02 EXHIBIT A 3626 (Draft).pdf
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- Attached to
- The USDA Seeks to Lease Office and Related Space in Mountain City, Johnson County, Tennessee
- Solicitation number
- 57-47019-26-FA-RLP
About this file
This is a GSA Form 3626 (Rev 10/21), a U.S. Government Lease for Real Property (Short Form), which serves as a template for federal real property lease agreements. The form is structured in two parts: Part I (Offer) completed by the offeror and Part II (Award) completed by the government. The lease document includes the location and description of premises, term specifications, rental rates, owner identification, and certification requirements. All offers are subject to terms outlined in the Request for Lease Proposals, Supplemental Lease Requirements, General Clauses (GSA Form 3517A), and other attachments.
The form specifies key lease parameters including a ten-year term with five years firm and provisions for government termination with 120 days' notice. Rental payment is due monthly in arrears on the first workday of each month. The form provides sections for itemized rental rate breakdowns including building shell rent (including real estate taxes), operating rent, and turnkey tenant improvement rent, with separate columns for firm term, non-firm term, and renewal term rates. Additional details include tenant improvement costs, interest rates for amortization, HVAC overtime rates, and adjustment rates for vacant premises. The award section lists required attachments including the Supplemental Lease Requirements, Agency Specific Requirements, OCIO ADP Wiring Guidelines, USDA Signage Guide, Security Requirements, GSA Form 3517A, Tenant Improvement Cost Summary, Seismic Form, and Floor Plan. The document becomes binding only upon signature by an authorized GSA Lease Contracting Officer.
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Text version
GENERAL SERVICES ADMINISTRATION GSA FORM 3626 (REV 10/21)
U.S. GOVERNMENT LEASE FOR REAL PROPERTY
(Short Form)
1b. BUILDING NUMBER
PART I - OFFER (Offeror completes Section A, C and D; Government shall complete Section B)
NOTE: All offers are subject to the terms and conditions outlined in Request for Lease Proposals No.
Supplemental Lease Requirements document, General Clauses (GSA Form 3517A), and any other attachments included herein.
A. LOCATION AND DESCRIPTION OF PREMISES OFFERED FOR LEASE BY GOVERNMENT
1. NAME AND ADDRESS OF
BUILDING (Include nine-digit ZIP Code)
2. LOCATION(S) IN BUILDING
2a. FLOOR(S) 2b. ROOM NUMBER(S) 2e NUMBER OF PARKING SPACES
OFFERED (INCLUDED IN RATE)
RESERVED TOTAL
RESERVED GATED
NON-RESERVED TOTAL
2c. SQ. FT.
RENTABLE
ABOA
Common Area Factor
2d. TYPE
GENERAL OFFICE
WAREHOUSE
OTHER (Specify)
B. TERM
3a. To have and to hold the said Premises with its appurtenances for the term beginning upon acceptance of the Premises as required by this Lease and continuing for a period of TEN (10) YEARS, 5 Years Firm, subject to termination and renewal rights as may be hereinafter set forth. The commencement date of this Lease, along with any applicable termination and renewal rights, shall be more specifically set forth in a Lease Amendment upon substantial completion and acceptance of the Space by the Government.
3b. The Government may terminate this Lease, in whole or in parts, at any time during the term of the Lease, by providing not less than 120 days prior written notice to the Lessor. The effective date of the termination shall be the day following the expiration of the required notice period or the termination date set forth in the notice, whichever is later. No rental shall accrue after the effective date of termination.
3c. This Lease may be renewed at the option of the Government for a term of 0 YEARS at the rental rate(s) set forth below, provided notice is given to the Lessor at least 0 days before the end of the original Lease term; all other terms and conditions of this Lease, as same may have been amended, shall remain in full force and effect during any renewal term.
C. RENTAL
4. Rent shall be payable in arrears and will be due on the first workday of each month. When the date for commencement of the lease falls after the 15th day of the month, the initial rental payment shall be due on the first workday of the second month following the commencement date. Rent for a period of less than a month shall be prorated. Rent shall not be adjusted for changes in real estate taxes or operating costs.
