Exhibit A GSA FORM 1364A.pdf
GSA Form PDF 171 KB Posted
- Attached to
- X1AA--New Replace Childress Clinic Lease
- Solicitation number
- 36C25721R0082
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Other versions and copies of GSA Form 1364A
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Who attaches GSA Form 1364A
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit J GSA Form12000.docx | DOCX document | |
| Exhibit C.1 Scope of Work Price List.xlsx | XLSX spreadsheet | |
| Exhibit E Wage Determination - Childress county.pdf | ||
| Exhibit I Security Requirements (Level II) 06.2018.pdf | ||
| Exhibit C Scope of Work.pdf | ||
| Exhibit G Rent table.xlsx | XLSX spreadsheet | |
| Exhibit F GSA1217 - Lessor Annual Cost Statement.pdf | ||
| Exhibit C.2 Childress Schedule B PACT 4292020.xls | XLS spreadsheet | |
| Exhibit B GSA FORM 1364A-1.pdf | ||
| Exhibit H 3516A Simplified Solicitation Provisions.pdf | ||
| RLP R100A Childress.pdf | ||
| Lease 36C25721L0008 L100A.docx | DOCX document | |
| Exhibit K GSA Form 3517B_Rev_10 2020.pdf | ||
| Exhibit L Program For Design.xls | XLS spreadsheet | |
| Exhibit I.1 Security Unit Price List FSL II 4 25 17.xlsx | XLSX spreadsheet |
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Text version
SIMPLIFIED LEASE PROPOSAL DATED:
SECTION I - BUILDING INFORMATION
A. BUILDING NAME
NUMBER OF FLOORS
TOTAL PARKING FOR BUILDING
STRUCTURED: SURFACE:
B. BUILDING STREET ADDRESS
LIVE FLOOR LOAD (LBS / SQ
FT) 7
CONSTRUCTION TYPE
C. CITY D. STATE
TOTAL RENTABLE AREA (SQ
FT)
A. BUILDING BUSINESS HOURS (MON - FRI)
E. 9-DIGIT ZIP CODE F. CONGRESSIONAL
DISTRICT 5
BUILDING AGE (YEARS) B. BUILDING BUSINESS HOURS (SAT - SUN)
SECTION II - SPACE OFFERED AND RATES
FLOOR LOCATION SUITE NUMBER ANSI/BOMA SQ FT TYPE OF SPACE FLOOR LOCATION SUITE NUMBER ANSI/BOMA SQ FT TYPE OF SPACE
ANSI/ BOMA
AREA (SQ FT)
A
COMMON
AREA
FACTOR
B
RENTABLE
SQ FT (RSF)
A x B =
C
FIRM TERM NON-FIRM TERM OPTION TERM
RENTAL RATE
(PER RSF/YR)
D
TYPE OF
SPACE
ANNUAL RENT
C x D =
E
RENTAL RATE
(PER RSF/YR)
F
ANNUAL RENT
C x F =
G
RENTAL RATE
(PER RSF/YR)
H
ANNUAL RENT
C x H =
I
10 OFFICE $
11 OTHER
12 TOTAL
13 COMPOSITE ABOA PER SQ FT RATES 12E ÷ 12A =
13A
12G ÷ 12A = 13B
12I ÷ 12A = 13C
A. RATE ADJUSTMENT FOR VACANT SPACE: $ / ABOA
SF
B. FREE RENT INCLUDED IN OFFER
A. HOURLY RATE FOR OVERTIME HVAC: B. AREAS REQUIRING 24 HOUR HVAC (LAN, ETC.) $ ABOA SF*
Zone $ Floor $ Entire space $
NUMBER OF PARKING SPACES OFFERED TO GOVERNMENT: A. STRUCTURED: C. SURFACE:
CHARGE FOR SPACES OFFERED TO GOVERNMENT (IF NOT IN RENT): B. STRUCTURED: $ / MO D. SURFACE: $ / MO
17 RIGHT TO USE OF ROOFTOP AREA FOR ANTENNAS AND ASSOCIATED RIGHTS IN BUILDING
SECTION III - OWNER/OFFEROR INFORMATION
A. OFFEROR (NAME AND COMPLETE MAILING ADDRESS) B. OFFEROR'S AUTHORIZED REPRESENTATIVE (IF APPLICABLE)
(NAME AND COMPLETE MAILING ADDRESS)
19 TELEPHONE NUMBER 20 E-MAIL ADDRESS
21 OFFEROR'S FORM OF BUSINESS:
C. DUNS NUMBER
Lessor Government:
EXHIBIT A TO LEASE NUMBER 36C25721L0008 OMB Control Number: 3090-0086 Expiration Date: 12/31/2022
GSA 1364A (REV. 11/2016)GENERAL SERVICES ADMINISTRATION
IN RESPONSE TO REQUEST FOR LEASE PROPOSALS (RLP) NUMBER
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0086. We estimate that it will take 1.5 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
*Only applies when the Government requires separate reimbursement for 24 hour HVAC as described under Section 1 of the Lease. Otherwise, include this cost in the operating rent as described under Section 6 of the Lease.
1. months free rent (includes shell, operating, TI and BSAC rent)
2. Other rental concessions structured as follows
3. None
INCLUDED NOT INCLUDED
INDIVIDUAL PARTNERSHIP CORPORATION - SPECIFY STATE:
NO. 3NO. 1 NO. 2 NO. 5NO. 4
SECTION V - PROPOSED ADDITIONAL TERMS, CONDITIONS
OFFEROR WILL COMPLETE THE FOLLOWING FIRE/LIFE SAFETY, ACCESSIBILITY, AND ENERGY SAVINGS IMPROVEMENTS AS
REQUIRED IN THE LEASE:
ADDITIONAL TERMS AND CONDITIONS WITH RESPECT TO THIS OFFER:
Lessor Government:
EXHIBIT A TO LEASE NUMBER 36C25721L0008
GSA 1364A (REV. 11/2016) BACK
SECTION IV - OFFER
RLP AMENDMENTS ACKNOWLEDGED (INITIAL)22
On behalf of the Offeror, the undersigned offers to lease to the Government the Premises described in Sections I and II, together with all other rights indicated therein, at the rental and other rates stated, on the terms and conditions set forth in the referenced Request for Lease Proposals and this Proposal. This Offer shall remain open for a period of 60 days.
A. SIGNATURE B. NAME C. TITLE D. DATE
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