The UTMB District Heating and Cooling System project consists of substantial selective and intricate demolitions, additions and modifications throughout the hospital campus. This project includes over 30 different buildings. The existing hospital campus steam heating system is being converted to hot water heating systems and/or modified to follow new UTMB requirements. The largest portion of the project, and the most difficult and critical for coordination, involves installing multiple 8-12” steam and heating hot water main lines, as well as condensate return lines across the roof of the entire 88-acre campus. The campus includes a high security research facility which houses critical research for some of the deadliest diseases. It is a restricted access zone with no vehicle or equipment access requiring excavations to be dug by hand and concrete to be brought in with power buggies. Much of the conversion scope of work within these facilities must be closely coordinated with campus leadership. In addition to the high security laboratory, there are other research facilities that require close management with the relocation of rare species of animals, as well as a high security jail housing prison inmates. Due to the various types of high security facilities being converted, it is essential to coordinate with UTMB and keep the schedule on track throughout the project. Many of the facility shutdowns have been scheduled months in advance and been closely managed to ensure facility impacts are minimized.