OFFEROR DELIVERABLES, SUBMITTALS, REQUIREMENTS & DOCUMENTATION CHECKLIST

Exhibit N to RLP No. 36C248-26-R-0042 | Vero Beach, Florida VA Primary Care Clinic

Offer Due: December 15, 2026, by 3:00 PM ET | Email: Javier.Correaochoa@va.gov

Instructions: Check each applicable item, enter the exact file name and page/location, and note status. Conditional items are marked “If applicable.” This checklist consolidates requirements stated in the RLP; Exhibits A–N remain controlling. Complete and execute Exhibit N and identify each required document by file name and page number.

Offeror Property/Site Prepared by Date Contact / Phone Email

1. Core offer forms and administrative eligibility

✓ Deliverable / requirement RLP reference Timing Applicability File name / page Notes / status

☐ Completed and signed GSA Form 1364, Proposal to Lease Space, including all pricing, broker compensation, concessions, deviations, and remarks

3.01; 3.03 B; Exhibit D

Initial offer Required

☐ Completed and signed GSA Form 1217, Lessor’s Annual Cost Statement, all sections

3.01; 3.03 A; Exhibit E

Initial offer Required

☐ Completed and executed Exhibit N deliverables form, listing each required file name and page number

4.03; Exhibit N

Initial offer Required

☐ Active SAM registration for “All Awards,” including required representations and certifications

3.01 J Before

lease award

Required

☐ Authorization from ownership to submit offer 3.01 C Initial offer If Offeror is not owner

☐ Conditional financing commitment stating amount, term, APR, and commitment length, or self-financing evidence (financial statements, 3 months bank statements, financial officer letter)

3.01 D Initial offer Required

☐ Evidence of compliant zoning, approved variances, or a plan and schedule to obtain zoning approvals

3.01 E Initial offer Required

☐ Ownership/control evidence, including deed or long-term lease and encumbrances

3.01 F Initial offer Required

☐ Executed agreement to acquire interest, owner statement that agreement is effective and conditions precedent are satisfied;

keep documents current

3.01 G Initial offer If no vested

property interest

☐ Proof of signing authority: corporate, partnership, LLC, or joint venture organizational documents and authorizing resolution/evidence

3.01 H Before

lease execution

Required

☐ Conflict-of-interest disclosure and authorizations for multiple representation

3.01 I Initial offer If applicable

☐ FAR 52.240-90 telecommunications/video surveillance representation

3.01 T Initial offer As triggered by

SAM response

☐ Small Business Subcontracting Plan 1.13; SAM Initial offer If other than small business and aggregate rent exceeds $900,000

2. Property, site, parking, plans and building documentation

✓ Deliverable / requirement RLP reference Timing Applicability File name / page Notes / status

☐ Legal property description, Tax ID, prior-year tax notices and bills, tax abatements, site/location/tax parcel maps, property facts, and color photograph

3.01 L Initial offer Required

☐ Parking plan and narrative showing 100 VA-exclusive spaces, secured and lit, no more than 250 feet from clinic main entry;

include pedestrian path

1.02; 3.01 M; 4.03 Factor 1, SF6

Initial offer Required

☐ Scaled floor plans at preferred 1/8 inch = 1 foot, including offered and exit-discharge floors; stairs, elevators, corridors, offered area, interruptions, and architectural features

3.01 O; 4.04 Initial offer Required

☐ CAD deliverables in .DWG and .PDF, separate poly-line layer, written layer matrix, corridor patterns, and accurate architectural features

3.01 O Initial offer Required

☐ Architectural modernization plans 3.01 N Initial offer If Building is not modern

☐ Test fit layout at Offeror expense 2.01 Initial offer If requested by

VA

☐ Vending facilities statement identifying any exclusive vending rights

3.01 P Initial offer Required

☐ Amenities evidence, including signed leases, construction contracts, or other acceptable proof that amenities will exist by occupancy

3.01 Q Initial offer Required

☐ Construction schedule covering permitting, design, principal construction work, milestones, completion, and required occupancy

3.01 V Initial offer Required

3. Fire, accessibility, environmental, energy and historic preservation reference Timing Applicability File name / page Notes / status

☐ Accessibility verification, or specific obligation to complete required accessibility improvements before acceptance

2.06 Initial offer Required

☐ Completed GSA Form 12000, Part A or B, as applicable 3.01 K;

Exhibit I

Initial offer Unless an RLP exemption applies

☐ Previous year fire alarm maintenance record compliant with NFPA 72

3.01 K Initial offer If system installed

and no exemption

☐ Previous year sprinkler maintenance record compliant with

NFPA 25

3.01 K Initial offer If system installed

and no exemption

☐ Valid Certificate of Occupancy, or engineer report; for new construction, code-edition documentation and written FPLS commitment

3.01 K Initial offer Required

☐ Fire/life-safety verification or commitment to complete means of egress, sprinkler, and alarm improvements before acceptance

2.07 Initial offer Required

☐ Current asbestos management or O&M plan and reinspection report performed within past 5 years, listing ACM and condition

2.05 D Initial offer If ACM is present

☐ Written disclosure of known hazardous conditions or environmental releases and known prior property use

2.09 Initial offer Required

☐ Current ASTM E1527-21 Phase I ESA focused on Government as user

2.10 When

directed by LCO

Required

☐ Phase II ESA, cleanup evidence, and compliance schedule addressing recognized environmental conditions

2.10 Initial offer If Phase I identifies

RECs

☐ Recent environmental studies and requested NEPA information; provide Government site access for studies

2.10 Initial offer As

applicable/requested

☐ NHPA/historic-property documentation; preservation architect qualifications, design solutions, and revised submissions

