FY 2017 Capital Equipment Budget Requests

Program:______

Prepared by: ______

Date______

To request Capital Equipment funding for FY2015-16:

  1. 1.Identify FY2015 Capital expenditures on Page 1, Equipment needs for FY2016-17 on Page 2, and future plans for FY2017-18 & 2018-19 on page 3.
  2. 2.Summarize that data on this page.
  3. 3.Get your supervisor’s approval before February 1 to submit to the Committee Chair.
  4. 4.Attend the meeting on February 24 where final budget recommendations will be made.

Capital Equipment Budget Request for FY2017:
Capital Equipment needed and installation if needed $______
__
Less Alternative Funding $______
Additional Capital Equipment Funding requested $______
Future Planning:
Capital Equipment needed in FY2017-18 $______
Capital Equipment needed in FY 2018-19 $______

Page 1 – Capital Equipment purchased FY2015-16

List the equipment purchased FY2016. You should account for the entire Capital Equipment Budget. If you did not purchase equipment you were funded to buy, indicate why.

Equipment Funded / Equipment Purchased / Amount
TOTAL

If you received additional funding, such as President’s Initiative fund, Resale accounts, Capital Equipment Emergency Funds, Industry donations or partnerships, please account for that funding.

Equipment Purchased / Reason / Source of Funds / Amount
TOTAL

Page 2 – Capital Equipment needed FY2016-17

List the Capital Equipment that you need to purchase for the FY2016-17 and briefly explain why it is needed. Identify any equipment needs, which are “Extreme” or “Urgent” needs and explain why they are higher priority (Place an asterisk (*) by any items identified as a need through your program’s assessment plan.

Equipment / Reason / Estimated Cost
TOTAL

Identify any other sources of meeting this equipment need that you have explored, and the results of your exploration.

Page 3 – Capital Equipment Planning for FY 20017-18 and 2018-19

List the capital equipment you expect will be needed in the next two years. Please identify the source of any alternative funding that you may be able to use. The purpose of this list is to allow planning ahead for Capital Equipment expenditures. Please do not list everything that you might need, but what you realistically expect to purchase at this time. This list will be revised annually, and equipment may be added as program plans and needs change.

FY 20017-18 Equipment / Reason / Other Funding Sources? / Amount
TOTAL
FY 2018-19 Equipment / Reason / Other Funding Sources? / Amount
TOTAL
Program Name : Prepared by: Date:
Approved By: Date:
Approved By: Date: