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Capital Improvement Project Request Form
Leave This Blank:
Complete the following form using the instructions provided below.
Department
*
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Justice of the Peace, Precinct 1, Place 2
Justice of the Peace, Precinct 2, Place 1
Justice of the Peace, Precinct 2, Place 2
Justice of the Peace, Precinct 3, Place 1
Justice of the Peace, Precinct 3, Place 2
Justice of the Peace, Precinct 4, Place 1
Justice of the Peace, Precinct 4, Place 2
Justice of the Peace, Precinct 5, Place 1
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Project Title
*
Project Information
New or prior request?
*
New Request
Prior Request
Identify the purpose of the expenditure from the options listed:
*
Buildings and Improvements
Infrastructure
Land
Land Improvements
Machinery and Equipment
Provide a clear and brief description of the scope and nature of your request.
*
What needs will this project resolve?
*
Estimated Cost Itemization
Indicate a (0) Zero for costs that are not applicable
Land Appraisals / Survey
*
Land Acquisition / Row
*
Architectural / Engineering
*
Construction
*
Inspections
*
Field and Plant Equipment
*
Vehicles
*
Communications Equipment
*
Computer / Software
*
Office Equipment / Furniture
*
Others (Please Describe)
Project estimated cost:
*
Source of estimate:
*
Construction Estimate
Comparable Cost Estimate
Other Estimate
Project's anticipated useful life:
*
1-5 Years
5-10 Years
10-15 Years
Over 15 Years
Other comments regarding project costs:
By initialing here, I certify that I have the proper authority to complete and submit this form.
*
Name
*
Title
*
If you have any questions regarding completion of this form, please contact Rey Salazar at X 5426.
* indicates required fields.
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