. Applicable Regulations, Codes, or Occupational Practices: 11. Equipment: Fixed and Moveable equipment should be itemized on the equipment list. If additional explanatory information is required, please attach as appropriate. a. EQUIPMENT LIST:

5 These rates are to be used for budgeting purposes only: Feasibility Rate Scale Low High Average Feasibility Studies/GSF $2.50 $4.00 $3.25 Utility/GSF Rate Scale Average Escalation Rate per year Offices $ % Classrooms $3.00 Research Labs $ % Libraries/Museums $ % O&M/GSF Rate Scale Average Escalation Rate per year Offices $ % Classrooms $5.24 Research Labs $ % Libraries/Museums $ % Total Project Budget/GSF Low High Average Escalation Rate per year Rate Scale Offices/Classrooms new space $300 $440 $ % remodeled space Varies $400 $ % Research Labs new space $500 $850 $ % remodeled space $350 $700 $ % Libraries/Museums new space $300 $600 $ % remodeled space $200 $500 $ % Form Approved by Associate Chancellor of Administrative Affairs, Facilities and Services November 2017 (For office use only) Date Received: Planner/Project Manager Assigned: Date Assigned: Project Number: Feasibility Studies and Projects greater than $1M: copy of executed documents distributed to all CCU members Revised November 2017