Building Modification\Addition Request Version 197.0

SelectionSelectionlocationroom_numorganizationorg_contactorg_phoneorg_emailcampus_contactcampus_contact_phonecampus_contact_emailcampus_secretarycampus_sec_phonecampus_sec_email

Email Address:

Phone Number:

Campus Secretary:

Email Address:

Phone Number:

Campus Contact Person:

Email Address:

Phone Number:

Name of Organization's Contact Person:

Name of Organization/Support Group Proposing the Request:

Room #:

Location at Facility:

Campus/Facility:

Describe equipment to be purchased or facility modification/addition. All purchases require quotes/specs. Attach site plans, floor plans, sketches, photos detailed plans, architectural/engineering designs. No purchases or down payments can be made before final approval.

If ESC, Choose Department:

change_description

Katy ISD Maintenance Department

kisd_installer

District approved product vendor or contracted service provider:

district approved vendorven number

Other:

other detailsven addressven_phoneven_email

Vendor#:

*To identify district approved service providers, contact the District Purchasing Department for assistance.

Vendor/Service Provider's Name and Address:

Phone Number:

Email Address:

Who will install the equipment or implement the modification/addition? (Check all that apply)

estimated project costfund1alt fundPrinEmail

Selection

"Building and Landscape Modification" Request for Approval of Equipment Purchase or Facility Modification/Addition

Katy Independent School District

This form must be completed and approved PRIOR to any PURCHASE or INITIATION of facility modification/addition. A complete summary of funding sources/plans and project description must be submitted with this request.

District Budget Code:

Alternate Funding Source for this Project:

Estimated Total Cost of Project:

Funding Source for this Project:

Date:

Email of Principal Submitting Request:

Initial Approver:

Date of Request: