GSA 1364WH Proposal to Lease Space (For Use with Warehouse Request

General Services Administration Regulation (GSAR) 570.802(c) and 570.802(d); Proposal to Lease Space; GSA Forms 1364WH, 1364, 1364A, 1364A-1, and 1217

GSA 1364 WH 2016

General Services Administration Regulation (GSAR) 570.802(c) and 570.802(d); Proposal to Lease Space; GSA Forms 1364WH, 1364, 1364A, 1364A-1, and 1217

OMB: 3090-0086

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PROPOSAL TO LEASE SPACE

OMB Control Number: 3090-0086
Expiration Date: XX/XX/XXXX

(For use with Warehouse Request for Lease Proposals)

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the
Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB)
control number. The OMB control number for this collection is 3090-0086. We estimate that it will take 2.3 hours to read the instructions, gather the
facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other
aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW,
Washington, DC 20405.
In Response to Request for Lease
Proposals (RLP) Number -->

DATED

SECTION I - DESCRIPTION OF PREMISES
1. BUILDING
DESCRIPTION

a. Building Name

b. Building Street Address

c. City

d. State

2a. FLOORS OFFERED

e. 9-Digit ZIP Code

2b. TOTAL NUMBER OF FLOORS
IN BUILDING

3. TOTAL RENTABLE SPACE IN OFFERED BUILDING
a. GENERAL PURPOSE
(Office)
SQUARE FEET

4. LIVE FLOOR LOAD

5. MEASUREMENT METHOD

POUNDS PER
SQUARE FOOT
9. CLEAR CEILING HEIGHT

FEET,

ANSI/BOMA

f. Congressional District

6. YEAR OF LAST
MAJOR RENOVATION
(if applicable)

b. WAREHOUSE

c. OTHER

SQUARE FEET
SQUARE FEET
7. BUILDING AGE
8. SITE SIZE
SQUARE FEET

OTHER

ACRES

10. NUMBER OF LOADING
DOCKS (exclusive to
offered space):

INCHES

11. TYPES OF LOADING 12. EXISTING HEIGHT
OF DOCK-HIGH
DOCKS (exclusive to
LOADING DOCKS
offered space):
(exclusive to offered
NUMBER OF DRIVE
space):
THRUS:

13. NUMBER OF DOCK
LEVELORS AND
OPERATING GRADE
(exclusive to offered space)

NUMBER OF DOCK
HEIGHTS:
14. BAY WIDTH
(offered space):

FEET,

15. BAY DEPTH
(offered space):

INCHES

19. WAREYARD SIZE:

FEET,

16. COLUMN SPACING
(offered space):

INCHES

FEET,

17. MAXIMUM TRUCK
TURNING RADIUS:

18. NUMBER OF VOLTS
AND NUMBER OF PHASE
ELECTRIC:

INCHES

20. TRUCK APRON SIZE: 21. TRUCK COURT DEPTH

X

(BLANK)

(BLANK)

Total Square Feet:

GENERAL SERVICES ADMINISTRATION

GSA 1364WH (REV. XX/XXXX)

SECTION II - SPACE OFFERED AND RATES
23. RENTABLE SQUARE FEET
(RSF)

22. ANSI/BOMA OFFICE
AREA SQUARE FEET (ABOA)

24. COMMON AREA FACTOR (CAF)

"Tenant Improvements" are all alterations for the Government-demised area above the building shell buildout, excluding costs identified as tenant improvements in the Security Unit Price List. Building Specific
Amortized Capital (BSAC) is the sum of costs identified as such in the Security Unit Price List. Neither the Tenant Improvements as stated in Block 12, nor the BSAC as stated in Block 13, are to be included in
the shell rent. It is expected that the tenant buildout will be fully amortized at the end of the firm term, and the rent will be reduced accordingly. Any desired rent increases or decreases beyond the firm term of
the lease should be reflected in the shell rate and fully explained as part of this written proposal. If Tenant improvements or BSAC improvements are to be amortized beyond the firm team, those calculations
must be itemized as part of this written proposal. The Offeror may attach additional pages as necessary.
Number of years each cost per square foot
is in effect. State any changes for any rent component.

