IUB - Request for Furniture Design Services

Contact Name:	REQUIRED
Department:	REQUIRED
Current Building and Room:	REQUIRED
Phone Number:	REQUIRED
Fax Number:	REQUIRED
Email:	REQUIRED
Alternate Contact Name:
Building and Room:
Phone Number:
Email:
Building(s) and room(s) number(s) where product is to be used:
Who will be using this product:
Position Level of Employee:

What is the general function of the space (check one):

general office
reception
conference
lab
private/Shared office
other

Is your plan to use (check one):

existing and new furniture
all new furniture

Is your preference (check one box per line):

metal or wood

contemporary or traditional

What product is currently in this space? List manufacturer and product line. If this is unknown or a product tag cannot be found, please leave blank.

What is your budget?

Is this request an estimate for funding approval?
Yes
No

Have you obtained funding for the project?
Yes
No

Do you have a timeline or deadline for project completion?

Yes
Date:
No

Comments:

Requisition #: REQUIRED

Account #: REQUIRED