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When organizations or service providers in Connecticut seek to enhance their community living arrangements through capital improvements, navigating the paperwork becomes a critical step. The Connecticut Capital Improvement Form, issued by the State of Connecticut Department of Developmental Services, serves as a structured guide for this purpose. Championed under the leadership of Governor Dannel P. Malloy and Commissioner Jordan A. Scheff, the form is a meticulously designed document ensuring that requests for enhancements to existing facilities are thoroughly evaluated and approved. Starting with the need for improvement, the form covers a broad spectrum of details including the description of the improvement needed, the scope of work envisaged, and the estimated cost of the project. Additionally, it brings into account the bidding process, thereby ensuring fairness and transparency in the selection of contractors. Notably, it underscores the necessity for approval at several levels, emphasizing the form's role in maintaining accountability and ensuring that any capital improvement undertaken addresses the genuine needs for the health or safety of the residents. Moreover, it appreciates the financial implications of such projects, requiring a detailed explanation of cost estimates and justifications for contractor selection, especially if the lowest bid is not chosen. This form, thus, stands as a vital tool in the realm of developmental services, guiding providers through the regulatory and procedural maze to improve community living arrangements.

Document Sample

 

State of Connecticut

 

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: 860 418-6000 TDD 860 418-6079 Fax: 860 418-6001

460 Capitol Avenue Hartford, Connecticut 06106

www.ct.gov/ddse-mail: ddsct.co@ct.gov

An Affirmative Action/Equal Opportunity Employer

 

BID SUMMARY FORM

Provider:

 

Date:

 

Address:

 

 

 

Project Location:

 

Number:

 

Description of Work:

 

 

 

Type of Contractor (General, Trade)

 

 

 

Contractors Requests to Submit Bids

 

 

 

 

 

Date Received

Bid Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contract Award To:

If exception to bidding process is requested, check reason:

Unable to solicit three bids

Urgency to complete work

Other:

 

If lowest bid is not selected, write justification for choice:

Remarks:

 

Prepared by:

Approved By:

Provider

Region

 

 

2

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 17b-244 and 17a-228 of the General Statutes and the regulations promulgated thereunder.

PROPOSED BY:

 

 

PROPOSED BY:

 

Private Residential Provider

 

Development Staff/Property Developer

 

 

 

(if Applicable)

 

 

________________________

 

_____________________

 

Signature (Name)

(I)

(Date)

Signature (Name) ( J)

(Date)

Print/Type Name

 

 

Print/Type Name

 

 

Tel No.:

 

 

Tel.No.

 

 

REVIEWED BY:

 

 

AFTER CONSULTATION WITH:

_______________________

________________

___________________

_________

Signature (Name) (L)

 

(Date)

(Signature) (Name)

(M)

(Date)

Regional Director for Region

 

Commissioner

 

 

Department of Developmental Services

Department of Social Services

(Or Authorized Designee)

 

(Or Authorized Designee)

 

Print/Type Name

 

 

 

 

 

Tel.No:

 

 

 

 

 

 

 

APPROVED BY

 

 

 

 

 

____________________________________

______________

 

 

(Signature) (Name)

(N)

 

(Date)

 

 

Commissioner

 

 

 

 

 

Department of Developmental Services

 

 

 

 

(Or Authorized Designee)

 

 

3

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 17b-244.

____________________________________

______________

(Signature) (Name) (O)

(Date)

Commissioner

 

Department of Developmental Services

 

(Or Authorized Designee)

 

4

Document Overview

Fact Name Description
Form Purpose This form is utilized for requesting capital improvements to existing community living arrangements, providing a formalized process to ensure the necessary approval and documentation for such improvements within the State of Connecticut.
Required Signatures The form necessitates signatures from various stakeholders including the proposing private residential provider, development staff or property developer, regional director for Region Commissioner Department of Developmental Services, and Commissioner Department of Social Services or their authorized designees, illustrating a multi-tiered approval process.
Governing Laws Payments related to the capital improvement projects are governed by Sections 17b-244 and 17a-228 of the Connecticut General Statutes, underscoring the legal framework that supports the implementation of these improvements.
Consent and Certification By signing the form, the individual certifies that the capital improvement project is deemed necessary for the health or safety of the residents, in accordance with the Connecticut General Statutes (CGS) 17b-244, reinforcing the state's commitment to maintaining high living standards.

Instructions on How to Fill Out Connecticut Capital Improvement

Before you begin filling out the Connecticut Capital Improvement form, it's important to gather all the necessary information about the project you are proposing. This includes details about the property, a comprehensive description of the needed improvements, the scope of work to be done, cost estimates, and any bids you've received if applicable. Being prepared with this information upfront will streamline the process of completing the form. Once you're ready, follow these step-by-step instructions to ensure your request is clearly communicated and properly documented.

