08 Attachment No. 1 to GSA Form 1364 - TEMPLATE_15-20 Yr_1.xlsx

GSA Form XLSX spreadsheet 60 KB Posted

Attached to
X1DB--Macon GA Health Care Clinic HCC 168,332 ANSI/BOMA
Solicitation number
36C10F26R0088
Issued by

About this file

Written by GovTribe AI ·

This file is a GSA Form 1364 pricing template attachment for a Department of Veterans Affairs real property lease solicitation. The template is designed for offerors to submit pricing for a healthcare clinic lease opportunity in Macon, Georgia, with a building size of 168,332 assignable square feet (ANSI/BOMA). The document provides separate pricing schedules for both 15-year and 20-year firm lease terms, requiring offerors to populate gray-shaded cells with financial data including fully-serviced annual rent, annual operating expenses, shell rent rates, tenant improvement costs, and related line items from GSA Forms 1217 and 1364.

Offerors must submit all dollar values in real dollars with a maximum of two decimal places and ensure that pricing information matches exactly with their corresponding GSA Forms 1364 and 1217 submissions. The template includes an OMB Scoring Information form section for each lease term option, where brokers or project managers must input lease-specific details such as parking spaces, estimated award and acceptance dates, lease acquisition method, VISN designation, appraised value, and lump sum payments for tenant improvements. No specific response deadlines, award dates, or evaluation criteria are provided in this template document, which serves as a pricing submission vehicle for the solicitation numbered 36C10F26R0088.

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Other versions and copies of GSA Form 1364

509 government files on GovTribe name GSA Form 1364. Different revisions are separate documents; copies of this exact file point search engines to its first posting.

File Revision Posted Attached to
3B.G(2026.09.11)GSA Form 1364 Open with Adobe Only-2KS0140.pdf 2026 U. S. GOVERNMENT SEEKS TO LEASE SPACE IN TOPEKA, KS
07 RLP 36C10F26R0024 Proposal to Lease Space GSA Form 1364 SPB County OPC 7_17_2026.pdf 2026 X1DB--South Palm Beach County, FL OPC 56, 076 ANSI/BOMA
08 RLP 36C10F26R0024 Attachment No 1 to GSA Form 1364 SPB County OPC 7_17_2026.xlsx 2026 X1DB--South Palm Beach County, FL OPC 56, 076 ANSI/BOMA
07 RLP 36C10F26R0024 Proposal to Lease Space GSA Form 1364 SPB County OPC 7_17_2026.pdf 2026 X1DB--South Palm Beach County, FL OPC 56, 076 ANSI/BOMA
H - GSA Form 1364 Proposal to Lease Space (Jan. 2023) Open with Adobe Only.pdf Jan 2023 General Services Administration (GSA) seeks to lease office space in Brunswick, GA
Exhibit F - GSA Form 1364 Proposal to Lease Space (Jan. 2023).pdf Jan 2023 U. S. Government Seeks Proposals to Lease 2, 405 to 2, 605 ABOA SQ FT of Office and Related Space in Washington, DC
4WY0059_Exhibit 2 GSA Form 1364 Proposal to Lease Space (Jan. 2023).pdf Jan 2023 U. S. Government Seeks to Lease Office Space in Cheyenne, WY – Solicitation Amendment No. 1
Exhibit F - GSA Form 1364 Proposal to Lease Space (Jan. 2023).pdf Jan 2023 General Services Administration (GSA) seeks to lease the following space: Solicitation No. 6GA0308
EXHIBIT F - GSA Form 1364 Proposal to Lease Space (Jan. 2023).pdf Jan 2023 Request for Lease Proposals (RLP) - Saipan CBOC
Proposal To Lease Space_GSA Form 1364.pdf Revision not stated General Services Administration (GSA) Seeks To Lease The Following Space:
Exhibit F - GSA Form 1364 Proposal to Lease Space.pdf Revision not stated General Services Administration (GSA) seeks to lease office space in Port Angeles, WA and Sequim, WA
F. GSA Form 1364 Proposal to Lease Space (1).pdf Revision not stated General Services Administration (GSA) Seeks to lease the following space: Solicitation No. 2TX1269
Exhibit G. GSA Form 1364 (2).pdf Revision not stated General Services Administration (GSA) Seeks to lease the following space: Solicitation No. 4TX1037
08. GSA Form 1364 - Attachment No. 1.xlsx Revision not stated X1DB--Santa Cruz Outpatient Clinic, New Procurement Lease Package
09. GSA Form 1364 - Proposal to Lease Space.pdf Revision not stated X1DB--Santa Cruz Outpatient Clinic, New Procurement Lease Package
Attachment No. 1 to GSA Form 1364 - Idaho Falls (10-15-20 Yr).xlsx Revision not stated Dept of Veterans Affairs seeks clinical space in Idaho Falls, ID
10 GSA Form 1364 080626.pdf Revision not stated U. S. Department of Agriculture Seeks to Lease Office and Related Space in Huntington, Indiana
Exhibit E. GSA Form 1364 (2).pdf Revision not stated General Services Administration (GSA) Seeks to lease the following space: Solicitation No. 3TN0311
Exhibit F. GSA Form 1364 (1).pdf Revision not stated General Services Administration (GSA) Seeks to lease the following space: Solicitation No. 4LA0288
Exhibit G. GSA Form 1364.pdf Revision not stated General Services Administration (GSA) Seeks to lease the following space: Solicitation No. 2TN0427
Show all 20

