9MD2071 - Exhibit G - GSA Form 1364C

PROPOSAL TO LEASE SPACE

(For use with Standard Request for Lease Proposals)

REQUEST FOR LEASE PROPOSAL NUMBER

9MD2071

SECTION I - DESCRIPTION OF PREMISES

XXXXX

XXXXX

XXXXX

OF FLOORS IN BUILDING

3. TOTAL RENTABLE SPACE IN OFFERED BUILDING

a. GENERAL PURPOSE (Office)

METHOD

6. YEAR OF LAST

MAJOR RENOVATION

(if applicable)

_____ acres

SECTION II - SPACE OFFERED AND RATES

“Tenant Improvements” are all alterations for the Governmentdemised area above the building shell buildout, excluding costs identified as tenant improvements in the Security Unit Price List. Building Specific Amortized Capital (BSAC) is the sum of costs identified as such in the Security Unit Price List. Neither the Tenant Improvements as stated in Block 12, nor the BSAC as stated in Block 13, are to be included in the shell rent. It is expected that the tenant buildout will be fully amortized at the end of the firm term, and the rent will be reduced accordingly. Any desired rent increases or decreases beyond the firm term of the lease should be reflected in the shell rate and fully explained as part of this written proposal. If Tenant Improvements or BSAC improvements are to be amortized beyond the firm term, those calculations must be itemized as part of this written proposal. The Offeror may attach additional pages as necessary.

Offerors may copy this section through lines 18 as needed. Insert them above Box 20 or in Box 29.

Number of years each cost per square foot is in effect. State any changes for any rent component.

a.

BUILDOUT COSTS PER CATEGORY

b.

AMORTIZATION

TERM

c.

AMORTIZATION

INTEREST RATE (%)

d.

ANNUAL RENT

$ PER RSF

e.

ANNUAL RENT

$ PER ABOA SF

f.

NO. YEARS RATE IS EFFECTIVE

12. TENANT IMPROVEMENTS

(per RLP requirements)

13. BSAC

(per RLP requirements detailed on Security Unit Price List)

14. SHELL BUILD-OUT

(per RLP requirements)

16. SHELL RENT (Including current real estate taxes. Refer to Line 28 on GSA Form 1217)

17. OPERATING COSTS (Refer to Line 27 on GSA Form 1217

18. TOTAL ANNUAL RATE

19. TOTAL ANNUAL RENT

TOTAL ANNUAL STEP RENTS

$__________RSF

$__________ABOA

_____ Thru _____

_____ Thru ____

_____ Thru _____

20.

SECTION III - LEASE TERMS AND CONDITIONS

21. INITIAL LEASE TERM

(Full Term)

22. RENEWAL OPTIONS

for Government to terminate lease:

a. Shell rate / RSF / Yr

23. OFFER GOOD UNTIL AWARD

(In accordance with Federal Acquisition Regulations 15.208)

24. Space will be altered and delivered in accordance with the Government's specifications and requirements in accordance with the Request for Lease Proposals (RLP) and the lease.

25. COMMISSIONS--IF APPLICABLE, ATTACH COMMISSION AGREEMENT

26. OFFEROR’S TENANT IMPROVEMENT FEE SCHEDULE

c. If other fees are applicable, state what they are in terms of a per ABOA square foot amount, or if using a percentage, what is the basis for determining the fee.

The Government will add the cost of the proposed fees to the net present value of the offered rental rate as described in the RLP’s Price Evaluation paragraph. This schedule will be applicable for Tenant Improvements and change orders during initial construction arising under any resulting lease contract.

27. ADDITIONAL FINANCIAL ASPECTS OF THE OFFER

Areas requiring 24 hour HVAC (LAN, etc.) $________per _______ ABOA sf NOTE: THE COST TO PROVIDE 24 HOUR HVAC SERVICE IS REIMBURSED SEPARATELY FROM RENT. THE COST FOR THESE OVERTIME UTILITIES MUST NOT BE INCLUDED IN THE OFFERED RENTAL RATE OR BASE OPERATING COSTS.

Building’s Normal Hours of HVAC Operation:

If a site is offered, state the total land costs: $________

28. LIST OF ATTACHMENTS SUBMITTED WITH THIS OFFER

(See Request For Proposal (“RLP”) requirements)

XXXXX

SECTION IV - OWNER IDENTIFICATION AND CERTIFICATION

30. RECORDED OWNER (Name and address including ZIP code)

NAME

STREET

CITY, ST ZIP

31. BY SUBMITTING THIS OFFER, THE OFFEROR AGREES UPON ACCEPTANCE OF THIS PROPOSAL BY THE 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 REQUEST FOR LEASE PROPOSALS, WITH ATTACHMENTS.

(Specify):

33. OFFEROR

XXXXXXXXXXXXXXXXXXXX

c. TELEPHONE NUMBER (Including area code) (XXX) XXX-XXXX extension __________

MM-DD-YYYY

ATTACHMENT TO

GSA FORM 1364C-STANDARD

LEASE PROPOSAL DATA

Fee owner Other:

Attach evidence of Offeror's interest in property (e.g., deed) and representative's authority to bind Offeror.

The Property is in a base (100-year) flood plain in a 500-year flood plain not in a flood plain.

(See RLP for minimum requirements)

RLP does not contain seismic requirements. No documentation required.

RLP contains seismic requirements. The Building

(See RLP for minimum requirements)

Historic property within a historic district.

Non-historic property within a historic district.

Historic property outside of a historic district.

None of the above.

(See RLP for minimum requirements)

Contains no ACM, or contains ACM in a stable, solid matrix that is not damaged or subject to damage.

Contains ACM not in a stable, solid matrix.

(See RLP minimum requirements)

The Property Meets Does not meet Lease fire/life safety standards.

(See RLP and Lease documents for minimum requirements)

The Property Meets Does not meet Lease accessibility standards.

(See RLP and Lease documents for minimum requirements)

Has received the ENERGY STAR® Label within the past twelve months. Date:

Has not received the ENERGY STAR® Label within the past twelve months; the Offeror has evaluated energy savings measures and

(See RLP and Lease documents for minimum requirements)

I am a HUBZone SBC Offeror and I elect to waive the price evaluation preference.

(See RLP and Lease documents for more information)

PAGE 1 of 4 GSA FORM 1364C-STANDARD (REV 11/12)