  1. Enter the current date under DATE (A).
  2. Under Property Address (B), provide the full address where the capital improvement is requested.
  3. In the Improvement Requested (C) section, clearly describe the type of improvement you're proposing.
  4. Fill in the Description of Need (D) with a detailed explanation of why the improvement is necessary.
  5. Outline the Scope of Work (E) to describe what exactly will be done in the project.
  6. Enter the Estimated Total Project Cost (F) as a dollar amount.
  7. Check the appropriate option under Expense Incurred by: to indicate whether the cost will be covered by the Provider or CIL.
  8. Provide a clear Explanation of Cost Estimate (G) to support the projected expenses.
  9. Under BID SUMMARY FORM, fill in details regarding bids from contractors, including the provider's information, project location, and bid amounts. Remember to justify if the lowest bid is not selected.
  10. Sign and date at the bottom of the form under PROPOSED BY, indicating your agreement and understanding that this document is a request and not a contract for development.
  11. Ensure all other required signatures and approvals are obtained in sections I to O, including those from the Development Staff/Property Developer, Regional Director, Commissioner, or their designees.

After completing the form with the necessary information and signatures, review it thoroughly to ensure accuracy and completeness. This request form is a crucial step in obtaining approval for capital improvements, so careful attention to detail is essential. Once reviewed, submit the form to the designated office as instructed, typically the Department of Developmental Services or its regional office. Remember, this form is part of a formal process to evaluate and potentially approve capital improvements, so it's important to follow all guidelines and provide comprehensive information to support your request.

More About Connecticut Capital Improvement

  1. What is the Connecticut Capital Improvement Form?

    This form is used by the State of Connecticut Department of Developmental Services to request improvements to existing community living arrangements. It covers a broad spectrum of requests from property improvements, specifying the nature of the improvement, describing the necessity, outlining the scope of work, and detailing the estimated cost. This document is essential for securing approval and funding for capital improvement projects within the state's developmental services sector.

  2. Who needs to fill out this form?

    Providers of community living arrangements in Connecticut or property developers working with such providers need to fill out this form. It's specifically used when these parties are seeking state approval and funding for capital improvements to properties serving individuals under the care of the Department of Developmental Services.

  3. What information must be included in the form?

    The form requires the following key information:

    • The address of the property where improvements are proposed.
    • A detailed description of the improvement being requested.
    • An explanation of why the improvements are necessary.
    • The scope of work that will be involved in the improvement project.
    • An estimated total project cost.
    • A bid summary form, including contractor information and bid amounts.
    • Signatures from the proposing parties and approvals from relevant DDS officials.

  4. Can expenses be incurred by someone other than the provider?

    Yes, the form allows for expenses to be incurred by parties other than the provider. However, the form requires that these details be specifically outlined, including the explanation of cost estimates. This ensures that all financial aspects of the project are transparent and accounted for.

  5. What if the lowest bid is not selected?

    If the lowest bid is not selected for the project, the form requires a written justification for this choice. This is to ensure transparency and fairness in the bid selection process, allowing for exceptional circumstances to be considered.

  6. Does this form constitute a contract for development?

    No, the form explicitly states that it does not constitute a contract for the development of a property. Payments and work related to the capital improvement project can only proceed under specific statutes and regulations of the State of Connecticut, ensuring that all necessary approvals and oversight are in place.

  7. What happens after the form is approved?

    After the form is approved, the project can move forward within the guidelines and funding provisions specified by the Department of Developmental services. This approval ensures that the project is deemed necessary for the health or safety of residents and that it aligns with state regulations and statutes governing such improvements.

Common mistakes

Filling out the Connecticut Capital Improvement form is a pivotal step for entities seeking approval for enhancements to existing community living arrangements. However, several common mistakes can hinder the submission process, leading to delays or even rejection of requests. Avoiding these pitfalls is essential to ensure a smooth and successful application.

  1. One frequent oversight is the incomplete filling of the property address in section (A). It's crucial to provide a full address, including any pertinent suite or apartment numbers, to ensure clear identification of the property in question.

  2. In section (B), where the improvement requested is detailed, applicants often provide vague descriptions. Precise and comprehensive information about the improvement helps in the assessment and approval process.

  3. The description of need in section (C) is sometimes overlooked or under-explained. Articulating a compelling and clear rationale for why the improvement is necessary can significantly impact the approval outcomes.

