ORF SPACE JUSTIFICATION DOCUMENT
Please complete Parts I-VI of this form (SJD) and submit to the ORSSpace Coordinator (SC),Terence Lewis, Division of Facilities Planning (DFP), Office of Research Facilities (ORF),Building 13, Room 1325, for processing. (If you need any assistance with this form, please contact Terence Lewis at (301) 496-5037.)
For DFP Use Only:
Date SJD Received by SC:______
ORF Service Group:______
ORF SJD#:______
Type of Space: ______
Net Assignable Space: ______
______
Requester:______
(Printed Name/Signature/Date)
______
(Title/Division/Office/Phone Number)
Division Director:______(Printed Name/Signature/Date)
Date Space is needed: ______
______
I.Project Description and Scope
A.Kind and Amount of Space Requested
1)Temporary ______Permanent ______
2)Space Trade______
3)Lab ______Admin ______Animal ______Clinical ______
4)Approximate SF ______
5)Comments:
B.Program Type
Expansion of Existing Space ______New Space ______
C.Description of Program Activity (include name of and type of functions performed by office/lab/branch)
D.Are there any location requirements (i.e., specific building, on or off campus)? If so, justify required location; provide detailed descriptions of limitations.
II.Staffing
A.Provide total number of existing IC staffing in requested building. Justify any change in staffing levels in comparison to latest census figures.
B.Provide staffing numbers and positions, broken down by organization or function, for the requested space, as appropriate. Indicate temporary, part-time and other positions accordingly. For contract staff, indicate why space cannot be provided as part of the terms of the contract.
III.Programmatic Justification for Space Request
A.Explain why space is needed by the requested timeframe and impact if space is not available by the requested timeframe.
B.If request is for temporary space during renovation, provide location of permanent space work request number, and the estimated start date, duration and completion date of renovation.
IV.Explain why current IC space cannot be used to accommodate proposed program.
V.Budget Impact
A.Long Term Impact
B.Cost Associated with Obtaining Space
VI.SJD Cost Estimate to Build Out and/or Lease Space
(Administrative/Office Space Type as example; values will change according to Space Type)
ORF SJD #______(will be provided by SC)
______Net Square Feet (NSF) ______Rentable Square Feet (RSF)
Estimate of Costs for Renovations of Building ______, Rooms: ______
Tenant alterations to space______x $38 (Admin/Office Type) $
DFP Service Fee27% of Alterations$
Telecommunications/LAN______x $22$
Moving Services______x $ 2$
Workstations
New ______x $7,000$
Reconfigured______x $3,500$
Total$
ORF/DFP Contingency Fee(10% of above totals)$
Total for Moving Expenses$______
Annual Lease/Rent Estimate
______rsf x $15.41 =$______
Security Supplement
______rsf x $______$ ______
Total Annual Lease/Rent$ ______
Grand Total for 1st year costs$ ______
Certification of Funds
CAN #______HNAM Code: ______
The _Director, (insert ORF Division here) ______has reviewed and approves the above estimate.
The Division (insert ORF Division here) _ has the estimated funds to complete this request within its budget.
______
Director, Division of Budget & Financial Management, ORF- Signature Date
VII.Recommendation
Space Coordinator, ORF Sign ______Date ______
Terence Lewis
Associate Director for ______, ORF
______
(Printed Name)
______
(Signature & Date)
VIII.Concurrence
Executive Officer, ORFSign______Date______
Karen Pane
IX.Approval
Director, ORFSign______Date ______
Daniel Wheeland
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Revised – 1/9/12, KS