PLANT OPERATIONS CUSTOMER REQUEST FORM
ATTENTION: Customer Service Center will not process any Customer Request Form that is not filled out completely
Email to : Certifying signature for approval Phone: (713) 743-4948
Revised Jan 2006
CAMPUS: (Check One)
UH System UH Central Campus UH Clear Lake UH Downtown UH Sugar Land UH Victoria
1) Date: / 2) Customer Service Center Use Only - Please DO NOT write in this space
Work Request Number:
Blanket / Project Number:
3) Requesting Department:
4) Name of Contact: (print/type)
5) Cost Center Information
(Business Unit - Fund Code - Dept Code - Program Code - Project ID)
Speed type (required):
6) Contact Phone Number:
7) Contact E-mail Address:
8) Bldg Name, Bldg # (Campus Map), and Room #(s) where work is to be done:
9) Full description of work: (attach supplement if necessary) (Check all that apply)
9A). Minor CosmeticRepairs, Restorative Maintenance, Attached Key Request // OTHER
9B). Renovations to a Building, or an area of a Building (Minor / Major)
9C). New Construction / Expansions to Buildings
9D). Exterior Building Surroundings / Site Modifications (Major)
9E). Change of Use of Space / Naming of Facilities
9F). Additional Space Needs / Land Acquisitions / Leases / Rentals / Building Purchasing / Trailers / Etc.
10) Purpose/Benefit: Define the purpose of the request and its benefit to the University / Dept.
11A) Proceed without Estimate
Proceed on material and labor basis.
Not to Exceed$
Note:Programmatic (11B) and Authorized Certifying signature(11D) approval will be required at this time, (skip item 11C) / 12A) Estimate Required
Detailed Estimate for completion of required work.
Note: Programmatic(12B) and Departmental Signatures (12C) are required. Authorized Certifying signature (12D) is required after estimateis approved.
11B) Departmental Required Signatures
Business Manager and/or Department Chair
Date:
Dean and/or Director (if applicable)
Date:
Provost/Vice President (If applicable)
Date: / 12B) Departmental Required Signatures
Business Manager and/or Department Chair
Date:
Dean and/or Director (if applicable)
Date:
Provost/Vice President (If applicable)
Date:
11C) Authorization to Proceed with Estimate
N/A (SKIP) / 12C) Authorization to Proceed with Estimate(to be completed by Plant Ops. Project Manager /Shop Supervisor, andsigned by Client / Representative).
Amount of Estimate
Proj. Mgr. / Shop Super. (FPC/FM)
Date:
Departmental Approval (Client)
Date:
11D) Authorized Certifying Signature* (Business Manager / Admin.)
NAME/TITLE (print/type)
Date:
PeopleSoft Division/College Code:
Enter new cost center and speed type : / 12D) Authorized Certifying Signature* (Business Manager / Admin.)
NAME/TITLE (print/type)
Date:
PeopleSoft Division/College Code:
Enter new cost center and speed type :
*Note: Approval by Authorized Certifying Signature (11D or 12D) gives Plant Operations the authority to transfer funds (refer to 11A & 12C) from the above noted cost center (5) into a new Plant Ops. construction project cost center. If greater than $50,000 a budget journal must be completed before the project starts. Cost Estimates are valid for 30 calendar days from issuance. Inactive estimate responses over the noted time period may trigger project cancellation.
INSTRUCTIONAL COVERSHEET
Revised Jan 2006
for
PLANT OPERATIONS CUSTOMER REQUEST FORM
CampusSelect Campus where work is to be performed.
1. DateEnter today's date.
2. Customer Service CenterDo not write in this space (For internal use only). Skip to item 3.
3. Requesting DepartmentEnter your department’s name.
4. Name of ContactName of Person requesting work who will oversee the work in process (Certifying Signature, Business Manager, and/or Client Representative overseeing project).
5. Cost Center Information Enter complete cost center information, ( i.e.. 00730-1026-H0184-F0406-NA,
Speed type 19236 ).
6. Contact PhonePhone number and mail code of contact person required, (i.e., Ph. ext. 3-8022; Mail code 1011).
7. Contact E-mail AddressEnter your e-mail address. This is very important as the Customer Service Center will notify your Dept, via e-mail, of their assigned customer request number.
8. Bldg. Name / Room # Enter the name & number of building, and identify the room(s) where work is to be performed.
9. Full description of workProvide description of full scope of work to be done (for better service by the Project Manager).
9-A Minor Cosmetic Repairs, or Restorative Maintenance – This would be minor improvements like replacing a door, painting an office, fixing / replacing locks, special events cleaning, moving furniture, replacement in-kind of equipment, pumps, building hardware, minor floor repairs,minor site landscaping / grounds work, Key requests, etc.
9A-1. Table / Chairs set-ups - include date, time, location and pickup time.
9A-2. Three (3) working days are required on all set-ups. Fraternities / organizations paying by check / cash should deliver payment to Room 102, General Services Bldg.
9A-3. Property Management forms are required for all furniture moves into a storage facility. PRP form must be signed by the Property Manager.
9A-4. All file cabinets must be empty when office moves are done by the labor shop.Other - Card Key Access System, Interior Signage, etc…
9-B Renovations to a Building - This is a project where all, or a portion of the building is renovated, or upgraded for aesthetics purposes, or code compliance.