5a. AMOUNT OF ANNUAL RENT 5b. RATE PER MONTH
RENTAL RATE BREAKDOWN FIRM TERM
($/RSF/YEAR)
NON-FIRM TERM
($/RSF/YEAR)
RENEWAL TERM
($/RSF/YEAR)
6. BUILDING SHELL RENT
(INCL. REAL ESTATE TAXES) 6a. $____________ 6b. $____________
7. OPERATING RENT 7b.$____________ 7c. N/A
8. TURNKEY TENANT
IMPROVEMENT RENT
(See blocks 12 below for additional breakdown of cost and amortization rate)
8b. N/A 8c. N/A
9. INTENTIONALLY DELETED 9a. N/A 9b. N/A 9c. N/A
10. TOTAL RENT
11. TENANT IMPROVEMENT COST 12. INTEREST RATE TO AMORTIZE TENANT
IMPROVEMENTS
13. HVAC OVERTIME RATE PER HOUR 14. ADJUSTMENT FOR VACANT PREMISES RATE ($/ABOA
SF/YEAR)
1a. LEASE NUMBER
10b. $____________ 10c. N/A 10a. $____________
8a. $____________
7a. $____________
6c. N/A
Exhibit A Lease Number 57-47091-26-FA
57-47091-26-FA
Shannon.Schoening Cross-Out
GENERAL SERVICES ADMINISTRATION GSA FORM 3626 (REV 10/21)
D. OWNER IDENTIFICATION AND CERTIFICATION
15. RECORDED OWNER
15a. Name 15b. Unique Entity Identifier (UEI)
15c. Address 15d. City 15e. State 15f. ZIP + 4
16. 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
17. OFFEROR’S INTEREST IN PROPERTY
OWNER AUTHORIZED AGENT OTHER (Specify)
18. OFFEROR Check if same as Recorded Owner 18a. NAME 18b. ADDRESS 18c. CITY 18d. STATE 18e. ZIP + 4
18f. Title 18g. E-mail address 18h. Telephone Number
18i. OFFEROR’S SIGNATURE 18j. DATE SIGNED
PART II - AWARD (To be completed by Government)
2. THIS DOCUMENT IS NOT BINDING ON THE GOVERNMENT OF THE UNITED STATES OF AMERICA UNLESS SIGNED BELOW BY
AUTHORIZED LEASE CONTRACTING OFFICER.
3a. NAME OF LEASE CONTRACTING OFFICER (Type or Print) 3b. SIGNATURE OF LEASE
CONTRACTING OFFICER
3c. DATE
Exhibit A Lease Number 57-47091-26-FA
1. Your offer is hereby accepted. This award consummates the Lease, which consists of the following attached documents:
A) this GSA Form 3626, B) Supplemental Lease Requirements, C) Agency Specific Requirements, D) OCIO ADP Wiring Guidelines, E) USDA Signage Guide, F) Security Requirements, G) GSA Form 3517A, General Clauses (Acquisition of Leasehold Interest in Real Property for Small Leases), H) Tenant Improvement Cost Summary showing the cost for building improvements, changes or additions that are agreed to be made by you, I) Seismic Form, and J) Floor Plan delineated the Premises.
| 1b BUILDING NUMBER: N/A |
| 1 NAME AND ADDRESS OF BUILDING Include ninedigit ZIP Code: |
| 2b: |
| RENTABLE: |
| RESERVED TOTAL: |
| RESERVED GATED: |
| Common Area Factor: |
| OTHER Specify: |
| NONRESERVED TOTAL: |
| undefined_3: |
| 5a AMOUNT OF ANNUAL RENT: |
| 5b RATE PER MONTH: |
| 15a Name: |
| 15b Unique Entity Identifier UEI: |
| 15c Address: |
| 15d City: |
| 15e State: |
| 15f ZIP 4: |
| I have read the RLP with attachments in its entirety and am requesting no deviations: Off |
| Check if same as Recorded Owner: Off |
| 18a NAME: |
| 18b ADDRESS: |
| 18c CITY: |
| 18d STATE: |
| 18e ZIP 4: |
| 18f Title: |
| 18g Email address: |
| 18h Telephone Number: |
| 18i OFFERORS SIGNATURE: |
| 18j DATE SIGNED: |
| 3a NAME OF LEASE CONTRACTING OFFICER Type or Print: |
| 3b SIGNATURE OF LEASE CONTRACTING OFFICER: |
| 3c DATE: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Text4: |
| undefined: |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| 11 TENANT IMPROVEMENT COSTS: |
| 12 TI Rate: |
| 6b: |
| 6a: |
| 7b Same as 7a: |
| 10b: |
| 10a: |
| 8a: |
| 13: |
| 14: |
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