Contact Information Full Name: * Email Address: * Phone Number with Area Code: * Fax Number with Area Code: Street Address: * City: * State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: * Name of Contact (If Other Than Yourself): Work Description: Building Name: * Room Number(s): * Description of Work: * Purpose of Project: What Would You Like to Accomplish with this Project? * Funding Estimate What is the Anticipated Cost of this Project? * Under $10,000 $10,000 to $50,000 $50,000 to $100,000 $100,000 to $200,000 $200,000 to $500,000 Over $500,000 Funding Status Is Funding Currently Available? * Currently Available - a fixed cost quote will be generated Not Currently Available - a budget estimate will be given Will 53 funds be used to fund this work? * yes no Payment Approval Authorizing Department: * Authorizing Representative: * Dean of College Area: * Has this Individual Approved this Request for an Estimate? * yes no Project Location Is the Space Currently Assigned to Your Department? * Yes No - if unknown, please contact Kristi Buffington at 970-491-0109 Are You Changing the Use of an Existing Space? * Yes No - mark Yes for things such as converting a conference room to an office Are You Adding Any New Space? * Yes No Time Constraints An Estimate is Required by this Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2019202020212022 The Work Needs to be Substantially Completed by this Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2019202020212022 Explain the Rationale for the Requested Completion Date: * Leave this field blank
