EXH H Form 1217 Lessor Annual Cost VA Horizon City TX.doc

GSA Form 1217 is a Lessor's Annual Cost Statement template used to document the lessor's estimated annual costs for services, utilities, and building ownership associated with a leased property. This form is part of the solicitation materials for the VA's lease of approximately 23,814 rentable square feet for a Community-Based Outpatient Clinic (CBOC) in Horizon City, Texas. The form is divided into two 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, electrical systems, plumbing, air conditioning, elevators, and miscellaneous items such as building engineering, security, social security taxes, and workmen's 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 costs. All cost entries are organized across three columns to show figures for the entire building, the government-leased area, and government-use-only calculations.

The form requires the lessor to certify that the amounts entered in the designated columns represent their best estimate of annual costs and must be signed by an authorized representative with title, name, signature, and date. This template allows lessors to provide transparent cost documentation for the VA's evaluation of lease proposals for the 10-year firm term with a 10-year soft term CBOC facility. Proposals for this solicitation (36C24W26R0013) were due no later than April 3, 2026, at 4:00 p.m. (EST).