2.11 Initial offer If historic

properties/ground disturbance may be affected

☐ ENERGY STAR label obtained within 12 months before final proposal revisions, or statutory-exception evidence and proposed cost-effective improvements

2.08; 3.01 R

By final proposal revisions

Required

☐ ENERGY STAR Online Tools analysis showing why no improvement is cost effective

2.08; 3.01 R

Initial offer If no improvements proposed

☐ Evidence supporting eligibility for additional time to obtain ENERGY STAR label and capability to earn it

3.01 R Initial offer If claimed; indicate

in initial offer and substantiate by FPR

☐ Hydrology compliance statement 3.01 S Initial offer If more than 5,000 SF of land will be disturbed

4. Pricing, design, tenant improvements, security and services reference Timing Applicability File name / page Notes / status

☐ Fully serviced gross rate per ABOA SF and RSF, itemized shell rent, TI, operating costs, parking, taxes, utilities/services, and other required components

3.03 B Initial offer Required

☐ Base annual services/utilities cost per ABOA SF and RSF tied to Form 1217 line 27; state whether operating costs are firm or adjustable

3.03; 3.08 Initial offer Required

☐ Shell rate per ABOA SF and RSF after the 5-year firm term, excluding TI

3.03 B Initial offer Required

☐ Hourly overtime HVAC rate and adjustment for vacant premises; periodic above-standard service rates if applicable

3.03; Lease Initial offer Required

☐ Rent concessions and all requested deviations entered in Form 1364

3.03 B Initial offer Required

☐ Completed Exhibit K Tenant Improvements Cost Summary / TICS table

4.03 Factor

3; Exhibit K

Initial offer Required

☐ Completed security cost breakdown/unit price list 3.03 C; 4.03 Factor 3

Initial offer Required

☐ Initial-offer Level 1 Design Intent Drawings: cover, demolition if applicable, partition, power/communications, furniture, and finish plans

3.06; 4.03

SF12

Initial offer Required

☐ Finish options supporting the turnkey design/pricing solution

3.01 table;

3.06

Initial offer Required

☐ Fixed lump-sum TI pricing based on ASR/FSL II requirements, excluding shell and building-specific security costs

3.03; 3.05;

3.06

Initial offer Required

☐ Security improvements pricing including administrative, contractor, PM, design, permit, overhead, and profit costs; no charge for existing items

1.10; 3.07 Initial offer Required

☐ Supporting documentation requested for OMB operating-lease scorekeeping

3.04 Upon

LCO

request

Required

5. Technical evaluation factor documentation reference Timing Applicability File name / page Notes / status

☐ Standalone PDF named “Appropriate land use” containing statement, zoning information, maps and aerial photos showing compliant clinic zoning and compatible land use within 1 mile

4.03 Initial offer Required

☐ Standalone PDF named “Neighborhood” containing statement, maps and aerial photos showing compatible businesses/tenants and stable neighborhood

4.03 Initial offer Required

☐ Standalone PDF named “Amenities” containing statement, maps and aerial photos showing at least 7 amenities within walkable 1,320 feet, including 2 restaurants; walking/driving paths and distances

4.03 Initial offer Required

☐ Standalone PDF named “Transit Accessibility” containing statement, maps and aerial photos showing usable bus stop within walkable 1,320 feet and pedestrian path

4.03 Initial offer Required

☐ Standalone PDF named “Access” containing statement, maps and aerial photos showing major highway within 5 miles and driving path

4.03 Initial offer Required

☐ Standalone PDF named “Parking” containing statement and architectural plans showing 100 exclusive spaces within 250 feet and pedestrian path

4.03 Initial offer Required

☐ Standalone PDF named “Visibility and Direct Access” containing statement, maps and photos showing roadway visibility and 3–5 turns to a major highway

4.03 Initial offer Required

☐ Standalone PDF named “Proximity to Hospitals with ER” containing statement, maps and aerial photos showing hospital with emergency room within 1 mile and driving path

4.03 Initial offer Required

☐ Standalone PDF named “Flooding and Environmental Issues” containing statement, floodplain maps and aerial photos showing site outside 100-year floodplain and free of major constraints; mitigation plan if applicable

4.03 Initial offer Required

☐ Standalone PDF named “Emergency Response” containing plan to address EMS/custodial emergency issues within 2 hours and nonroutine issues before end of day

4.03 Initial offer Required

☐ Standalone PDF named “M-O Qualifications and Proximity” containing property management/operations plan; team/company profiles;

medical-facility experience; work-order tracking; map showing team within 50 miles

4.03 Initial offer Required

☐ Standalone PDF named “A-E Design” containing statement and architectural plans demonstrating VA PACT CBOC/TIL compliance and Section 3.06 DIDs

4.03 Initial offer Required

☐ Standalone PDF named “Available Space” containing architectural plans showing 12,900–12,948 ABOA SF, one floor, no more than two operationally connected suites

4.03 Initial offer Required

☐ Standalone PDF named “Past Performance” containing three references and completed Exhibit J questionnaires from cited references

4.03 Initial offer Required

6. Final packaging and submission quality control

✓ Deliverable / requirement RLP reference Timing Applicability File name / page Notes / status

☐ Signed proposal saved as accessible PDF with visible original signatures; retain original signed proposal for VA request

3.02 Initial offer Required

☐ Email identifies Offeror name, address, telephone number, and signer’s name/title; proposal attached and sent only to designated VA email

3.02 Initial offer Required

☐ All statements are substantiated by supporting documentation; exact file names and page locations entered in Exhibit N

4.03; Exhibit N

Initial offer Required

☐ Offer submitted no later than December 15, 2026, 3:00 PM ET to Javier.Correaochoa@va.gov

Cover; 3.02 Initial offer Required