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The Connecticut Capital Improvement form is an essential tool designed to facilitate the process of requesting funding for enhancements to existing community living arrangements. This form serves various stakeholders, including private residential providers and developmental services staff, by outlining the necessary steps for submitting a capital improvement request. Key sections of the form include the property address, a detailed description of the requested improvement, and the specific needs that justify the project. Additionally, the scope of work and estimated total project cost must be clearly articulated. This ensures that all parties involved have a comprehensive understanding of the project at hand. The form also includes a bid summary section, which allows providers to document contractor information and bid amounts, as well as any exceptions to the bidding process that may arise. Ultimately, the Connecticut Capital Improvement form aims to streamline the approval process while ensuring that projects meet the required health and safety standards for residents, as stipulated by state regulations.
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File Information
| Fact Name | Fact Description |
|---|---|
| Governing Laws | The Connecticut Capital Improvement form is governed by Sections 17b-244 and 17a-228 of the General Statutes. |
| Purpose | This form is used to request capital improvements for existing community living arrangements managed by the Department of Developmental Services. |
| Approval Requirement | Approval for the capital improvement is required before any work can commence on the property. |
| Contact Information | The form includes contact details for the Department of Developmental Services, including phone and fax numbers. |
| Expense Incurred By | Applicants must indicate whether the expense will be incurred by the provider or the community living arrangement. |
| Bid Summary | A bid summary form is included for contractors to submit bids, detailing the work to be done and the associated costs. |
| Justification for Bid Selection | If the lowest bid is not selected, the applicant must provide justification for their choice of contractor. |
| Health and Safety Certification | The project must be certified as necessary for the health or safety of residents, as stated in CGS 17b-244. |
| Signature Requirement | Multiple signatures are required on the form, including those from the provider, regional director, and commissioner. |
| Equal Opportunity Statement | The form includes a statement affirming that the Department of Developmental Services is an affirmative action/equal opportunity employer. |
Connecticut Capital Improvement Sample
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State of Connecticut |
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Department of Developmental Services |
Dannel P. Malloy |
Jordan A. Scheff |
Governor |
Commissioner |
DEPARTMENT OF DEVELOPMENTAL SERVICES
REQUEST FOR CAPITAL IMPROVEMENT TO EXISTING
COMMUNITY LIVING ARRANGEMENTS
DATE
(A)
APPROVAL IS REQUESTED FOR THE CAPITAL IMPROVEMENT DETAILED BELOW AT:
Property Address (B)
Improvement Requested (C):
Description of Need (D):
Scope of Work (E):
Estimated Total Project Cost (F): $
Expense Incurred by: (check one)
Explanation of Cost Estimate (G):
Provider
CIL
Phone: 860
460 Capitol Avenue Hartford, Connecticut 06106
www.ct.gov/dds
An Affirmative Action/Equal Opportunity Employer
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BID SUMMARY FORM |
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Provider: |
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Date: |
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Address: |
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Project Location: |
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Number: |
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Description of Work: |
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Type of Contractor (General, Trade) |
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Contractors Requests to Submit Bids |
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Date Received |
Bid Amount |
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Contract Award To:
If exception to bidding process is requested, check reason:
Unable to solicit three bids |
Urgency to complete work |
Other: |
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If lowest bid is not selected, write justification for choice: |
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Remarks: |
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Prepared by: |
Approved By: |
Provider |
Region |
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Property Address:
(H)
The undersigned acknowledge that this document does not constitute a contract for development of a property and further acknowledges that any payments by the State of Connecticut related to this property may only be made pursuant to Sections
PROPOSED BY: |
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PROPOSED BY: |
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Private Residential Provider |
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Development Staff/Property Developer |
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(if Applicable) |
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________________________ |
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_____________________ |
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Signature (Name) |
(I) |
(Date) |
Signature (Name) ( J) |
(Date) |
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Print/Type Name |
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Print/Type Name |
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Tel No.: |
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Tel.No. |
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REVIEWED BY: |
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AFTER CONSULTATION WITH: |
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_______________________ |
________________ |
___________________ |
_________ |
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Signature (Name) (L) |
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(Date) |
(Signature) (Name) |
(M) |
(Date) |
Regional Director for Region |
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Commissioner |
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Department of Developmental Services |
Department of Social Services |
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(Or Authorized Designee) |
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(Or Authorized Designee) |
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Print/Type Name |
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Tel.No: |
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APPROVED BY |
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____________________________________ |
______________ |
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(Signature) (Name) |
(N) |
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(Date) |
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Commissioner |
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Department of Developmental Services |
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(Or Authorized Designee) |
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By signing below, I hereby certify that this capital improvement project is considered by the Department of Developmental Services to be a required project for the health or safety of the residents as detailed in CGS
____________________________________ |
______________ |
(Signature) (Name) (O) |
(Date) |
Commissioner |
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Department of Developmental Services |
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(Or Authorized Designee) |
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Common mistakes
When completing the Connecticut Capital Improvement form, one common mistake is failing to provide a complete property address. This information is essential for identifying the location of the proposed improvement. Omitting details such as the street number, street name, or zip code can lead to delays in processing the request.