  4. Another common mistake occurs in the scope of work section (E), where applicants fail to detail each step of the proposed improvement project. A well-outlined scope of work is crucial for understanding the complexity and extent of the proposed enhancements.

  5. The estimated total project cost in section (F) often lacks a detailed breakdown. Providing a comprehensive breakdown of costs promotes transparency and justifies the financial request.

  6. Section (G), which requires an explanation of the cost estimate, is sometimes neglected or not detailed enough. Clarification of how costs were estimated lends credibility to the financial aspects of the proposal.

  7. In the bid summary form, not soliciting at least three bids when possible can be a significant misstep. As exceptions to this requirement should be justifiable, failing to meet this standard without a valid reason can impact the review process negatively.

  8. Selecting a bid that is not the lowest without providing a justification for this choice is another mistake that can raise questions about the decision-making process and hinder approval.

  9. Finally, inaccuracies or omissions in the signature sections (I, J, L, M, N, O) can invalidate the application. This critical error, often overlooked, ensures accountability and formalizes the request.

To navigate these challenges, it is advisable to review the application meticulously, ensuring that each section is completed with accurate and detailed information. Emphasizing clarity, completeness, and the justification of choices made throughout the form can expedite the approval process. The goal should always be to present a well-thought-out plan that clearly outlines the need, scope, and financial aspects of the proposed capital improvement, ultimately benefiting the resident's health and safety as per CGS 17b-244.

Documents used along the form

When undertaking capital improvements in the state of Connecticut, particularly for existing community living arrangements, several documents accompany the Connecticut Capital Improvement form to ensure a smooth, lawful, and efficient process. These documents serve as essential supplements, providing a cohesive approach to project initiation, budgeting, government compliance, and contractor engagement.

  • Project Plan or Proposal: This document outlines the project's objectives, timeline, and steps required for completion. It acts as a roadmap for the entire project.
  • Building Permit Application: A necessary form for legal authorization from local municipalities to begin construction work, ensuring all improvements comply with zoning laws and building codes.
  • Environmental Impact Assessment: Evaluates the potential environmental consequences of the proposed capital improvements, required for projects that might affect natural resources or habitats.
  • Contractor Agreements: Legal contracts with contractors and subcontractors hired for the project, detailing the scope of work, compensation, and terms of service.
  • Insurance Documentation: Verifies that the project and involved parties have adequate insurance coverage, protecting against potential liabilities arising from construction activities.
  • Construction Schedule: A detailed timeline highlighting major milestones, deadlines for each phase of the project, and coordination of contractor work periods.
  • Cost Estimate Reports: Break down the expected expenses associated with the capital improvements, including materials, labor, permits, and any unforeseen costs.
  • Change Order Forms: Official requests for changes or additions to the original scope of work, which may affect the project’s timeline and costs.

These documents collectively provide a foundation for transparent, accountable, and successful capital improvement projects. Beyond the initial application, they ensure adherence to legal and regulatory standards, facilitate clear communication among all parties involved, and help manage the project's financial aspects. Proper preparation and execution of these forms and documents are vital to achieving the desired improvements effectively and efficiently.

Similar forms

The Connecticut Capital Improvement form is similar to other documentation involved in the procurement and project management process, notable for requesting project approvals, estimating costs, and formalizing agreements. Two significant documents that bear resemblance in function and structure include the Project Proposal Document and the Construction Bid Form. These documents, like the Connecticut Capital Improvement form, play pivotal roles in managing and implementing projects within various sectors.

The Project Proposal Document is often the first step in initiating a project, much like the Connecticut Capital Improvement form, which seeks approval for capital improvement projects. The Project Proposal outlines the project's objectives, scope, expected outcomes, and estimated budget. It is designed to provide stakeholders and decision-makers with sufficient information to approve, modify, or reject the proposed project. This document shares similarities with the Connecticut form, particularly in sections detailing the description of the need (section C), scope of work (section E), and estimated total project cost (section F), aiming to secure the necessary approvals before proceeding.

Similarly, the Construction Bid Form complements the Connecticut Capital Improvement form in its role within the procurement phase of a project. It is utilized to invite bids from contractors, detailing the work to be performed and asking for a comprehensive bid that includes a cost estimate. Comparable to the bid summary form section of the Connecticut document, it includes information on the project location, description of work, type of contractor needed, and bids received, ultimately leading to the contract award decision. The requirement to justify the selection if the lowest bid is not chosen echoes the Connecticut form's provision for explaining choices, emphasizing transparency and accountability in the selection process.

