S02 Exhibit E_1364_Attachment_Arev_05.22.2025_1.pdf

PDF 382 KB Posted

Attached to
X1AA--Raleigh VA Dental Clinic RLP
Solicitation number
36C24625R0058
Issued by

About this file

This is a GSA Form 1364 Attachment A—a pricing template for federal real estate lease proposals structured as a "Proposal to Lease Space – Rate Structure." The template is not to exceed 12,232 usable square feet and accommodates a 20-year lease term divided into base year and soft terms periods.

The rate structure requires lessors to propose pricing across all 20 years, with each year specifying: total annual rent, base square foot rate, cost of services/utilities/maintenance per square foot, cost of tenant improvement per square foot (if applicable), and total square foot rate. Years 1-5 comprise the base year term, Years 6-10 represent the first soft terms period, Years 11-15 represent the second soft terms period (3-5 year soft terms), and Years 16-20 represent the third soft terms period (3-5 year soft terms). The second page of the template contains completed pricing data showing total annual rent amounts (ranging from $627,642.39 to $681,440.22), services/utilities/maintenance costs of $17.63 per square foot, and total square foot rates of $70.19 and $73.34 across various years. Both lessor and government initials are required to validate the proposal. This template is used by the General Services Administration to standardize lease pricing submissions for federal space requirements.

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S02 Exhibit C_ ASR_Statement of Work Standalone Dental Clinic_Durham without SPS_1.pdf PDF
S02 Exhibit B_Floor Plan_Raleigh Stand-Alone Dental Clinic Revised_1.pdf PDF
S02 Exhibit P_Deed Proof of Ownership_1.pdf PDF
S02 Exhibit E_1364_Attachment_Arev_1_1.pdf PDF
S02 Exhibit O_FAR 52.204_24 Representation Digital _Nov. 2021_1.pdf PDF
S02 Exhibit J_12000 FPLS_Part AandPart B_1.pdf PDF
S02 Exhibit M_Security Unit Price List FSL II_final_1.pdf PDF
S02 Exhibit F_1217 - Lessor_s Annual Cost Statement_1_1.pdf PDF
S02 Exhibit D_1364 Proposal to Lease Space.Jan. 2023_1.pdf PDF
S02 Exhibit I_3518 Representations and Certifications_Jan. 2022_1.pdf PDF
S02 Exhibit H_3517B General Clauses.Feb. 2025_1.pdf PDF
S02 Exhibit A_Lease Template L100.5.25_1.pdf PDF
S02 Exhibit G_3516 Solicitation Provisions.2025_1.pdf PDF
S02 Exhibit L_Security Requirements_FSL Level II_Aug. 2022_1.pdf PDF
S02 Exhibit N_Tenant Improvements Cost Summary TICS_Table.Jul.2022_1.pdf PDF
S02 Dental Clinic _Request for Lease Proposal_May 2025.revised.FINAL.1.pdf PDF
S02 Exhibit K_Seismic Forms A - F with Instructions_1.pdf PDF
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S02 Exhibit P_Deed Proof of Ownership.pdf PDF
S02 Exhibit L_Security Requirements_FSL Level II_Aug. 2022.pdf PDF
S02 Exhibit E_1364_Attachment_Arev.pdf PDF
S02 Exhibit Q_Wage Determination_Dental Clinic_Wake County.pdf PDF
36C24625R0058.docx DOCX document
S02 Exhibit C ASR_SOW Dental Clinic Final_slj.9.22.25.pdf PDF
S02 Exhibit F_1217 - Lessor_s Annual Cost Statement.pdf PDF
S02 Exhibit A_Lease Template L100.5.25.pdf PDF
S02 Exhibit I_3518 Representations and Certifications_Jan. 2022.pdf PDF
S02 Exhibit G_3516 Solicitation Provisions.2025.pdf PDF
S02 Exhibit D_1364 Proposal to Lease Space.Jan. 2023.pdf PDF
S02 Exhibit E_1364_Attachment_Arev_05.22.2025.pdf PDF
S02 Exhibit N_Tenant Improvements Cost Summary TICS_Table.Jul.2022.pdf PDF
S02 Exhibit O_FAR 52.204-24 Representation Digital _Nov. 2021.pdf PDF
S02 Exhibit K_Seismic Forms A - F with Instructions.pdf PDF
S02 Dental Clinic _Request for Lease Proposal_May 2025.revised.FINAL.pdf PDF
S02 Exhibit B_Floor Plan_Raleigh Stand-Alone Dental Clinic Revised.pdf PDF
S02 Exhibit M_Security Unit Price List FSL II_final.pdf PDF
S02 Exhibit H_3517B General Clauses.Feb. 2025.pdf PDF
S02 Exhibit J_12000 FPLS_Part AandPart B.pdf PDF
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Attachment A to GSA Form 1364

PROPOSAL TO LEASE SPACE – RATE STRUCTURE

SPACE – NOT TO EXCEED _12232____ USABLE SUARE FEET

Rentable Area: square feet – Total

Usable Area: square feet – Total

Soft Terms

YEAR 1: YEAR 6:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 2: YEAR 7:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 3: YEAR 8:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 4: YEAR 9:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 5: YEAR 10:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

Lessor Initials: ________________ Gov’t Initials: ______________

FULL Service Rate Structure

67.1

Base Year Term

Exhibit E taylor.mccuiston Cross-Out taylor.mccuiston Cross-Out

Attachment A to GSA Form 1364

PROPOSAL TO LEASE SPACE – RATE STRUCTURE

SPACE – NOT TO EXCEED _____ USABLE SUARE FEET

Rentable Area: square feet – Total

Usable Area: square feet – Total

3-5yr. Soft-Terms (2) – Rental

Rates YEAR 11:

3-5yr. Soft-Terms (3) – Rental

Rates YEAR 16:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ 17.63 Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 12: YEAR 17:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 13: YEAR 18:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 14: YEAR 19:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

YEAR 15: YEAR 20:

$ Total Annual Rent $ Total Annual Rent

$ Base Square foot Rate $ Base Square foot Rate

$ Cost of Services, utilities & maintenance per square foot $ Cost of Services, utilities & maintenance per square foot

$ Cost of Tenant Improvement per square foot, if applicable $ Cost of Tenant Improvement per square foot, if applicable

$ Total Square foot rate $ Total Square foot rate

Lessor Initials: ________________ Gov’t Initials: ______________

642858.22

642858.22

642858.22

642858.22

681440.22

627642.39

627642.39

627642.39

627642.39

17.63

17.63

17.63

642858.22

17.63

17.63 17.63

17.63

17.63

17.63

70.19

70.19

70.19

70.19

70.19 73.34

73.34

73.34

73.34

73.34

VHAHAMHammoL Inserted Text

S02 Exhibit E_1364_Attachment_A_11through20.pdf
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