697DCM-27-L-00001 Attachment D - Lessors Annual Cost Statement.pdf
PDF 271 KB Posted
- Attached to
- Industrial Flex Space Savoy, IL
- Solicitation number
- 697DCM-27-L-00001
About this file
FAA Form 4400-89: Lessor's Annual Cost Statement
This is a Federal Aviation Administration (FAA) Form 4400-89 template used to document a lessor's annual costs associated with providing real estate space to the government. The form is submitted in response to a lease opportunity (referenced as Lease Contract #697DCM-27-L-00001 for space in Savoy, Illinois, dated September 1, 2026) and requires the lessor to provide detailed cost breakdowns to support fair market value determination for comparable facilities.
The form consists of three primary sections. Section I captures estimated annual costs of services and utilities furnished by the lessor as part of rental consideration, including cleaning and janitorial services, heating (labor, fuel, maintenance), electrical systems (lighting, power, special equipment, maintenance), plumbing (water, supplies, repairs), air conditioning, elevator operations, and miscellaneous costs such as building management, security, landscaping, and social security/workers' compensation insurance. Section II documents estimated annual costs of ownership exclusive of capital charges, including real estate taxes, hazard and liability insurance, building maintenance and replacement reserves, lease commissions, and management expenses. For all line items, the lessor must provide costs for both the entire building and the FAA-leased area specifically. Section III requires formal certification and signature from authorized lessor representatives attesting that entered amounts represent their best estimates of annual costs. The instructions emphasize that costs should reflect actual prior-year expenses or, for new construction, the lessor's best cost estimates, with explanations required when government-leased space services or utilities differ from building-wide offerings.
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Text version
OMB Control No. 2120-0595
Federal Aviation Administration Lessors Annual Cost Statement, 10/2022 FAA Form 4400-89 Pg. 1
Department of Transportation
Lessor’s Annual Cost Statement
In response to Announcement/ Lease Contract #: 697DCM-27-L-00001
SAVOY, ILLINOIS
Date: 9/1/2026
Paperwork Reduction Act Burden Statement A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0595. Public reporting for this collection of information is estimated to be approximately 120 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524
It is the established policy of FAA to enter into leases only at rental charges that are consistent with prevailing ranges in the community for comparable facilities.
INSTRUCTIONS: Offeror must read the detailed instructions found at the end of the document, fill in all applicable boxes, and provide the Solicitation submittal to the Real Estate Contracting Officer. Any attachments should be clearly listed in the appropriate section at the bottom.
1. Solicitation No.
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2. Statement Date
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3. Rentable Square Footage
3A. Entire Building
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3B. Leased by FAA
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4. Building Name and Address Building Name:Click or tap here to enter text.
Street:Click or tap here to enter text.
City:Click or tap here to enter text.
State:Click or tap here to enter text.
Zip Code:Click or tap here to enter text.
SECTION I – Estimated Annual Cost of Services and Utilities Furnished by Lessor as Part of Rental Consideration
Services and Utilities Lessor’s Annual Cost For (c) For Government Use
Only (a) Entire Building (b) FAA Leased Area
A. Cleaning, Janitor, and/or Char Service
5. Labor Cost
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6. Supplies (Wax, cleansers, cloths, etc.)
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Lessors Annual Cost Statement, 10/2022 FAA Form 4400-89 Pg. 2
7. Contract Services (Window washing, waste, and snow removal)
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Services and Utilities (cont.)
Lessor’s Annual Cost For (c) For Government Use
Only
(a) Entire Building (b) FAA Leased Area
B. Heating
8. Labor Cost
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9. Fuel (check one) ☐Oil ☐Gas ☐Coal ☐Electric
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10.System Maintenance and Repair Costs
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C. Electrical
11. Current for Light and Power (Including elevators)
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12. Replacement of bulbs, tubes, starters
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13. Power for special equipment
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14. System Maintenance and Repair (Ballasts, fixtures, etc.)
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D. Plumbing
15. Water (For all purposes) (Include sewage charges)
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16. Supplies (Soap, towels, tissues not in 6 above)
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17. System Maintenance and Repair
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E. Air Conditioning
18. Utilities (Include electricity, if not in C11)
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Lessors Annual Cost Statement, 10/2022 FAA Form 4400-89 Pg. 3
19. System Maintenance and Repair
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Services and Utilities (cont.)
Lessor’s Annual Cost For (c)For Government Use
Only
(a) Entire Building (b) FAA Leased Area
F. Elevators
20. Labor Costs (Operators, starters, etc.)
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21. System Maintenance and Repair
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G. Miscellaneous (To the extent not included above)
22. Building Engineer and/or Manager
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23. Security (Watchmen, guards, not janitors)
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24. Social Security Tax and Workmen’s Compensation Insurance
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25. Lawn and Landscaping Maintenance
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26. Other (Explain on separate sheet)
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27. SECTION I TOTAL $Click or tap here to enter text.
$Click or tap here to enter text.
SECTION II – Estimated Annual Cost of Ownership Exclusive of Capital Charges
Services and Utilities (cont.)