Another frequent error involves not clearly describing the improvement requested. In section (B), individuals may use vague language or skip this part altogether. A clear and specific description helps reviewers understand the project’s purpose and necessity. Without this clarity, the request may be questioned or rejected.
People often overlook the importance of providing a detailed explanation of the project's estimated costs. Section (F) requires an estimated total project cost, but some may leave this blank or provide an unrealistic figure. Accurate cost estimates are crucial for budgeting and approval processes. Providing a well-thought-out explanation of costs can prevent misunderstandings later on.
Lastly, individuals sometimes fail to include the necessary signatures in the appropriate sections. The form requires signatures from multiple parties, including the provider and authorized designees. Missing signatures can result in the form being considered incomplete, which can stall the entire approval process.
Key takeaways
When filling out and using the Connecticut Capital Improvement form, consider the following key takeaways:
- Complete All Sections: Ensure that every section of the form is filled out accurately. This includes providing details about the property address, the specific improvement requested, and a comprehensive description of the need for the project.
- Estimate Project Costs: Clearly outline the estimated total project cost. This helps in budgeting and ensures transparency in the funding process.
- Understand the Bidding Process: Be aware that a bid summary form is part of the submission. You must document all bids received and provide justification if the lowest bid is not selected.
- Approval Requirements: Recognize that submitting this form does not guarantee project approval. The project must be deemed necessary for the health or safety of residents, and it requires authorization from the Department of Developmental Services.
Similar forms
The Connecticut Capital Improvement form shares similarities with the Grant Application form. Both documents require detailed descriptions of the proposed improvements and their necessity. They also include sections for estimated costs and justifications, ensuring that funds are allocated efficiently. Like the Capital Improvement form, a Grant Application must be reviewed and approved by relevant authorities before any financial commitment is made.
Another document that aligns closely is the Project Proposal form. This form also outlines the scope of work, project costs, and the intended benefits of the improvements. Both documents serve as a means to communicate project details to decision-makers, ensuring that all necessary information is presented clearly for evaluation.
The Budget Proposal form is similar in that it breaks down the financial aspects of a project. It requires a detailed cost estimate, just like the Capital Improvement form. Both documents aim to provide transparency in funding and ensure that resources are allocated appropriately for community needs.
The Contract for Services is another related document. This contract formalizes agreements between service providers and the state, detailing the responsibilities and expectations for capital improvements. While the Capital Improvement form is a request, the Contract for Services solidifies the commitment once the project is approved.
In the realm of documentation for property transactions, understanding intricacies such as the New York Mobile Home Bill of Sale is crucial, as this form facilitates the transfer of ownership while protecting the rights of both the buyer and seller. For those seeking guidance on how to complete such forms effectively, refer to the Templates and Guide, which offers valuable resources to assist you in navigating the process smoothly.
The Request for Proposal (RFP) is akin to the Capital Improvement form in that it seeks bids from contractors for a specific project. Both documents require a clear description of the work to be done and the criteria for selection, ensuring that the best contractor is chosen for the job.
The Change Order form also shares similarities. It is used to request modifications to an existing project, including adjustments in scope or costs. Just like the Capital Improvement form, it requires detailed explanations and justifications for the proposed changes, maintaining clarity and accountability throughout the project lifecycle.
The Environmental Impact Assessment form is another document that parallels the Capital Improvement form. Both require a thorough evaluation of the potential effects of a project on the surrounding community and environment. This ensures that any improvements made are sustainable and considerate of public health and safety.
The Compliance Certification form is similar in that it confirms adherence to regulations and standards. Both documents require signatures from authorized personnel, indicating that all necessary approvals have been obtained and that the project aligns with state guidelines.
The Feasibility Study is another document that serves a similar purpose. It assesses the practicality of a proposed project, considering factors such as cost, timeline, and community impact. Like the Capital Improvement form, it aims to ensure that only viable projects receive funding and support.
Lastly, the Maintenance Plan is comparable as it outlines ongoing responsibilities after a capital improvement is made. Both documents emphasize the importance of long-term sustainability and care for community resources, ensuring that improvements continue to benefit residents over time.