SCC Capital Equipment Request Form

Definition: An equipment purchase over $5,000 with a lifespan of at least three years

MNSCU Requirements: Purchases between $5,000 and $9,999.99 require two written quotes. Purchases over $10,000 require two written quotes and the bidding needs to be coordinated with the Purchasing Dept. Purchases $25,000 and higher require a sealed bid process.Please work with the Purchasing Department for proper procedures.

Requestor(s) Names:
Department:
Supervisor/Dean:

Description of requestedequipment and how it will be used:

Equipment lifespan:

Ancillary costs associated with the purchase (please describe):

Electrical modifications:
(Check with Maintenance)
Installation:
Training:
Other (specify):

Total cost for the request, including ancillary costs:

What is the need this equipment?

How will this this equipment impact your program? (e.g., how many students/staff benefit from the purchase, how often will it be used, etc.):

How will the purchase of this equipment support the college’smissionand strategic plan?

Is your requestsupported by any of the following items?(please describe):

Assessment Plan:
Operational Plan:
Program Review Recommendations:
Advisory Committee or Industry Partners:
Other (specify):

Does the equipment require any electrical upgrades or facility renovations? (e.g., does it fit UL Safety Standards; is there appropriate ventilation, etc.)Check with Maintenance before submitting request.

Yes / No / N/A / If yes, how will these be addressed?

Will this purchase enhance safety within the college or your department?

Yes / No / N/A / If yes, how?

Are there other departments, service areas, or programs that can also use the requested equipment?

Yes / No / N/A / If yes, which ones and how will they use it?

What other potential sources have been researched for funding this purchase? (e.g., Perkins, grants, industry partners, campus foundations, etc.)

If the purchase requires bids, have they been secured?

Yes / No / N/A / If no, is there a plan in place to secure them?

Is there any other data or information that you want the committee to consider for this application?

Requestor Name(s) / Signature
Dean/Supervisor Section
Do you recommend approval of this request? / Yes / No
Rationale:
Dean/Supervisor Name (print) / Signature