This form should be used to support a single Capex bid request to Facilities Management (FM), tick those that apply:
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refurbishment or alterations to existing space
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request for additional space
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involves construction
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change use or function of an existing space
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other_______________________________
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involves furniture or room layout drawings
Please explain the issue or problem. Advise why additional space is needed. Explain how existing space is inadequate. Indicate any space that will be relinquished. Describe any negative impacts if this work does not proceed. Provide any costs if known, FM will scope and estimate overall project costs.
Building code: ___________________
:
Room number: ____________________
Type of space required (tick those that apply) :
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Academic Office (Full or part time);
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Filing/storage;
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General staff (Administrative);
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Post Graduate (Hons, Masters, PhD);
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Meeting room;
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Teaching room;
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Laboratory;
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Computer room;
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Other (please specify) _________________________
Space will be used primarily by (tick those that apply) :
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Existing staff;
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staff yet to be hired;
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Full-time;
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Part-time;
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Post Graduate;
□ other (please specify) _________________________________
Number of occupants ranges from _____ to _____
(please note FM programmes Capex work July/August each year, for work to be undertaken during the next financial year. Summer trimester work is scheduled 12 months in advance.
What is your expected delivery timeframe for this work: _____________________________
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(please tick to indicate that you have read and understood the following)
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All alterations/renovations are subject to VUW funding decisions and/or an FM Feasibility study
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FM will charge schools/CSUs for ongoing occupancy charges associated with any newly created space
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Only requests with an appropriate approval signature will be considered for space allocation
Estimate of costs, if known $
Are school funds available? yes/no Amount $ Cost centre number:
(please provide FM with a single point of contact for all communications):
Client (please provide a single point of contact): FM single point of contact:
Name: _____________________________________________
School/CSU: _______________________________________
Contact number: ____________________________________
Email: _____________________________________________
Space Planner (Charlotte Phillips)
Facilities Management
463 5503
Charlotte.phillips@vuw.ac.nz
Any changes or variations outside original project scope of this document are approved and managed by the
FM Project Team via the variation and scope management change processes. Any further changes requested by the Client/Stakeholder may have additional cost and programme implications.
Please list any known risks or potential hazards associated with this project:
Schedule of information attached (plans, photos, costs, quotes, schedules etc) that support your request
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By signing this request, the Head of School or Director of Central Service Unit agrees that the information contained within this document is correct and that the fulfilment of this request would advance the strategic goals of the School or CSU and in doing so would advance the strategic goals of Victoria University of
Wellington as a whole.
For Head of School
Date: or For Director of Central Service Unit
Date:
F
M
Date request received
Capex request number
Is the project major/minor?
Space planning recommendation
Decision
Priority (High/medium/Low)
Client notification date
Space assigned, if applicable
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