a.
BUILD-OUT COSTS
PER
CATEGORY

b.
AMORTIZATION
TERM

c.
AMORTIZATION
INTEREST
RATE (%)

d.
ANNUAL RENT
$ PER RSF

e.
ANNUAL RENT
$ PER ABOA
SQUARE FOOT

f.
NUMBER OF
YEARS RATE
IS EFFECTIVE

c. PER SQUARE
FOOT
d. FOR YEARS
RATE

e. PER SQUARE
FOOT
RATE

f. FOR YEARS

25. TENANT
IMPROVEMENTS
(per RLP
requirements)
26. BSAC
(per RLP requirements
detailed on Security
Unit Price List)
27. SHELL BUILD-OUT
(per RLP
requirements)

28. TOTAL BUILD-OUT
COSTS
29. SHELL RENT
(Including real estate
taxes. Refer to Line
28 on GSA 1217)
30. OPERATING COSTS
(Refer to Line 27 on
GSA 1217)

31. TOTAL RATE/
SQUARE FOOT

32. TOTAL ANNUAL
RENT
a. PER SQUARE
FOOT
RATE
33. STEP RENT
(SHELL RATES)

b. FOR YEARS

/RSF

/RSF

Thru

/ABOA

/RSF

Thru

/ABOA

Thru

/ABOA

a. Number of parking spaces for the future building/facility which are under the control of the Offeror:

Surface

Structured

b. Number of auto parking spaces required by local code:

Surface

Structured

c. Number of truck/trailer parking spaces required by local code:

Surface

Structured

Surface

Structured

Surface

Structured

34. PARKING d. Number of auto parking spaces for Employee/Visitor Use (per RLP):
e. Number of parking spaces (auto and truck) for Official Government Vehicles (per RLP):
f. Does the rental rate offered above include RLP - required parking costs?
YES

NO

If NO, complete the following:

Annual cost per space:

Surface

Structured

Annual cost per truck/trailer space:

GSA 1364WH (REV. XX/XXXX) PAGE 2

SECTION III - LEASE TERMS AND CONDITIONS
35. INITIAL LEASE TERM
(Full Term)
a. Number of Years

36. RENEWAL OPTIONS

b. Years Firm

c. Number of Days Notice for
Government to Terminate Lease:

a. Shell Rate/
RSF/Year

b. Years Each

c. Number d. Number of Days
of
Notice to
Options
Exercise Option

38. Space will be altered and delivered in accordance with the Government's
specifications and requirements in accordance with the Request for
Lease Proposals (RLP) and the lease.

37. OFFER GOOD UNTIL AWARD
39. COMMISSIONS (if applicable), ATTACH COMMISSION AGREEMENT
a. Tenant Representative Commission:

b. Owner's Representative Commission:

%

%

% at lease award and

40. OFFEROR'S TENANT IMPROVEMENT FEE SCHEDULE
a. Architectural/Engineering fees will be (choose one):
1.
2.
3.

c. Schedule of Commission Payments:

41. ADDITIONAL FINANCIAL ASPECTS OF THE LEASE
per ABOA SF

Adjustment for Vacant Premises:
Utilities in Offered Space (By Lessor or Lessee?):

per ABOA SF
% of Total TI construction costs.

Janitorial in Offered Space (Lessor or Lessee?):

flat fee

b. Lessor's Project Management Fee will be
construction costs.

% at lease occupancy

percent of Total TI

c. If other fees are applicable, state as per ABOA square foot, or if using a
percentage, the basis for determining the fee.

Trash Removal in Offered Space (Lessor or Lessee?):
HVAC Overtime Rate
per hour per (choose one)
(n/a if net of utilities)
zone
floor
space
For rates based on a "per zone" basis, provide the following:
Number of zones in offered Space:
Areas requiring 24 hour HVAC (LAN, etc.)

per ABOA SF*

The Government will add the cost of the proposed TI fees to the net
present value of the offered rental rate as described in the RLP's
Present Value Price Evaluation paragraph. This schedule will be
applicable for Tenant Improvements.

*Only applies when the Lessor provides utilities and the
Government requires separate reimbursement for 24 hour HVAC as
described under Section 1 of the Lease. Otherwise, include this
cost in the operating rent, as described under Section 6 of the
Lease.

42. FREE RENT INCLUDED IN OFFER

Building's Normal Hours of HVAC Operation:
(indicate n/a if the lease is to be net of utilities)

1.

months free rent (includes shell, operating, TI and BSAC rent)

2. Other rental concessions structured as follows

Monday - Friday

AM

to

PM

Saturday

AM

to

PM

Sunday

AM

to

PM

Percent of Government Occupancy:
3. None

%

Current Year Taxes:
Based on fully assessed value?

YES

NO

Is the offered space part of multiple tax bills?