Dos and Don'ts

When you are filling out the Connecticut Capital Improvement form, it is essential to be thorough and precise to ensure your request is processed smoothly. Here are some tips on what you should and shouldn't do:

Do:
  • Review the entire form before starting: Make sure you understand every part of the form to avoid mistakes.
  • Provide clear and concise information: When describing the improvement requested and the scope of work, be specific to ensure your needs are understood.
  • Check your math: Double-check the estimated total project cost and any other figures provided to avoid delays due to corrections.
  • Include detailed justification for exceptions: If you select an exception to the bidding process, provide a thorough explanation to support your request.
  • Ensure signatures are correct and legible: Signatures are required for validation; make sure they are readable and include the actual date of signing.
  • Consult with relevant parties before submission: Discuss the form with development staff or property developers if applicable, and ensure all information is accurate and complete.
Don't:
  • Rush through the form: Taking your time to fill out the form carefully can prevent errors and omissions.
  • Leave sections incomplete: Every part of the form is important; missing information can result in delays or denial of your request.
  • Guess on dates or figures: Ensure all dates, including project start and completion dates, and financial figures are accurate and based on actual estimates or schedules.
  • Ignore the instructions for the bid summary: The bid summary form is crucial for the approval process, so follow the instructions precisely when completing this section.
  • Forget to provide contact information: Your contact information should be up to date and complete, allowing for straightforward communication regarding your request.
  • Submit without reviewing: Before submission, review the entire form to ensure all information is correct and that there are no blank fields unless specified.

Misconceptions

Understanding the Connecticut Capital Improvement form involves navigating through some common misconceptions. Clarifying these misunderstandings helps ensure that applicants are better informed and can navigate the process more smoothly.

  • Only large construction projects qualify: Many believe that the Connecticut Capital Improvement form is solely for large-scale construction efforts. However, it also applies to smaller projects aimed at enhancing or maintaining existing community living arrangements.

  • Approval is guaranteed upon submission: Simply submitting the request does not ensure approval. Each submission undergoes a stringent review process, factoring in the necessity, scope, and estimated costs associated with the proposed capital improvement.

  • The lowest bid must always be selected: While cost-efficiency is crucial, the lowest bid is not automatically chosen. Justifications for selecting a higher bid can be made based on contractor reliability, quality of work, or urgent timelines.

  • Any repairs or enhancements qualify as capital improvements: Not all repairs or upgrades meet the criteria for capital improvements. The proposed project must align with the form's intent of supporting substantial enhancements or upgrades to living arrangements.

  • Submission without consulting developmental services is sufficient: Coordination with the Department of Developmental Services or a designated consultant is crucial before and after the submission to ensure the project aligns with state regulations and standards.

  • Signing the form guarantees immediate funding: Signing and approval do not mean immediate allocation of funds. Approved projects are subject to budgetary considerations and statutory regulations governing state expenditures for these initiatives.

Dispelling these misconceptions fosters a clearer understanding of the Connecticut Capital Improvement form, helping providers and developers make informed decisions and prepare effective submissions.

Key takeaways

When engaging with the Connecticut Capital Improvement form, which is overseen by the Department of Developmental Services, several key aspects must be understood for its proper utilization. These aspects are critical for providers seeking capital improvements to existing community living arrangements. Below are five vital takeaways that one should be aware of:

  • Detailed Project Information: The form requests specific details about the capital improvement, including the property address, description of the need, scope of work, and the estimated total project cost. It is imperative to provide comprehensive and accurate information to avoid delays or rejections.
  • Expense Responsibility: One section of the form requires clarification on who will bear the costs associated with the capital improvement. This transparency is essential for budgetary planning and ensures that the project's financial aspects are clearly defined from the outset.
  • Bid Summary and Justification: The process includes a bid summary form, where details of the bids received are outlined. If the lowest bid is not selected, a justification for this choice must be provided. This component ensures fairness and accountability in the contractor selection process.
  • Approval Layers: The form must be reviewed and approved by multiple parties, including the provider's development staff or property developer, regional directors, and ultimately the Commissioner of the Department of Developmental Services or their designee. Each signature signifies a crucial approval step, showcasing the procedural thoroughness required for project commencement.
  • Compliance Certification: By signing the form, the applicant certifies that the capital improvement project is necessary for the health or safety of the residents, as stipulated by Connecticut General Statutes (CGS) 17b-244. This certification highlights the project's significance and ensures compliance with state regulations governing capital improvements.

Understanding these key aspects of the Connecticut Capital Improvement form is crucial for any party involved in enhancing the living conditions of community residences. Proper completion and submission of this form pave the way for improvements that are essential for resident safety and well-being, reflecting a commitment to quality care and regulatory compliance.

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