Capital Request Form - PDF

							Instructions – Capital Request Form

    General

    This form should be filled out if you are requesting capital items for FY
    2011. Instructions have been included in this document on procedures to
    fill out this form. A capital item is considered any individual item that has a
    useful life of at least two years, has a cost of at least $5,000, and is
    tangible in nature. Items generally considered capital are vehicles,
    servers, land, buildings, heavy equipment, etc. Please note software is
    considered capital, if a single license costs $5,000 or more.

    Multiple capital requests can be made in this workbook by copying the tab.
    The tab is at the bottom of the workbook. Right click on the tab labeled
    “Capital Request”, select Move or copy, check the box “Create a copy” and
    click OK. Tabs can be renamed by double-clicking on the tabs and typing
    the new title. You may wish to re-title the tabs to indicate the item being
    requested. This process can be repeated as often as needed to create
    multiple requests in one workbook for your department.


    COMPLETING THE CAPITAL REQUEST FORM:

    Please complete the non-shaded portions of the form.

    Department Name - name of department. (Example – “Finance”)

    Description – a general description of the item you are requesting
    (Example – “Laser Printer”)

    # requested – Enter the number of items you are requesting. (Example –
    “2” for two printers)


    Cost per item – Leave this field blank. This field will automatically
    calculate when completing the Capital Costs section at bottom of page.

    New or Replacement – indicate if item is to replace existing equipment

    Estimated useful life - expected useful life of item requested.

    Item to be replaced, if applicable – identify item to be replaced.

    Asset ID - number assigned to the item to be replaced. If not sure, contact
    Finance. Item to be replaced will be surrendered to the Procurement
    Director for disposition.

    Part of 5 Year Capital Plan – indicate if item is part of the 5 year capital
    plan

    If no, why - Give explanation.



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Instructions – Capital Request Form

    Justification of Capital Request – please give an explanation of why the
    item is being requested such as to replace aged, worn out or obsolete
    items, provide new or improved services, comply with federal or state
    requirements, save on future operating costs, correct a problem, etc.

    Capital Costs – Please break down by type of cost for the requested item.
    List under “Other” any other cost besides the cost of the equipment,
    freight, sales tax, and advertising. The total field will automatically
    calculate and fill in the amount under “Cost per Item”. If requesting more
    than one item, please list the cost for only one item. Please use the space
    to the right to put any additional information needed.

    Source of Funding – please indicate proposed funding source for items.
    Other could include bond, capital lease, Local Accomodations Tax, etc.
    Please use the space to the right to put any additional information
    regarding potential funding sources.

    Estimated Change in Operating Costs – please provide estimates of any
    changes expected in the operating costs of the department due to the
    purchase of the requested item(s). Indicate the types of cost (Annual
    Maintenance, Fuel & Oil, etc.) and the amounts for 2011 and 2012 (some
    of the operating expenses may be less the first year depending on when
    the item is first placed into service). This section does not need to be
    completed if there is no change in operating costs expected. The total of
    all additional 2011 operating costs related to capital requests should be
    included in the separate line item on the budget worksheet titled
    “Operating Costs related to Capital Requests”. Operating costs for items
    approved will be distributed to the appropriate budget categories.




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