Estimate the costs in which the Federal Government is requested to participate.
| 1. Demolition | $ _______________ |
| 2. General alteration and renovation (e.g., carpentry, masonry, painting) | $ _______________ |
| 3. Plumbing | $ _______________ |
| 4. Heating, ventilation, and air conditioning | $ _______________ |
| 5. Electrical | $ _______________ |
| 6. Architect's and engineer's fees | $ _______________ |
| 7. Other costs (specify) | $ _______________ |
|
8.
TOTAL ALTERATION AND RENOVATION COSTS (to Federal Government) |
$ _______________ |
| 9. Fixed equipment | $ _______________ |
| PHS SOURCES AND AMOUNTS: | ALL SOURCES AND AMOUNTS OTHER THAN PHS: |
|---|---|
| __________________________________ | ___________________________________________________ |
| __________________________________ | ___________________________________________________ |
| __________________________________ | ___________________________________________________ |
| __________________________________ | ___________________________________________________ |
| __________________________________ | ___________________________________________________ |
|
Total net square feet of floor area in alteration and renovation proposal | _________________ |
|
Estimated cost per net square foot, excluding fixed equipment |
$ _______________ |
