Submitted Application for a 2019 CIP Project

AppID19265
I. Administrative Section 
1. Project Name: DMV Donovan - Renovate Staff Breakroom and Staff Restrooms
2. Project Description (One Sentence): Renovation of Staff Breakroom and Staff Restrooms.
3a. Project Location: County: Clark
3b. Project Location: City: N. Las Vegas
4. Department (department requesting project): Motor Vehicles
5. Division (division requesting project): Admin Services
6. Agency (agency requesting project):
7. Agency contact person: Gareth Jones
8. Contact phone: 775-684-4804
9. Contact email: gjones01@DMV.NV.GOV
The Department ranking of this project:
10. The Department will rank their projects 1 through the lowest ranked project (e.g., If 5 projects were submitted by the Department a ranking of 1 would be assigned to the most important or most needed project and a ranking of 5 would be the least needed project). 8
11. Has this project been previously requested in a prior CIP? Unknown
12. SPWD 4 digit Building No. (for existing buildings) 9832
13. Facility Condition Analysis Project No. (if recommended)
14. Is the property State Owned? Yes
15. If the facility is existing, is it State owned? Yes
II. Narrative Section 
16. Project Description: Install new kitchen counter tops, counter top sinks and cupboards in Staff Breakroom. Install new fixtures and fittings in two staff restrooms. Reconfigure toilet and sink arrangement so as to create space for a paper and soap dispensers. Install new nonslip flooring in two restrooms.
17. Project Justification: Existing breakroom fixtures are original to the building and require constant repairs. Counter tops are badly worn and it's difficult to maintain a hygienic food preparation area. Existing restroom fixtures and fittings are original to the building and parts difficult to obtain. Sink splashes on to the floor which then creates a slip hazard. Non Slip floor required as at present a walkoff mat is in the restroom to prevent slips. This is not hygienic.
18. Project Background Information: This project does not appear on any facilities condition report. The staff made complaints during a recent DMV facilities staff and B&G management visit.
19. Mechanical and/or Electrical Equipment Replacement Projects:
19a. Type of equipment to be replaced:
19b. Year existing equipment was installed:
19c. Manufacturer of existing equipment:
19d. Model of existing equipment:
19e. Are there any known hazardous materials? Unknown
Environmental Considerations
20a. Hazardous Materials (Asbestos, Lead Paint, etc.):
20b. Will the site require any hazardous material abatement? Unknown
21. Ramifications if the Project is not Approved (short essay):
Health, Life Safety, and/or Legal Issues
22. Please describe any health, life safety, and/or legal issues that will be resolved by completing this project (Short Essay):
23. Proposed Project Schedule Impacts/Issues
23a. Will this project require relocating personnel or vacating the building for any period of time? No
23b. Explain:
23c. Has any design work been completed on the proposed project? No
23d. What is the latest date this project could be completed without disrupting your program?
23e. What is the driving proposed completion date?
III. Preliminary Construction Cost Estimate and Funding Sources Section 
Preliminary Construction Cost Estimate and Funding Sources (The SPWD will prepare all final cost estimates. This schedule is for preliminary purposes only.)
24. Land (if land must be purchased): 0
25. Offsite construction: 0
26. On-site Development: 0
27. Utility connection fees: 0
28. Water rights deeded: 0
29. Furniture, Fixtures and Equipment: 0
30. Specialty equipment: 0
31. Data and network equipment: 0
32. Telephone equipment costs: 0
33. Moving: 0
34. Renovation of vacated space: 0
35a. Correction of known deficiencies: 0
35b. (describe deficiencies)
36a. Any known commitments: 0
36b. (describe commitments)
37a. Known hazardous material abatement: 0
37b. (describe hazardous materials)
38. Total project costs: 65,000
NOTE: COSTS FOR EXTENDED LEASE AGREEMENTS MUST BE INCLUDED IN YOUR OPERATING BUDGET
39. Proposed funding of total project cost:
39a. Agency:
39b. Federal
39c. State 65,000
39d. Other/Donor
39e. (describe source of 'Other/ Donor' funding):
39f. Total: 65,000
40. Agency point of contact for outisde funding if 39a, 39b, or 39c funding sources are providing funds.
40a. Name
40b. Phone Number
40c. Email Address
IV. Site Analysis Section 
Site Analysis (New construction only)
41. Estimated land area to be acquired (acres)
42. Will this project require new parking spaces? No
43. Are utilities available to site? Yes
44. Will project require relocation of existing utilities? No
45. Are there any required offsite improvements (or right-of-way dedications)? No
46. Is the site in a flood plain? No
47. Is the site in an airport impact zone? No
48. Does the site contain any underground storage tanks? Unknown
49. Does the site contain any adverse soil conditions? Unknown
50. Will the site require an environmental assessment? Unknown
51. Will rezoning or a special use permit be required? No
52. Will any Utility connection fees need to be paid? No
53. Will any water rights need to be deeded? No
54. Will construction traffic degrade existing access or facilities? No
55. Will the site require any hazardous material abatement? Unknown
56a. Other site considerations affecting cost? (describe): No
56b. Describe Site Considerations:
V. Programming Section 
Programming (New construction, building remodels, and building additions only)
57. Has any architectural programming occurred?
(Programming is an architectural definition of the needs/problems that must be addressed by the project)
58. Has any advanced planning occurred in previous CIPs? No
59. Usable Square footage required (including storage space)
59a. New Construction SF:
59b. Remodel/Renovation SF: 500
59c. Addition SF 8,042
59d.Total project SF: 8542
60. Occupancy type (Assembly, business, educational, factory/industrial, high hazard, institutional, mercantile, residential, storage, utility/miscellaneous) : Business
61. Approximate number of staff to occupy facility: 25
62. Approximate number of visitors per day: 325
63. Will this project require funding for any furnishings, fixtures and equipment? Yes
64. For existing facilities, are there any known hazardous materials? (e.g., Asbestos, lead paint or underground storage tanks): Unknown
65. How many years of future growth will this project accommodate? 20
66. List of required facilites (laboratory space, classroom space, office space, conference rooms, cafeterias, maintenance shops, garages) and any unusual related equipment required for your project:

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NOTE:  IF YOU ARE THE “AGENCY CONTACT PERSON”, AND HAVE NOT BEEN CONTACTED BY THE ASSIGNED PROJECT MANAGER BY APRIL 16, 2018, PLEASE CONTACT THEM.