Project Request Form - Facilities
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2Facilities Use Only:
Facilities Administration/Management
Project Request W/O #____________________
Campus Planning
Date Received______________________
Action Taken: __________________________
Project Management & Construction
______________________________________
Facilities Management
Scoping Estimate: _______________________
Project Request Form
PROJECT REQUEST FORM
Project Request FormRequest Form
(see page 2 for instructions)
1. Type of Request
(check all that apply)
Int./Ext. Renovation or Int./Ext. New Construction
(ex. add/remove/relocate doors, windows, walls, etc.)
Change of Use of Space
(ex. change storage to office, non-lab to lab, etc.)
Installation of Specialized Equipment
(ex. lab equipment with HVAC/electrical requirements, AV install)
Signage/Graphic
(ex. suite ID signs, large format signs/graphics)
Furniture/Interior Design
(ex. reconfigure/design workstations, purchase new furniture)
Maintenance/Repair of Existing Facilities/Infrastructure
(ex. bldg systems maintenance, roadways/sidewalks)
Technology Infrastructure
)
(ex. ITU networking/telecom updates, server installations, etc.
2. Requestor Information
Name: __________________________________ Dept/Unit:_______________________________
Phone #:___________________ Email: ________________________ Date: ______________
3. Location/Description of Requested Project
Fairfax
PW - Sci/Tech
Arlington
Other _______________________________________
Interior Work
Exterior Work
Building/Location: _______________________________________________________________________
For exterior work, describe location using nearest building/street intersection, north/south/east/west of existing landmark, etc.
Floor: ___________________________ Room(s): __________________________________
Description of Requested Work
:
(attach a separate sheet if more space is needed)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
4. Schedule Requirements
(see page 2 for general schedule information):
Requested Completion Date
(explain any critical schedule requirements)
: __________________________________
________________________________________________________________________________________
5. Funding Sources
Funds Available ($ amount): ___________________
Budget Code: ___________________
Source of Funds
: ________________________________________
(general/non-general or self-generated funds, grant, gift)
6. Project Request Approval
(see page 2, item 6 for approval signatures required for requests above $15,000):
Unit Approval Authority: __________________________________________________________________
Signature / Print Name
Date
7. Email completed form to Facilities Customer Service Center -
csc@gmu.edu
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Parent category: Business