University of California, Santa Cruz

PROJECT SUMMARY FORM

1.  Project Type: / Major Capital Improvement Project
2.  Project Identification:
Date Prepared:
Budget Year:
Project Number:
Project Title:
3.  Project Description and Justification:
(Begin description here)
4.  Funding Source:
Fund Name / Fund-Org / Amount
$
Total Project Cost: / $
5.  Funding Schedule: / 6.  LRDP Classification:
Preliminary Plans / $ / Consistent with the LRDP
Working Drawings / Not consistent with LRDP - (the campus is required to submit a Regent’s Item requesting an amendment to the LRDP).
Construction
Equipment (Groups 2 & 3)
Total Project Cost / $ / 7.  Attach EIC Form
Approval recommended by the Advisory Committee on Campus Planning and Stewardship
Date

Project Approved By:

Chancellor / Date