Who attaches GSA Form 1364

Agency Files
General Services Administration Public Buildings Service Central Office 229
Department of Veterans Affairs Office of Construction and Facilities Management 34
Department of Agriculture Under Secretary for Farm Production and Conservation 30
General Services Administration Public Buildings Service Central Office Office of Leasing 23
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8 17
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 10 13
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 20 13
General Services Administration Public Buildings Service Region 5 13

Other files

File Type Posted
17 - Offering Entity Acknowledgement Form.pdf PDF
04B - Lease Exhibit - New Construction_FEB 2026.pdf PDF
05A10 Appendix A10 Generic Extra-Small CSC Design Narrative.pdf PDF
09 - VA Form 10091 - FSC Vendor File Request.pdf PDF
05A06 Appendix A.6 VA_Leased_CBOC_Standard Layout Guide 10_29_25.pdf PDF
00 Global RLP Template R100 - VA Version_MAY 2026_ Macon.pdf PDF
12 - GSA Standard Form 330 - Architect Engineer Qualifications.pdf PDF
14 - Operations and Maintenance Plan Acknowledgement_FEB 2026.pdf PDF
10 - Past Performance List of References_FEB 2026.docx DOCX document
A- RLP Exhibit - New Construction_FEB 2026.pdf PDF
03 - Offeror Compliance Matrix_BVTO_FEB 2026.xlsx XLSX spreadsheet
05B Appendix B_LSN_Lease Service Narrative 7.28.26.pdf PDF
05A01 Appendix A.1 ProjectRoomContents_FY25 MACON GA HCC Final Excel 2026.07.08.xlsx XLSX spreadsheet
16 - Certification and Commitment of Building Energy Performance and Green Globes_FEB 2026.pdf PDF
02 - Pre-Bid Conference Registration Form_FEB 2026.docx DOCX document
04 Global Lease Template L100 - VA Version_MAY 2026.pdf PDF
C - RLP Exhibit - Prospectus_FEB 2026.pdf PDF
04A - Exhibit Lease - Broker Project_MAY 2026.pdf PDF
05A09 Appendix A.9 2 Visio-Generic Extra Small Data Center Design Package 2.pdf PDF
05A041 Appendix 05A.4.1 OIT Data Center Design.pdf PDF
00 No Proposal_Market Response Form_MAR 2026.docx DOCX document
05A11 Appendix A.11 3Generic Extra Small CFD Package.pdf PDF
13 - GSA Form 527 - Contractors Qualifications and Financial Information.pdf PDF
01- 3516 Solicitation Provisions_Feb. 2025.pdf PDF
07 - GSA Form 1364 - Proposal to Lease Space.pdf PDF
11 - Past Performance Questionnaire - PPQ_FEB 2026.pdf PDF
05A04 Appendix A.4 VA CBOC Info Transp Sys Specs 5_29_2025.pdf PDF
05A07 Appendix A.7 Macon HCC 2 Floors.pdf PDF
21-Bibb County Davis Bacon.pdf PDF
05A2 Appendix A.2_4-1 VA_Leased_CBOC_Design_Narrative_LDN_9-23-2026.pdf PDF
05A PFD_FY25 MACON GA HCC_Final_ 2026.07.29.pdf PDF
