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CDBJr. 06/2020
Alt. Contact :
Alt. Phone No. :
Alt. Email :
SECURITY / ACCESSUTILITIESOTHER :
Bldg No :
Fall Semester Start Spring Sem. Start Summer Sem. Start Holiday Break End of FY / CY
Classroom Impact Lab Impact Research Impact Grant / Funding Fundraising
Safety / Security Event / Ceremony Gameday New Employee Equipment Install
COLLEGE / OFFICE FACILITIES / R&R 3RD PARTY OTHER :
Date :
Date :
Date Received : Date Initiated : Entered By :
Attachments: FM Exec Group :
Project No : Other Notes :
Facilities Management, 1161 W Samford Av, Auburn University, AL 36849 / 334-844-4810 / www.auburn.edu/facilities
FACILITIES MANAGEMENT USE ONLY
A2E JOC 3rd Party
Form Prepared / Submitted By :Dean / VP / AVP Printed Name :
Dean / VP / AVP Signature :
V. PROJECT APPROVALS - REQUIRED
Critical Factors :
Critical Dates / Other :( Rather than listing "ASAP", please briefly list any specific dates or reasons for the expedited handling of your project )
IV. ANTICIPATED PROJECT FUNDINGFunding Source :Funding Range : ESTIMATE ONLY 1,000 - 50k 50k - 250k 250k - 500k 500k - 1M over 1M
( No commitments will be made regarding any dates until after the project has been fully scoped, estimated, and funded )
Are You Requesting : JOB ORDER CONTRACTING (JOC) AUTHORITY TO EXECUTE 3RD PARTY
Do These Apply : WORK ORDER PREVIOUSLY SUBMITTED INSURANCE / DAMAGE CLAIM
III. SCHEDULE REQUIREMENTS / CRITICAL DATES
GROUNDS / LANDSCAPE MECHANICAL / HVAC / PLUMBING ELECTRICAL / TELECOM
Building Name / Location :
Room Number(s) / Area :Project Description / Request: (be detailed and attach any plans, sketches, photographs, and/or any other relevant materials)
NEW BUILDING / ADDITION RENOVATION / REFURBISHMENT BLDG ENVELOPE / ROOFSTUDY / PROGRAM ADDITIONAL SPACE / RELOCATION FURNISHINGS / EQUIPMENT
I. REQUESTOR INFORMATIONCollege / Office :
Department :
Primary Contact :
Primary Phone No. :
Primary Email :
to Facilities Management by EMAIL to [email protected]
Project No : ________________
Project Initiation FormINSTRUCTIONS: Please complete ALL sections, and then return the fully completed & SIGNED form
COVID-19
II. PROJECT INFORMATIONIS THE WORK REQUESTED IN RESPONSE TO AND/OR AS A RESULT OF COVID-19 (CORONAVIRUS)?