Lessor’s Annual Cost For (c)For Government Use Only
(a) Entire Building (b) FAA Leased Area
28. Real Estate Taxes Click or tap here to enter text.
29. Insurance (Hazard, liability, etc.)
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30. Building Maintenance and Reserves for Replacement
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Lessors Annual Cost Statement, 10/2022 FAA Form 4400-89 Pg. 4
31. Lease Commission Click or tap here to
Services and Utilities (cont.)
Lessor’s Annual Cost For (c)For Government Use Only (a) Entire Building (b) FAA Leased Area
32. Management Click or tap here to enter text.
33. SECTION II TOTAL
$Click or tap here to
$Click or tap here to enter text.
SECTION III- Lessor Certification and Signature(s)
34/35. LESSOR CERTIFICATION- The amounts entered in Columns (a) and (b) represent my best estimate as to the annual costs of services, utilities and ownership for the offered space.
TYPED NAME AND
TITLE
SIGNATURE DATE
34A.Click or tap here to enter
34B. 34C.Click or tap to enter a date.
35A.Click or tap here to enter
35B. 35C.Click or tap to enter a date.
Lessors Annual Cost Statement, 10/2022 FAA Form 4400-89 Pg. 5
LESSOR’S ANNUAL COST STATEMENT INSTRUCTIONS
INSTRUCTIONS FOR COMPLETING HEADER INFORMATION:
1. Enter the Government lease or Solicitation number, if available.
2. Enter the date that your statement was prepared and signed.
3A. Enter in this block a computation of the rentable area (multiple tenancy basis) for the entire building. The rentable area shall be computed by measurement to the inside finish of permanent outer building walls to the inside finish of corridor walls (actual or proposed) or to other permanent partitions, or both. Rentable space is the area for which a tenant is charged rent. It is determined by the building owner and may vary by city or by building within the same city. The rentable space may include a share of building support/common areas such as elevator lobbies, building corridors, and floor service areas. Floor service areas typically include restrooms, janitor rooms, telephone closets, electrical closets, and mechanical rooms. The rentable space generally does not include vertical building penetrations and their enclosing walls, such as stairs, elevator shafts, and vertical ducts.
3B. Enter in this block a computation of the rentable area to be rented to the Government. For this area, follow the procedure as outlined above, except that measurements are to be made only to the center of the partitions, which separate the area to be rented by the Government from adjoining rented or rentable areas.
4. Identify the property by name and address.
INSTRUCTIONS FOR COMPLETING SECTION I- ESTIMATED ANNUAL COST OF SERVICES AND UTILITIES
ITEMS 5. - 26. The services and utilities listed in this section are required in most of our rented space whether furnished by the Government or the Lessor unless otherwise stated in the solicitation. Carefully review the Solicitation and/or the proposed lease to identify those services and utilities to be furnished by you as part of the rental consideration. Then enter the actual cost from the previous year or for new construction, enter your best cost estimate, for each of these services and utilities in column (a) for the entire building and in column (b) for the area to be rented to the Government.
If any service or utility furnished for the space rented by the Government is not furnished throughout the building, or the cost of a service or utility furnished to the Government space exceeds the cost of the same service or utility furnished to other rented space, explain on a separate sheet.
For convenience, each major category has been divided into separate items such as labor costs and supplies so that they may be entered when applicable. However, in the event that your records are not maintained for each item contained in Section I, 5 through 26, the total for a major category (A through F) may be entered under the category heading in columns (a) and (b) in lieu of the specific items.
System maintenance and repairs includes the annual cost of such items as oiling, inspecting, cleaning, regulating, and routine replacement costs.
INSTRUCTIONS FOR COMPLETING SECTION II- ESTIMATED ANNUAL COST OF OWNERSHIP EXCLUSIVE OF
CAPITAL CHARGES AND SECTION III- LESSOR CERTIFICATION AND SIGNATURE.
Items 28 through 32 will be useful in the Government’s determination of the fair market value of the space to be rented and shall be completed irrespective of whether Section I is applicable, as follows:
28. Include all applicable real estate taxes imposed upon the property.
29. Enter the annual cost of fire, liability, and other insurance carried on the real estate.
30. Enter the annual cost of wages, materials, and outside services used in repairs and maintenance of the building itself and all similar repairs and maintenance costs not included in Section I above (Heating, Electrical, Plumbing, Air Conditioning, and Elevators). This includes major repairs and changes in the nature of a permanent improvement such as annual cost to replace relatively short-lived items such as boilers, compressors, elevators, and roof coverings.
31. Enter any lease commission that you may be responsible for due to the Government leasing action.
32. Include administrative expenses such as agency fees, legal fees, auditing, and advertising. Do not include financial charges such as income or corporate taxes or organization expense.
33. Include the total of all the items above.
34 / 35. Complete Lessor Certification and Signature
INSTRUCTIONS: Offeror must read the detailed instructions found at the end of the document, fill in all applicable boxes, and provide the Solicitation submittal to the Real Estate Contracting Officer. Any attachments should be clearly listed in the appropriate section at the bottom.
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