05A03 Appendix A.3 Room_Data_Matrix_7_3_24 _1.xlsx XLSX spreadsheet
04C - Exhibit Lease - Prospectus_MAY 2026.pdf PDF
05A05 Appendix A.5 VA Security Requirements_FSL Level II_ Oct 2024.pdf PDF
05 Agency Specific Requirements_ASR - Cover Page.pdf PDF
20 - VA Handbook 6500.6 - 3.12.10 FOR RLP.pdf PDF
06 - GSA Form 1217 - Lessors Annual Cost Statement.pdf PDF
18 - FAR 52.204-24 Representation Regarding Certain Telecom.pdf PDF
36C10F26R0088.docx DOCX document
05A2_1 Addendum A to LDN- Macon - Oct 2026.pdf PDF
05A08 Appendix A.8 Macon HCC 3 floor.pdf PDF
15 - GSA Form 12000 for Prelease Fire Protection and Life Safety Evaluation for an Office Building_May 2015.pdf PDF
B - RLP Exhibit - Broker Project_MAY 2026.pdf PDF
19 - 3517B General Clauses_Apr. 2026.docx.pdf PDF
Show all 44

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Att #1 to 1364

Department of Veterans Affairs

Lease Function, City, State
RLP #
Attachment #1 to the Form 1364
Offeror Name:[INSERT HERE]
Building Total Rentable Square Feet :RSF
Building Total ABOA Square Feet:0ABOA
Common Area Factor:0%
Number of Stories:0
Parking:0
Land Acquisition Costs (not including site improvements or demolition):$0.00
Annual Operating Expenses (line 27 from GSA Form 1217):$0.00Annually
Annual Operating Expenses Rate per (line 27 from GSA Form 1217):$0.00per ABOA
Real Estate Taxes (Line 28 GSA Form 1217):$0.00
Insurance (Line 29 GSA Form 1217):$0.00
Building Maintenance & Reserve Replacement (Line 30 GSA Form 30):$0.00
Management (Line 32 GSA Form 1217):$0.00
Tenant Improvement Lump-Sum Total:$0.00
Tenant Improvement Lump-Sum Rate per ABOA:0
Lessor Tenant Improvement Amortization Rate:0%

15 Year Firm Term:

Lease Year123456789101112131415
Fully-Serviced Annual Rent not including Tenant Improvements (paid lump sum):$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Operating Expenses (Form 1217 - Line 27):$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Shell Annual Rent with Tenant Improvements paid lump sum:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Shell Rent Rate (1364 - 29.e), not including Operating Expenses (Form 1217 - Line 27) or Tenant Improvements (1364 - 25.a - Paid Lump Sum) per ABOA:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Operating Expenses (Form 1217 - Line 27) per ABOA:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Fully-Serviced ABOA Rental Rate with Tenant Improvements paid lump sum:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0

Lump sum items:

Total Tenant Improvements Lump Sum Cost:$ - 0
Tenant Improvements Lump Sum Rate per ABOA:$ - 0

