Project Request Form / Office of Facilities Planning,UM-Dearborn

Office of Facilities Planning

Online Project Request Form

For detailed instructions on how to completed this form, click here.

Please send an additional materials to:
Project Request, Facilities Planning, 1143AB, UM-Dbn.

TO ENSURE YOUR REQUEST ISPLEASE FILL IN ALL REQUIRED

Requestor's Name (required)
Project Contact Name (required )
Requesting Department (required )
Requestor's Campus Address (required)
Requestor's Phone (required)
Project Location (required)
Desired Project Completion Date (required)
Requestor's Fax (required)
Available Project Funds (required)

Brief Project Description (send or fax (x33830) a sketch if available)

PROJECT REQUIREMENTS (check all that apply):

Space Requirements
	Remodel Existing Space Need Additional Space New Space Use Existing Location:Room #
Buildling Layout Changes
	Partitions Doors Ceilings Windows
Equipment/Fixtures (please define/describe equipment in "Brief Project Description" section, or attach catalog page) (Fixture=Chalkboard, Bulletin Board, Attached Coat Rack, Etc.)
	Install Remove Relocate
Furniture
	New Furniture Purchase Design Layout Relocate Reconfigure Refurbish
Utilities
	HVAC Electrical Plumbing Telecom/Data Other
Lighting
	Modify New
Finishes
	Floors Carpet Tile Walls Paint Wall Coverings Ceiling Window Coverings Blinds Shades
Signage
	Interior Exterior Other
Security
	Locks/Access Control Intrusion Detection Theft Protection Other
Safety & Environmental
	Research/Lab Chemical Gas, Oil Storage Air Emission Sources Eye Wash Other Hazardous Industrial Waste Handling Elevator Renovation Cleaning Operations Equipment/Systems Discharging Water, Waste Water Soil Erosion/Sediment


Site
	Utilities Landscaping Access Roadways Sidewalks Parking Lots Buildings

CHARTFIELD

Account	Fund	Org	Subclass	Program	Proj/Grant

Authorized Individual

An authorization signature is required before proceeding with any purchase orders or requisitions for the project.

To complete the Project Request Form, please click the SUBMIT button.

Once you've completed the the project request, a representative from the facilities team will either contact you to arrange a meeting with the facilities team or forward your request to the appropriate department as a work order.

Please Note: Total project costs will include all applicable design, construction, equipment, and regulatory fees.

Office of Facilities Planning
1143 AB
www.umd.umich.edu/dept/facilplan

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