Fillable FALL19 IER REQUESTFORM

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FALL19 IER REQUESTFORM

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LPC INSTRUCTIONAL EQUIPMENT (IE) REQUEST
FALL 2019 - 2020
THE FOLLOWING INFORMATION WILL CONTRIBUTE TOWARD A QUALITY IE REQUEST
Criteria
Strong Evidence
Adequate Evidence
Limited Evidence
LPC Mission & Planning
Priorities
(5 points) [Section 3]
Ranking Scale
Clear and compelling evidence/data
that equipment will fully support
LPC Mission and Planning Priorities.
4-5
Clear evidence/data that equipment
will fully support LPC Mission and
Planning Priorities.
2-3
Limited or no evidence/data that
equipment will support LPC
Mission and Planning Priorities.
0-1
Educational Items:
Programmatic Impact
and Institutional Support
(10 points) [Section 4]
Ranking Scale
Clear and compelling evidence/data
(as stated in program review) that
this equipment will have substantial
impact on program curriculum.
8-10
Clear evidence/data (as stated in
program review) that this equipment
will have substantial impact on
program curriculum.
4-7
Limited or no evidence/data (as
stated in program review) that this
equipment will have an impact on
program curriculum.
0-3
Teaching & Learning
(10 points) [Section 5]
Ranking Scale
Clear and compelling evidence/data
that equipment provides much
needed or beneficial enhancement to
instruction.
8-10
Clear evidence/data that equipment
provides enhanced instruction that is
not met through current means.
4-7
Limited or no evidence/data that
equipment provides enhanced
instruction that is not met through
current means.
0-3
Outcomes
(5 points) [Section 6]
Ranking Scale
Clear and compelling evidence/data
that equipment will support course
and/or program outcomes above and
beyond current capability.
4-5
Clear evidence/data that equipment
will support course and/or program
outcomes beyond current capability.
2-3
Limited or no evidence/data that
equipment will support course
and/or program outcomes beyond
current capability.
0-1
Total Cost of Ownership
(Financial &
Sustainability)
(5 points) [Section 7]
Ranking Scale
All items/issues in the Financial and
Sustainability sections fully
addressed.
4-5
Items/issues in the Financial and
Sustainability sections are partially
addressed.
2-3
Items/issues in the Financial and
Sustainability sections minimally
or not satisfactorily addressed.
0-1
IE Rubric: RAC will evaluate each IE request based on the IE rubric. RAC stresses the importance of quality requests. RAC
may choose not to rank incomplete IE requests.
Please note the following deadlines when submitting your IER Request.
September 13, 2019: Fall 2019 IER Requests Due to Dean
September 20, 2019: Fall 2019 IER Requests Due to Administrative Services
Office by 5:00pm with all signatures
All IER requests must have Fall 2019 IER Checklist attached as cover page.
Please Do Not Submit this Page
Fall 2019 Instructional Equipment Request Checklist
This checklist is your cover page to your IER Request (pages 3-9)
Incomplete forms will be returned.
Action Item
Action Required
Review Instructional
Equipment Definition
Instructional equipment expenditures are eligible if the equipment, library material,
or technology is for classroom instruction, student instruction or demonstration, or in
the preparation of learning materials in an instructional program. There are five
categories that will be used to classify instructional support. The following are
examples:
Equipment and Furniture: instructional equipment and furniture for primary use by
students in instructional programs:
o Classroom/Laboratory equipment, including whiteboard, screen, projector,
etc.
o Instructional furniture, including desks, tables, podium, chairs, etc.
Information Technology: instructional information technology equipment for
student use in classrooms and/or laboratories, including desktops, laptops, monitors,
printers, servers, network/wireless infrastructure, AV/TV, multimedia.
Software: software licenses are allowed but only the initial year is permitted. Other
software that are permitted are those that are used in excess of one year and softwar
e
m
odifications that add capacity or efficiency to the software that defers obsolescen
ce
a
nd results in an extension of the useful life of the software, including registration,
counseling, student services, learning management systems for student use.
Adaptive Equipment: adaptive equipment for ADA/OCR students are allowed to
assist them in a learning environment.
5 Library Material: databases, on-line subscriptions, books, periodicals, videos, etc.
Review form for
completion
Each field of the IER must be completed with required information. Please do not
leave fields blank.
Furniture Requests: All requests for furniture quotes must go through the College
Projects Manager, Ann Kroll.
Requisition and
Quote Attached
IER request must have a requisition for each vendor, valid quote*, W-9 and
vendor profile form.
The required tax rate to be used is 9.25%.
Shipping estimates need to be included on the vendor quote
.
*
A quote is not a print screen from a website, or shopping cart details.
IT Signature
The IER form must be vetted by Stephen Gunderson to ensure the request meets
current IT standards and if IT staffing is required to install or support request.
Maintenance &
Operations Signature
All IER forms must be vetted by Walt Blevins to ensure the request does not require
DSA approval and if M&O staffing is required to install or maintain the request.
Division Dean
Signature
The Division Dean will review the IER forms for completion, required signatures,
and verify all RAC requirements.
Vice President
Signature
The Vice President will review the IER forms for completion, and required
signatures.
IE #: _______________
Total $:_____________
INSTRUCTIONAL EQUIPMENT REQUEST
FALL 2019-2020
Requeste
r Name: ________________________Division Name: ________________________
__________________________SUMMARY INFORMATION_________________________
Title of Item:
Room: ______________________________
Equipment Location Building: ____________________
Location and Delivery Comments:
SECTION 1: EQUIPMENT DESCRIPTION______________________________________
