PROJECT REQUEST FORM

Statewide Internet Portal Authority

Please fill out the following form to request a single service from the Statewide Internet Portal Authority. If at any time you need assistance completing the form, please email sipa@cosipa.gov

Date of Request:

Entity Name:

Entity Type:

Requestor First Name:

Requestor Last Name:

Requestor Title:

Requestor Email:

Requestor Phone:

Entity Resources - check all that apply:

I have a project manager dedicated to this project.I have a developer that will be assigned to this project.I have a technical manager that will be assigned to this project.I have a project sponsor assigned to oversee and make decisions related to this project.

Entity Project Manager Name:

Title:

Email:

Phone:

Entity Developer Name:

Title:

Email:

Phone:

Entity Technical Manager Name:

Title:

Email:

Phone:

Entity Project Sponsor Name:

Title:

Email:

Phone:

Please explain how the entity will support and sponsor this project.

Please describe the benefits this project provides to the organization and its users.

If you have never worked with SIPA before, how did you hear about our services?

Type of Requested Service - please select the type of service the entity is requesting. Remember that each service requested needs to have a separate form completed.

Websites

Do you currently have a website?

Please list the URL(s) of your existing websites.

Do you want to keep your current domain name/URL?

What features are you looking for in a website (photos, RSS feed, video, calendar, social networking)?

Google Applications - check all that apply

Google Application licenses (email, instant messaging, groups, calendar, docs, sites, contacts, video)Google Message Discovery (message archiving)

What email platform is your entity currently using?

How many email accounts does your entity have?

How many licenses is your entity requesting?

Describe any related or additional requirements and/or details.

Payment Processing - check all that apply

Accept credit cards online (Visa, MasterCard, American Express, Discover)Accept credit cards over-the-counter (Visa, MasterCard, American Express, Discover)Accept electronic checks onlineAccept electronic checks over-the-counter

How is the entity currently taking payments (manually, cashier, mail process, not taking payments, etc...)?

Will the entity require integration with the state accounting system (COFRS)?

Will the entity require integration with a 3rd party provider or application (i.e. court fines, utility payments, or other software)?

What is the name of the provider where integration is needed?

What financial institution does the entity use?

List the services for which you will apply payment processing.

What is the estimated number of transactions per year?

What is the average transaction amount?

Explain any high or low transaction periods you may have:

For over-the-counter requests, how many stations are needed?

For over-the-counter requests, what Internet browser do you use? (List all in use i.e. Internet Explorer 7 & 8, Firefox, Chrome)

Please describe any related or additional requirements:

Mobile Pulse

How many laptops with cellular connectivity and GPS devices does your entity use?

How many Android devices does your entity use? (include tablets if they have cellular)

How many Mobile Pulse licenses are you requesting? (Multiples of 25)

List all the cellular vendors used by the previously listed devices (Verizon, AT&T, Sprint, T-Mobile, etc..)

List the type of staff in your organization using the previously mentioned devices (Police, Fire, Permit Staff, IT, etc..)

Do you want the optional custom mapping at a fee?

Do you want the Mobile Pulse service to be completely anonymous with no ability to see individual location of speed tests?

Entity Technical Contact Name:

Title:

Email:

Phone:

ESRI

Are you currently using a GIS Service?

Describe your need and how you plan to utilize the service.

Describe any related or additional requirements and/or details.

Colorado.gov Photo Carousel

What event/issue/campaign would you like to highlight?

Provide a state describing the event/issue/campaign including a tagline. Your tagline should be fairly brief and not exceed 5-8 words.

Provide a link to your event/issue/campaign for more information.

salesforce.com

Please describe the overall solution you need.

What are the current system(s) in place and what are the main issues?

Please describe the quantity and types of users in your desired solution.

Please describe your funding and desired timing for this initiative.

What other alternatives are you considering?

Event Registration

How is the entity currently taking payments (manually, cashier, mail process, not taking payments, etc...)?

Will the entity require integration with the state accounting system (COFRS)?

Will the entity require integration with a 3rd party provider or application (i.e. court fines, utility payments, or other software)?

What is the name of the provider where integration is needed?

What financial institution does the entity use?

List the services for which you will apply payment processing.

What is the estimated number of transactions per year?

What is the average transaction amount?

Explain any high or low transaction periods you may have:

For over-the-counter requests, how many stations are needed?

For over-the-counter requests, what Internet browser do you use? (List all in use i.e. Internet Explorer 7 & 8, Firefox, Chrome)

Why are you requesting the Event Registration Tool?

What types of events will you be utilizing Event Registration?

Please describe any related or additional requirements:

Custom Web Application

Please describe in as much detail as possible the custom web application's feature and functions being requested.

Please describe your current process for this request.

Please describe how this process will be improved by the implementation of the application requested.

Provide a brief explanation of your technical environment.

Who is the end user or customer for the application?

Approximately, how many users will be using the application?

Please describe any related or additional requirements:

Timeline

Is there a mandated or legal requirement for this project?

Please list the requirement (rule, regulation statute):

Funding

Does the entity have a funding source for this project?

What is the funding source (grant, fees, tax collection, etc)?

The identification of a funding source is not a critical component of determining the acceptance of a project request. Knowing this information allows SIPA to better understand what pressures, constraints, and opportunities may exist when working with your entity.

Thank you for completing your project request. You will be contacted after the project has been reviewed.