Office of Campus Infrastructure and Sustainability

Office of Campus Infrastructure and Sustainability

Space / Renovations Request

Instructions:

1. Primary Contact Person to complete Section A electronically, print off and complete Section B – Project Approval(s).

2. If no costs are associated with the Request, proceed to Instruction #5. Otherwise, submit request to Lorrie Hennig, OCIS and request a preliminary Total Project Cost estimate (TPC).

3. Primary Contact Person then to complete Sections C (based on the preliminary TPC), D and E (required) electronically, print off and re-sign Section B.

4. If the Department wishes to proceed, obtain the appropriate approval signature(s) in Section F.

5. Submit the original signed request, and any TPC or accompanying floor plan(s), to the Director, OCIS.

Campus………………………

Building………………………

Room Number(s)……………

Primary Contact Person……

Job Title and Extension….…

Department Name/………….

Section A: Project Summary

1) Reason for Request
Describe why this project is necessary (If the project does not require additional space or a change in use of space, proceed to Section A-6. If space changes are required proceed with Section A.)
2) Request
Describe the project.
Is the space identified in the proposed project currently part of your department’s allocation?
If no, who is the current holder of the space?
Have you contacted the current holder?
Does the current holder support this request?
If no, please explain:
Will the space continue to be used for its current purpose?
If no, please describe requested use of space:
Will any other departments be affected by this request?
If yes, please explain:
3) Implications
Note: Vacated space reverts to the University for reassignment.
Will any existing space be vacated if this request is approved?
If yes, please list the space(s):
What will the implications be if this request is not approved?
4) Current Space Allocation / Facility Design
Describe why your department’s current space allocation / facility design is inadequate to meet its needs.
5) Future Considerations
How long will the space be used for the requested purpose?
Do you anticipate an increase/decrease in the size of your department? Short term? Long term?
6) Requested Completion Date
Include rationale.

Section B: Project Approval(s)

1) Primary Contact Person

I acknowledge that any future changes may cause delays, or result in the need to prepare a revised Request.

Signature Date

Print Name Title

2) Director, OCIS.

This Request is approved for submission to the Program Manager. OCIS for a TPC estimate.

Signature Date

Print Name Title

Section C: Project Costs

Total Project Cost Estimate (TPC) / Operating Costs
To be completed by the Primary Contact Person, based on the TPC provided by OCIS. /
Based on the information provided, the cost for this project is estimated to be $
Date of Estimate (Day/Month/Year):
Will the project result in increased operating costs for the space?
If yes, $ /square meter /

Section D: Other Costs (NOT Included in TPC)

Other Costs E.g. Research equipment, specialized lab equipment, furniture, etc.
To be completed by the Primary Contact Person. Please provide a general list of items. /
Will there be other costs associated with this project?
Other costs for this project are estimated to be: $
Date of Estimate(s) – (Day/Month/Year): /

Section E: Project Funding (Including Other Costs – Section C)

Requests will not be approved prior to identification of Funding.

Funding Source(s)
Identify / Timing of
Receipt of Funds
E.g. quarterly, annually, etc
and dollar amount(s) / Total Funding Commitment
Enter total dollar amount / Index /
Fund
As applicable
1)
2)
3)
4)
5)
6)
Total

Section F: Project and Funding Approvals for projects under $50K

Project requests under $50K.

(Note: All requests for additional space and/or changes in space will require SMC approval.)

Ø To be signed as applicable by one of the following: Associate and Assistant Deans, Directors, Department Chairs, and Managers.
Ø Approvals require one-up signing authority. /

I have reviewed the above request and have confirmed that the proposal is consistent with divisional and/or departmental plans. I acknowledge that any project tendered at a cost exceeding the above pre-design estimate will not proceed unless the party involved and/or my department agree(s) to meet the costs in excess of that sum.

Ø Within Administrator’s current space allocation:

Signature Date

Print Name Title

Ø If space request resides outside Administrator’s current space allocation and within the current space allocation of the Department’s Vice-President or Principal:

To be signed as applicable by one of the following: Departmental Vice-President or Principal (or, for areas not reporting through a VP or Principal, must be signed by the President.)

Signature Date

Print Name Title

Section F: Project and Funding Approvals for projects $50K to under $2M

Project requests $50K to under $2M.

(Note: All requests for additional space and/or changes in space will require SMC approval.)

Ø To be signed as applicable by one of the following: Departmental Assistant Vice-President, Vice-President or Principal (or, for areas not reporting through a VP or Principal, must be signed by the President.)
Ø Approvals require one-up signing authority. /

Ø Within Administrator’s current space allocation:

Signature Date

Print Name Title

Ø If space request resides outside Administrator’s current space allocation of the Departmental Vice-President or Principal:

Space Management Committee

Signature Date

Print Name Title

Section G: Space Management Committee Decision

Request approved as presented

Incremental operating costs to be paid by Department

Request approved in part, see attached letter of explanation

Request denied, see attached letter of explanation

Request deferred, see attached letter of explanation

Signature Date

Print Name Title / Chair: SMC

Capital Project Proposal – Office of Campus Infrastructure and Sustainability Page | 1