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 PARTYDo 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 pif@auburn.edu

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)?

04-30-2018

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save as copy button: print button: clear form button: college / office: department: check box - additional space / relocation: Offcheck box - furnishings / equipment: Offcheck box - security / access: Offcheck box - new building / bldg addition: Offcheck box - renovation / refurbishment: Offcheck box - building envelope / roof: Offcheck box - utilities: Offcheck box - grounds / landscaping: Offcheck box - mechanical / hvac / plumbing: Offcheck box - electrical / telecom: Offcheck box - other project type: Offdescription - other project type: building name / location: bldg no: room numbers / area: project description: check box - seeking Job Order Contracting (JOC): Offcheck box - seeking Authority to Execute: Offcheck box - seeking 3rd Party: Offcheck box - maintenance work order previosuly submitted: Offcheck box - insurance / damage claim involved: Offcritical factors: fall semester start: Offcritical factors: spring semester start: Offcritical factors: summer semester start: Offcritical factors: holiday break execution: Offcritical factors: end of FY / CY: Offcritical factors: classrooom impact: Offcritical factors: lab impact: Offcritical factors: research impact: Offcritical factors: grant appl / funding: Offcritical factors: fundraising: Offcritical factors: safety / security: Offcritical factors: event/ceremony: Offcritical factors: gameday: Offcritical factors: new employee: Offcritical factors: equipment install: Offother critical factors or dates (be specific): funding source - college/office: Offfunding source - facilities / repair & renovation (r&r): Offfunding source - 3rd party: Offfunding source - other: Offfunding source - other description: funding limit: ESTIMATE ONLY: Offfunding limit: $1 - $49k: Offfunding limit: $50k - $249k: Offfunding limit: $250k - $499k: Offfunding limit: $500k - $999k: Offfunding limit: $1 million and over: Offform prepared by: prep date: dean / vp / avp printed name: alternate contact name: primary contact name: primary email address: alternate email address: primary phone number: xxx-xxx-xxxx: alternate phone number: xxx-xxx-xxxx: check box - study / program: Offin response to and/or as a result of COVID-19?: Off