9-C New Construction - Construction of a new building on a site where it had not previously existed, or where a building has been demolished. Expansions - Additions to existing buildings that will expand, or increase the available square footage of the structures.
9-D Exterior Building Modifications – This would be signage, major landscaping, exterior lighting, sidewalks, construction of streets, sewers, electrical systems, steam tunnels, or other facilities necessary to operate the physical plant, or other exterior campus modifications that require the services of licensed professionals.
9-E Change of Use of Space – It is extremely important to report any “CHANGE” in the use of a space. For example: an office to classroom, or classroom to lab changes. Types of Space: General Purpose Classroom, Teaching Laboratory, Research Laboratory, Computer Lab, Library, Office-Faculty Office-Administrative, Office-Graduate Assistant, Office Clerical, Physical Plant, Student Services, Auditorium/Theatre, Recreation, Student Union/Organization, Housing, Athletics, Conference, Non-University.
Naming of Facilities - Room or building that may receive a name change for any reason.
9-F Land Acquisition / Building Purchases - purchase of land, with or without a building structure.
Portable Building or Trailer – Renting, Leasing, or purchasing a temporary structure may require utility installations.
Lease Space / Rentals - Building space leased from other entities or expansion of lease space. Institutions may lease space to provide space for programs while permanent space is constructed and for short-term projects when permanent space is not cost-effective.
10. Purpose/BenefitIn accordance with State and University policy, every expense document must contain a purpose/ benefit statement defining the purpose of the request and the benefit to the University / Dept. Your Customer Request Form will not be processed if this statement is not fully completed.
11A. Please check if applicable Proceed on material and labor basis. Check this box only if an estimate is not neededfor the work you wish completed. If you have a not to exceed amount please enter (not required). Please note that the Box requiresProgrammatic (11B) and Authorized Certifying signature(11D) approvals. The "Authorization to Proceed with Estimate" (11C) becomes "not applicable", and work will proceed immediately.
11B. Departmental ApprovalNot required when (9A checked). Departmental approval(11B) must be Dean, Department Chair, Business Manager, or Provost. Staff / secretary approval will not be accepted.
11C. Authorization to ProceedN/A (SKIP).
with Estimate
11D. Authorized Certifyinga. In accordance with MAPP policy, Certifying signature is required on all expense documents. b. It is also very important that each Certifying signature enter his or her PeopleSoft Division, or College Code, (i.e.. Academic Affairs -H0005, Admin & Finance H0154). This will enable the Customer Service Center to verify the appropriateness of the signature.
C. NOTE– If the project should qualify for the Plant Operations Small Project Streamlining
Process (see 9B with a cost of $1,000 to $50,000) then see description in 12D.
12A. Please check if applicable Detailed Estimate for completion of required work. Check this box if you wish to receive an estimated cost for the work requested. Note that Departmental Signatures ((12B)are required at this time. However, theAuthorized Certifying signature approval (12D) is recommended, but not required,until the estimate has been given to, and approved by the Departmental signatory (12C).
12B. DepartmentalApprovalSee Definition above (11B).
12C. Authorization to Proceeda. This section will be completed by the appropriate Project Manager, and an estimate with Estimate provided to the requestor. Those projects over $50,000 will not qualify for the Small Project Streamline Process (Fast Track).
b.For those projects over $50,000, the estimate will be inclusive of all related project charges necessary to complete the scope of work. It also will include a project management fee of 3% of the total project cost.
c. Departmental (12C)approval will be required before sending the Customer Request Form to the Authorized Certifying Signature(12D).
12D. Authorized Certifying a. In accordance with MAPP policy, Certifying signature is required on all expense documents. b. After an estimate has been approved by the Departmentalsignatory, Authorized Certifying signature is required before Plant Operations can proceed.If the original cost center information has changed. Be sure to include the speed type number.
c. It is also very important that each Certifying signatureenter his or her PeopleSoft Division, or College Code, (i.e.. Academic Affairs -H0005, Admin & Finance H0154). This will enable the Customer Service Center to verify the appropriateness of the signature.
d. Projects under $1,000 will be billed directly to the departmental cost center, and are not subject to project management fees.
e. NOTE -Whenever a renovation (9B) project exceeds $1,000 but less than $50,000, the approval by the Authorized Certifying Signature (11D or 12D) on this Customer Request Formgives Plant Operations the authority to transfer funds from the Departmental cost center designated on the work request into a new Plant Operations construction project cost center. Once work has been completed and all invoices paid, any remaining funds will be returned to the Dept. However, if the original scope of work requested is "under estimated" by the Job Order contractor, or the Project Manager,work will be completed at no additional charge to the requesting Dept. This does not include any unforeseen circumstances, (i.e. as a result of demolition during renovation, or a user requested change in scope of work during the course of the project). Additional charges to the requesting Department could apply, in this case.
f. If the project is over $50,000, a budget journal must be completed to transfer funds from the departmental cost center into a new construction project cost center. All budget journals should be forwarded to F&O Business Administrator.
g. Also, for those projects under $50,000, if a change in the scope of work increases the overall project funding, an e-mail from the Certifying Signature can grant the authority for Plant Operations to remove additional funds from the Departmental cost center.
E-mail completed form to appropriate certifying signature who should approve and then forward the form via e-mail to the CSC at with the word Approved in the body of the message.