Project #: University of Colorado Denver Facilities Projects Scope of Work Questionnaire Please review questionnaire, provide comments, and save the form. Project Manager Assigned: Overview Project Location: Building/Rm./Area: General Description of Project: Anschutz Medical Campus CU Denver Campus Drawings Attached? ilities Management Distribution tification of the Project and a request for feedback will be sent to the following people: Health & Safety Dave Turnquist Mike Barden and Ken Neeper (Projects) Jay Campbell (Facilities Operations) Vimol Mitchell and Jim Nelson (BMO) Dave Thorson (Engineering) Chris Jarecki (Code Official) Tom Sawyer (Fire & Life Safety) Diana Taipalus and Chimgeh Bataa (Finance and Administration) Carol Caulkins (Facilities Support Services) Todd Akey (State Buildings ministration and Finance Melissa Lemieux (Real Estate) Grace Reed (Space Acquisitions) Optional Recipients (select as needed): University Police Ethan Carter Doug Abraham Robin Brown (Electronic Security) Office of Information Technology Institutional Planning Rob Lee Betty Charles Grant Nixon Michael Del Giudice Andre Vite (University Architect)
Suzann Ruedeman (School of Medicine Facilities Director) Client (select name) sponse from SOW Review Group to the Project Manager: ponse will be anticipated within ten (10) business days from date of electronic distribution. sponse Instructions: Each comment should correspond to its respective question in the questionnaire. Responses are entered at the bottom of this form. ill a Permit be required? ill a 3rd-Party Code Review be required? ill DRB review be required? Project Information: t Sure t Sure t Sure This Questionnaire presents an overview of the proposed project and solicits reviewer comments which will enable the Project Manager to complete the scope of work. Anticipated Funds Available: Is the existing use of the project area changing? If "", describe how is the space/facility currently being used before and after completion? Is the number of persons in the area increasing/decreasing? (indicate # of persons) t Sure
Before: After: Outline the client's proposed schedule for the project; include the deadlines for the project deliverables: Will the project require exterior staging and/or parking Is this leased space? Will moving services and/or temporary storage of equipment and furniture during remodel be required? Architectural change? (see page 5) Mechanical (HVAC/Plumbing) change? (see page 6) Electrical Change? (see page 7) Health & Safety concerns? (see page 8) Will roadways, parking, and sidewalks be impacted? (see page 9) Additional Project Information Is there any electronic security required? (see page 10)
Will Information Technology be impacted? (see page 11) Will Education/Audio Support be impacted? (see page 11) Architectural Are walls being built, or existing walls being removed? If yes, please describe: Will there be any removal or addition of doors? If yes, please explain: Will there be any removal of, or addition to the floor coverings? If yes, please explain: Is new millwork anticipated? Will the roofing be affected? Will the ceiling be: Hardcap Acoustical Tile If other, please explain: Will furniture be included in this project? Will outside Architect/Engineer consultants be retained? w/grid System Ceiling Other
Do you anticipate any mechanical system changes? If "yes", describe the mechanical changes: Are there new ventilation requirements? Does the room currently have HVAC? Are there plumbing additions or changes? If "yes", explain: Mechanical (HVAC/Plumbing) Are any bio-safety cabinets or laminar flow hoods involved directly or tied-into the ductwork? Bio-Safety cabinet or laminar hood to be moved or removed? Bio-Safety cabinet with exhaust ductwork? *If you answered "yes" to any part of above, a green tag must be performed. Are any chemical fume hoods to be moved, removed, affected, or tied into the existing ductwork? If "yes", please describe modification needs: Are any autoclaves present? Are there any refrigerators or freezers to be moved, removed, or affected in the area?
Are any electrical system changes anticipated? Is the lighting being changed? Are equipment electrical loads being changed? Electrical Will there be any removal of or additional transformers? Describe the information systems modifications, if any to the existing space (data jacks, telephone jacks, etc.) Will any major electrical outages be required? Health and Safety Will any (potentially) asbestos containing materials be disturbed? An asbestos and a lead based paint survey must be completed and documented. Please identify: Will any sink traps be removed?
Will fluorescent light fixtures be changed / moved? Is any (potentially) lead-based paint present? Are physical hazards associated with the work, project equipment, or operations present? If "yes", please identify (electrical hazards, natural gas lines, water lines, etc.) *If you answered "" to above, appropriate lockout/isolation controls will need to be implemented. Will hazardous (ignitable, corrosive, reactive, or toxic) wastes be generated by this project? Will the project involve release of ANY material or odors into the air? (Any project work that may affect air quality in nearby buildings or adjacent areas of the same building should be discussed with HSD, to minimize operational problems during the project.) Are any infectious materials/wastes present? If yes, please list (biohazard boxes, sharps containers, glass slides, etc.) *Green Tagging must be performed if you answered yes to question above Are there any cryogenic materials in use? Was the area used for radioactive materials? Is this project currently sprinklered?
If no, will sprinklers be required? Are there any mercury thermostats or switches present in the project? Is there lead sheeting or shielding present in the project? Are there any batteries present in the project from fire alarm systems or emergency lighting systems? Is there any Freon present in refrigeration and/or air conditioning units? Hazardous Materials Are there hazardous materials used in conjunction with proposed activity? Has a chemical process been clearly articulated for the code official? Is an HMIS required by the code official? Will parking permits be required? Site Impact - Facilities Support Services / University Police If yes, please list (contractor, vendors, etc.) *Parking and Transportation must be involved if you answered yes to above Will any parking spaces, lots, loading zones, drive aisles, driveways, parking meters, parking structures, or streets either at Anschutz Medical Campus or Downtown Denver Campus be affected?
Will any aspect of the project affect pedestrian walkways? Will the project affect access to buildings (doors, docks, ramps, etc.)? If yes, please explain: Will signage be needed for alternate routes, parking, pedestrian walks, and vehicles? If yes, please explain: Will the project require additional dumpsters, or dumpster relocation? If yes, please explain:: Is it anticipated that contractors will be working after hours or on weekends? *If you answered yes to above the University Police and Facman Dispatch require a list of names & dates prior to work Will exterior lighting be affected? Electronic Security Will locks be changed during the project or after the project? Are there currently cameras, security systems that would be affected by the project? Will there be new cameras, security systems added to the project? During the project will there be areas affected for security (securing the project area, security outside the project area, etc.)? Will card access be added?
Will card access be changed or modified? Are there Privacy materials (HIPAA, FERPA, Pll, etc.) coming to the project? Will there be a need for panic (duress, medical, etc.) alarms in the finished space? Are there high value or high risk materials coming to the finished space? Will there be equipment (ULT freezers, incubators, etc.) installed in the finished space? Will IT wall jacks be moved? Will new IT wall jacks be needed? Will IT wall jacks be deleted? Will new computers be added? Will new telephones be added? Will wireless networking be required? Information Technology
Will workstation support be required when the computers are moved to the renovated area? If yes, how many computers will need support? Will Audio Visual Systems be impacted by the project? If yes, explain impact: Will classroom space be impacted by the project? If yes, explain impact: Education Support / Audio Visual Relocation Will this work require any moving prior to project start? Will this project results in any moves post construction? Will there be staff moves involved?