YES

NO

If so, provide tax ID numbers and square footage for each in the
blank space below the question on total land costs. Attach the legal
description of the offered property.
If a site is offered, state the total land costs:
43. LIST OF ATTACHMENTS SUBMITTED WITH THIS OFFER (See RLP requirements)

44. ADDITIONAL REMARKS OR CONDITIONS WITH RESPECT TO THIS OFFER

GSA 1364WH (REV. XX/XXXX) PAGE 3

SECTION IV - OWNER IDENTIFICATON AND CERTIFICATION
45. RECORDED OWNER
a. Name

b. Address

c. City

d. State

e. ZIP Code + 4

f. DUNS Number

46. BY SUBMITTING THIS OFFER, THE OFFEROR AGREES UPON ACCEPTANCE OF THIS PROPOSAL BY HEREIN SPECIFIED DATE. TO LEASE
TO THE UNITED STATES OF AMERICA, THE PREMISES DESCRIBED, UPON THE TERMS AND CONDITIONS AS SPECIFIED HEREIN, IN FULL
COMPLIANCE WITH AND ACCEPTANCE OF THE AFOREMENTIONED RLP, WITH ATTACHMENTS.
I have read the RLP with attachments in its entirety and am requesting no deviations.
47. Offeror's Interest in Property
Owner
48. OFFEROR

Agent

Other

Check if same as Recorded Owner

a. Name

b. Address

f. Title

g. E-Mail Address

i. Offeror's Signature

c. City

d. State

e. ZIP Code + 4

h. Telephone Number

j. Date Signed

GSA 1364WH (REV. XX/XXXX) PAGE 4

LEASE PROPOSAL DATA

In Response to Request for Lease Proposals (RLP) Number
DATE:

Offeror's Interest in the Property
1.

Fee owner

Other:

Attach evidence of Offeror's interest in property (e.g., deed) and representative's authority to bind Offeror.
Flood Plains:
2. The Property is

in a base (100-year) flood plain

in a 500-year flood plain

not in a flood plain.

(See RLP Section 2, Flood Plains.)
Seismic Safety: The Building
RLP does not contain seismic requirements. No documentation required.
RLP contains seismic requirements. The Building:
Fully meets seismic requirements or meets an exemption under the RLP
3.
Does not meet seismic requirements, but will be retrofitted to meet seismic requirements
Will be constructed to meet seismic requirements
Will not meet seismic requirements
(See RLP Section 2, Seismic Safety.) Attach appropriate documentation.
Historic Preference: The Building is a
Historic property within a historic district.
Non-historic developed site or non-historic undeveloped site within a historic district.
4.
Historic property outside of a historic district.
None of the above.
(See RLP Section 2, Historic Preference.) Attach appropriate documentation.
Asbestos-Containing Material (ACM): The Property
Contains no ACM, or contains ACM in a stable, solid matrix that is not damaged or subject to damage.
5.
Contains ACM not in a stable, solid matrix.
(See RLP Section 2, Asbestos.)
Fire/Life Safety:
6. The Property

Meets

Does not meet Lease fire/life safety standards.

(See RLP Section 2, Fire Protection and Life Safety.)
Accessibility:
7. The Property

Meets

Does not meet Lease accessibility standards.

(See RLP Section 2, Accessibility.)
ENERGY STAR®: The Building
Has received the ENERGY STAR® Label within the past twelve months.
8.

Date (MM-DD-YYYY):

Has not received the ENERGY STAR® Label within the past twelve months; the Offeror has evaluated energy savings measures and
Determined that none are cost effective.

Determined that the following are cost effective (Attach additional pages):

(See RLP Section 2, Energy Independence and Security Act.)
Waiver of Price Evaluation Preference. A HUBZone small business concern (SBC) Offeror may elect to waive the price evaluation preference provided
in Section 4 of the RLP. In such a case, no price evaluation preference shall apply to the evaluation of the HUBZone SBC, and the performance of work
requirements set forth in Section 1 of the Lease shall not be applicable to a lease awarded to the HUBZone SBC Offeror under this solicitation. A
9.
HUBZone SBC desiring to waive the price evaluation preference should so indicate below.
I am a HUBZone SBC Offeror and I elect to waive the price evaluation preference.

(See RLP and Lease documents for more information.)

GSA 1364WH (REV. XX/XXXX) PAGE 5


File Typeapplication/pdf
File TitleGSA 1364 WH 2016 draft a4.pdf
AuthorRezaMotamedamin
File Modified2016-10-27
File Created2016-10-27

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