20 Year Firm Term:

Lease Year1234567891011121314151617181920
Fully-Serviced Annual Rent not including Tenant Improvements (paid lump sum):$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Operating Expenses (Form 1217 - Line 27):$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Shell Annual Rent with Tenant Improvements paid lump sum:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Shell Rent Rate (1364 - 29.e), not including Operating Expenses (Form 1217 - Line 27) or Tenant Improvements (1364 - 25.a - Paid Lump Sum) per ABOA:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Annual Operating Expenses (Form 1217 - Line 27) per ABOA:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Fully-Serviced ABOA Rental Rate with Tenant Improvements paid lump sum:$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0

Lump sum items:

Total Tenant Improvements Lump Sum Cost:$ - 0
Tenant Improvements Lump Sum Rate per ABOA:$ - 0

Instructions

1. Offerors are to populate all cells that are colored "gray"

2. Offerors are to provide all dollar values in "real" dollars, with a maximum of two decimal places.

3. Offerors are NOT to input any formulas or other "values" copied from another spreadsheet.

4. Offerors are to ensure the information provided on this form matches exactly the information on the Offerors GSA Form 1364 and 1217 (to the decimal place).

15-yr term - OFFEROR 1 OMB Scoring Information Form

Brokers: Please fill out this form and submit to your PM for every Initial Offer and every FPR you receive. A scoring run must be conducted each time we receive price proposals. The NUSF and number of stories will usually be the same for all offerors, but if they are not, then please copy this tab and fill out a separate chart for each offer. If multiple lease terms or pricing scenarios were offered, please copy this tab and fill out a separate chart for each lease term or scenario. Please fill out the information in the green fields below.

Parking Spaces
Estimated Lease Award Date
Estimated Lease Acceptance Date
Lease Acquisition Method
Project (City, State):Lease Function, City, StateVISN:Appraised Value:(For pre-award existing buildings only)
ABOA:0Parent Facility:Lease Term:15
Number of Stories:0Procurement Type:Procurement Stage:

Offeror: [INSERT HERE] Fill in additional offerors as needed

(annual rent, not rental rate)Fully Serviced Rent:
Year 1$0.00
2$0.00
3$0.00
4$0.00
5$0.00
6$0.00
7$0.00
8$0.00
9$0.00
10$0.00
11$0.00
12$0.00
13$0.00
14$0.00
15$0.00
Form 1217 InfoLine 27$0.00
Line 28$0.00
Line 29$0.00
Line 30$0.00
Line 32$0.00

Land Cost: $0.00

Lump Sum Payments TIA $0.00

20-yr term - OFFEROR 1 OMB Scoring Information Form

Brokers: Please fill out this form and submit to your PM for every Initial Offer and every FPR you receive. A scoring run must be conducted each time we receive price proposals. The NUSF and number of stories will usually be the same for all offerors, but if they are not, then please copy this tab and fill out a separate chart for each offer. If multiple lease terms or pricing scenarios were offered, please copy this tab and fill out a separate chart for each lease term or scenario. Please fill out the information in the green fields below.

Parking Spaces
Estimated Lease Award Date
Estimated Lease Acceptance Date
Lease Acquisition Method
Project (City, State):Lease Function, City, StateVISN:Appraised Value:(For pre-award existing buildings only)
ABOA:0Parent Facility:Lease Term:20
Number of Stories:0Procurement Type:Procurement Stage:

Offeror: [INSERT HERE] Fill in additional offerors as needed

(annual rent, not rental rate)Fully Serviced Rent:
Year 1$0.00
2$0.00
3$0.00
4$0.00
5$0.00
6$0.00
7$0.00
8$0.00
9$0.00
10$0.00
11$0.00
12$0.00
13$0.00
14$0.00
15$0.00
16$0.00
17$0.00
18$0.00
19$0.00
20$0.00
Form 1217 InfoLine 27$0.00
Line 28$0.00
Line 29$0.00
Line 30$0.00
Line 32$0.00

Land Cost: $0.00

Lump Sum Payments TIA $0.00

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