Request for Facilities…

                                            Request for Facilities Management Services
                                             Please complete sections A-E below and submit to the FM Work Control Center
                                                 1300 Service Building (003) · Tel 301.405.2222 · Fax 301.405.1473
A. Requester Information
  Name:                                                                              Phone:
    Title:                                                                             Email:
    Dept:                                                                               Fax:
B. Description of Service             (Select type and describe service)

  Special Service         Maintenance          Minor Alteration            Lease       Campus Project            Capital Project

Location of Work:      Building
                      Room(s)
               or campus area
Desired Date / Time of Delivery:
Service Requested:




C. Financial Information (not required for Maintenance requests)
   Billing Dept:                                                                     Billing
Contact Person:                                                                    Address:

        Payment Method(s)                             Fund Source Account #                              Funding Amount
Fund from campus account(s):



Paid directly by you:

Requesting funding from a
campus, State or external source:

D. Request Authorization
      Select an authorization option for your request and sign:

      I request delivery of the services described above and authorize payment of all associated costs.

      I request a detailed project budget for the services described above. This option is required if campus or
      State funding is requested.

Signature:                                                                     Date:


E. Approvals      (required for all Lease Requests, Campus, and Capital Projects and where campus or State funds are requested)

Dean / Director                                                                          Date:

Vice President                                                                           Date:

 FM use - W.O. / Proj. #:                                                                 Unit:
              Proj. Title:                                                               Date:
            Instructions for the "Request for Facilities Management Services"
Please complete sections A - E and forward to Facilities Management Work Control Center, Room 1300, Service Building

     Section               Field                           Instructions for Entering Information
  A - Requester      Providing this information will enable us to contact you or another appropriate person to discuss and
   Information       manage our delivery of services. Enter information for the person we should contact.
                            Name          Name of the primary customer for these services.
                            Phone         Campus, business, or personal telephone number
                            Email         Full email address
                             Title        Requester's campus or business title
 B - Description     Categorizing your request and providing a brief description of the services desired will help us better
   of Service        understand your needs.
                      Type of Service Special Services include requests for assistance to support special events.
                                          Minor Alteration is defined as work in a facility that is beyond maintaining an
                                          existing building component. For this type of work, there is no space use change
                                          and no design services required. This type of work is intended to move quickly
                                          ("fast track") into implementation.
                                          Maintenance is the recurrent, day to day, periodic or scheduled work required to
                                          preserve or restore a facility to such condition that it can be effectively used for
                                          its designated purpose.
                                          Lease requests are for additional space requirements that be located in rental
                                          facilities off-campus.
                                          Campus Projects are facility improvements or new construction projects under
                                          $1M which may be approved by the UM administration's Facilities Council.
                                          Capital Projects are those improvements for new facilities or major renovations
                                          that cost $1M or more and require approval beyond the UM administration's
                                          Facilities Council (i.e. University System of Maryland Board of Regents and/or
                                          the Maryland State Legislature).
                         Location of      Provide the building and room(s) or campus area where the services will be
                            Work          delivered or work will be executed.
                       Desired Date /     If the delivery of the service is time sensitive, provide an indication of when you
                     Time of Delivery desire delivery.
                       Description of     Provide a brief description of what services you need or what goal you desire.
                        the Services
                         Requested
   C - Financial     Funding account information will be required for all types of service other than Maintenance. The
   Information       funding amount may not be available at the time of request.
                        Billing Dept.     Provide the department / unit to be billed for these services.
                      Contact Person Provide the financial contact (if different than the requester).
                      Billing Address Provide the building / room where any financial information should be mailed
                          Payment         Three types of payment methods are available - campus accounts, a personal
                          Methods         account, or State or external funding accounts.
                             and          Campus accounts - Provide the financial account code(s) and amount if
                      Funding Source available.
                       Accounts and       Paid directly by you - Provide your Social Security number.
                          Amounts         Requesting funding from a campus, State, or external source - Provide the
                                          type of funding you are requesting if available.
   D - Request       Select one of these choices:
  Authorization      ·= Delivery of services and payment authorization authorizes FM to purchase materials and
                         services, commit labor and other FM resources to the completion of the request.
                     ·= Detailed project budgets are required for most projects and will provide clear statements of work,
                         costs, schedules, and the project's review/approval requirements.
  E - Approvals      Campus policy requires the approval of all lease requests, campus, and capital projects by the
                     appropriate Dean or Director and Vice President(s). Please forward the completed form to the
                     appropriate person for approval prior to forwarding to Facilities Management.
      FM Use         Facilities Management will use this section to assign a Work Order or Project number and unit and
                     create a descriptive title.