The equipment is:
☐
A Replacement
☐
An Upgrade
☐
New Equipment/Technology
Describe the specific equipment requested and how it will be used to replace, upgrade or provide new
technology to LPC from what is currently in place:
3
LPC MISSION STATEMENT:
LPC is an inclusive learning-
centered institution providing
educational opportunities and
support for completion of students’
transfer, degree, basic skills,
career-technical, and retraining
goals.
LPC PLANNING PRIORITIES:
Accreditation: Establish regular and ongoing processes to implement best
practices to meet ACCJC standards.
Curriculum: Provide necessary institutional support for curriculum
development and maintenance.
Tutoring Services: Expand tutoring services to meet demand and support
student success in Basic Skills, CTE, and Transfer courses.
Professional Development: Coordinate available resources to address current
and future professional development needs of faculty, classified professionals,
and administrators in support of educational master plan goals.
SECTION 1: EQUIPMENT DESCRIPTION (contd)________________________________
If applicable, describe the legal requirement, mandate, or safety concern for purchase of this equipment,
making specific reference to the legal requirement or regulation:
SECTION 2: LPC MISSION STATEMENT AND LPC PLANNING PRIORITIES______
Specify how the equipment supports LPC’s Mission Statement and Planning Priorities:
4
SECTION 3: EDUCATIONAL ITEMS – PROGRAM REVIEW______________________
Specify the educational programs this equipment supports:
If this equipment is included in your Program Review, please include the exact wording. If equipment is
not included, explain why:
5
SECTION 4: TEACHING AND LEARNING______________________________________
Describe in detail the impact this equipment will have on teaching:
Describe in detail the impact this equipment will have on learning:
Each academic year, this equipment will impact: ____ # of classes/sections ____ # of students
SECTION 5: OUTCOMES (SLOs)_______________________________________________
Using your documented SLOs, specify how the equipment will enable student learning outcomes to be
achieved.
What are the consequences related to learning outcomes if request is not funded?
6
SECTION 6: TOTAL COST OF OWNERSHIP (FINANCIAL & SUSTAINABILITY)___
What is the potential life span of the requested equipment?
If new storage is needed what are the storage requirements, location requirements, and costs associated
with the new equipment: (NOTE: Specific storage costs should be detailed in the “Part A: Initial
Start-up Costs” section below.)
If this equipment replaces old equipment but the old equipment will not be retired, are there on-going
storage requirements, location requirements, and costs associated with the old equipment? If so, provide
details.
What will
be required to mai
nt
ain the equipment, such as regular servicing or upkeep? (Specific on-going
costs should be detailed in the “Part B: On-Going Annual Operating Costs” sections below as applicable.)
Explain how this equipment meets or exceeds basic sustainability efforts and/or provides renewable
resources to the college:
7
If your proposed equipment will require assembly or installation, please explain what is required, who
will perform it, and what the cost will be?
SECTION 6: TOTAL COST OF OWNERSHIP (contd)___________________________
Part A: Initial Start-up Costs
Item
Cost
Comments
Equipment or Materials
Taxes (9.5%)
Shipping or Delivery Charge
Installation Costs *
Miscellaneous Costs:
Facilities Modifications
Operator Training
Maintenance & Repair Training
Storage
Other: ______________________
Vendor Discount
Grand Total:
*
For items requiring installation, requesters are required to check with District Purchasing (Victoria
Lamica) regarding District policies.
Part B: On-Going Annual Operating Costs
Item
Cost
Comments
Annual Service or Maintenance
Estimated Parts Replacement Per Year
Outside Standardization or Calibration
Costs
Storage Costs
New Supply Costs
Miscellaneous Costs:
Maintenance & Repair Labor
Other: ______________________
Annual Operating Costs:
Indicate the source of funding for on-going annual operating costs:
8
SECTION 6: TOTAL COST OF OWNERSHIP (contd)___________________________
Part C: Incremental Labor Costs
OPERATOR:
Indicate the key operator: ___________________________________________________________________
Is this in their current scope of duties? _________________________________________________________
Indicate cost to train key operator (include in Initial Start-up Costs above): _________________________
Indicate amount of time per month key operator will use equipment: _______________________________
MAINTENANCE & REPAIRS:
Indicate the person performing maintenance and repairs: ________________________________________
Is this in their current scope of duties? ________________________________________________________
Indicate cost to train for maintenance and repairs: ______________________________________________
Indicate amount of time per month maintenance will be required: _________________________________
APPROVALS_________________________________________________________________
Funded requesters will be expected to respond to a brief RAC feedback survey by a requested deadline.
Requests for computer-related equipment and printers must be reviewed and signed off by
the
LPC IT Department.
Requests that require M&O assistance with assembly or installation must be signed off by M&O.
SIGNATURES:
______________________________________
Requester
______________________________________
IT Approval
______________________________________
M&O Approval
______________________________________
Division Dean
______________________________________
Vice President
________________________________
Date
________________________________
Date
________________________________
Date
_______________________________
Date
_______________________________
Date
9
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FALL19 IER REQUESTFORM

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Completed 20 February 2020

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