Project Qualification Form - Cummins

Project Qualification Form
As part of your grant request to the Cummins Foundation Architecture Program, we ask
that you complete the form below to help us better understand your proposed project,
and determine its fit within the guidelines and priorities of the Architecture Program.
For any questions that require further detail or additional background, please attach a
separate document with the necessary information.
Grant Request Details
Requestor:
Date:
Project:
Project Manager:
Funding Sources:
Please attach a proposed
project budget.
Entity Receiving
Architecture Program
Funding, if approved:
Owner of the facility
(if different during
construction and once
occupied, please explain)
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Criteria
Yes/No
1
What is the proposed function(s) of the building What group(s) will use the space and for what
purposes
2
3
4
5
Is this proposed project for a public building
Is the proposed project located in Bartholomew County If so, please detail
location.
Does zoning allow the proposed uses and building on this land
Please explain how you plan to pay for construction of the building.
Yes
No
Yes
No
Yes
No
6
7
8
Is this project a renovation or update to an existing building If so, please
explain.
Has the public engaged in this project Is there a possibility of a referendum
or remonstrance If so, please explain.
Has a long-term plan been developed for the building’s maintenance and
funding If so, please attach.
Yes
No
Yes
No
Yes
No
9
10
What is the estimated start and completion date for this project
START DATE:
COMPLETION DATE:
What is the proposed building type (e.g. school, fire station, community center, etc.)
What is the estimated total square footage and height of the building
11
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Comments:
Signatures for Submission
Requestor: Date: / /
Project Manager: Date: / /
Funding
Sources: Date: / /
Date: / /
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