Revised 03/04/2013
California State University
Capital Claims Submittal Form
Campus Name: [Campus]
Enter the name of your campus.
Project Name: [Project Name]
Enter the project name for which this claim is being processed. We’ve provided a complete list of projects on
page #2 of this document. Please copy and paste your project name into the field above.
GO Bond Fund-Subfund Number: [Fund Number]
Enter the appropriate fund-subfund (listed below) number to the input box above
Claim/PFA Amount: [Claim Amount]
Enter the claim amount in dollars above (include decimal: nnnn.nn).
E-Mail Address: [Contact Email]
Enter the e-mail address of the person you would like to receive the “Cumulative Disbursements” certified letter
for this fund.
Please save this document and e-mail to: claims@intranet.calstate.edu
Fund-Subfund Numbers
0574-302
0574-317
0574-372
0785-306
0658-306
0658-325
6028-301
6028-311
6028-371
6041-303
6041-308
6041-312
6041-316
October 2009 Tax Exempt
March 2009 Tax Exempt, BL 09-09
Build America Bonds, BL 09-15
October 2009 Tax Exempt
April 2012 Tax Exempt
October 2011 Tax Exempt
October 2009 Tax Exempt
March 2009 Tax Exempt, BL 09-09
Build America Bonds, BL 09-15
March 2010 Build America Bonds
March 2009 Tax Exempt, BL 09-09
October 2009 Tax Exempt
November 2009 Tax Exempt
Capital Claims Submittal Form
6041-327
6041-334
6041-335
6041-372
6041-382
6048-304
6048-306
6048-307
6048-311
6048-312
6048-340
6048-372
6048-382
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September 2012 Tax Exempt
October 2011 Tax Exempt
December 2010 Build America Bond
Build America Bonds, BL 09-15
October 2009 Build America Bonds
October 2009 Tax Exempt
September 2012 Tax Exempt
March 2010 Build America Bonds
March 2009 Tax Exempt, BL 09-09
October 2011 Tax Exempt
December 2010 Build America Bond
Build America Bonds, BL 09-15
October 2009 Build America Bonds
3/15/2016
Revised 03/04/2013
Campus Projects List
Bakersfield - Electrical Transducer at Icardo Center
Los Angeles - Administration, Seismic Upgrade
Bakersfield - Fire Alarm System Upgrade
Los Angeles - Corporation Yard & Public Safety
Bakersfield - Math & Computer Science Building
Los Angeles - Forensic Science Building
Chancellor's Office - Budget Office
Los Angeles - Science Replacement Bldg. Wing B
Channel Islands - Classroom & Faculty Office Reno/Add
Monterey Bay - Heating Energy Efficiency Upgrades
Channel Islands - Entrance Road
Monterey Bay - Library Redesign
Channel Islands - Infrastructure Improvements
Northridge - Campus Utility Infrastructure
Channel Islands - Solano Hall Bldg. Renewal/Roof Repair
Northridge - Engineering Renovation Phase II
Channel Islands - Substation
Northridge - Performing Arts Center
Channel Islands - West Hall-PW
Northridge - Science I Replacement - Equipment
Chico - Taylor II Replacement Bldg-PW
Pomona - College of Business Administration - E
Dominguez Hills - Educational Resource Ctr. Addition
Pomona - Fire Alarm System Renewal, Ph. II
Dominguez Hills - Electrical Infrastructure, Phase II
Sacramento - Capistrano Hall HVAC
Dominguez Hills - Minor Cap-Energy Incentive
San Bernardino - Access Compliance Barrier Removal
Dominguez Hills - Nursing Facility Improvements
San Bernardino - College of Education
Dominguez Hills - Water Line Renewal - Campuswide
San Diego - Storm/Nasatir Halls Renovation
Dominguez Hills - Water Line Sliplining, Phase II
San Francisco - Joint Library: JPL and Sutro (2010/11)
Dominguez Hills - Welch Hall & Extended Ed MBCx
San Francisco - Joint Library: JPL and Sutro (2011/12)
East Bay - Electrical Infrastructure Renewal, Phase I
Campuswide
San Francisco - Nursing Facility Improvements
East Bay - Electrical Infrastructure Renewal, Phase II
San Francisco - School of the Arts/Font Street Property
East Bay - Nursing Facility Improvements
San Jose - Spartan Complex Renovation-PW
East Bay - Plumbing System Upgrade, Meiklejohn Hall
San Luis Obispo - Crandell Gymnasium (Seismic)
Capital Claims Submittal Form
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3/15/2016
Revised 03/04/2013
East Bay - Student Services Replacement Building
San Luis Obispo - MBCx Express - Infrastructure Upgrade
Fresno - Faculty Office/Lab Bldg-PW
San Marcos - ADA Compliance
Humboldt - Behavioral & Social Sciences, Phase I
San Marcos - Social & Behavioral Science Bldg - E
Humboldt - MBCx - 2008 Energy Projects
San Marcos - Social & Behavioral Science Bldg - WC
Humboldt - West and East Gym HVAC/Electrical
San Marcos - Social & Behavioral Science Building - C
Humboldt - West Gym Office Renovation
Sonoma - Mechanical and Lighting Renewal
Long Beach - Liberal Arts Replacement
Stanislaus - Science II (Seismic)
Long Beach - Library Addition and Renovation
Stanislaus - Stockton University Park Nursing
Long Beach - Peterson Hall 3 Replacement
Systemwide - Office of the Statewide Audit
Long Beach - Tennis Court Repairs & Replace Relay Control Syst.
Systemwide - Working Capital
Capital Claims Submittal Form
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3/15/2016