Exhibit G. GSA Form 1217 Lessor Annual Cost. Huntingdon County.pdf
GSA Form PDF 267 KB Posted
- Attached to
- X1DZ--Space for Lease at Huntingdon County, PA for 20, 162 Rentable / 14, 935 Net Usable Square Feet
- Solicitation number
- 36C24423R0004
About this file
This document is a Lessor's Annual Cost Statement form submitted in response to Solicitation Number 36C24423R0004 from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4. The form provides estimated annual cost details for leasing approximately 20,162 rentable square feet of space in Huntingdon County, Pennsylvania. Costs are listed for cleaning, janitorial services, heating, electricity, plumbing, air conditioning, elevators, building management, security, landscaping maintenance, real estate taxes, insurance, building maintenance, lease commissions, and management fees. The lessor certifies that the amounts entered represent their best estimate of the annual costs of utilities, services, and ownership expenses associated with the leased property.
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EXHIBIT G Page 1 of 1
RLP NO. 36C24423R0004
LEASE NO. 36C24423L0004
LESSOR: ________ GOVERNMENT: ________ GSA FORM 1217 2016-electronic ver.
LESSOR’S ANNUAL COST STATEMENT
1. SOLICITATION FOR OFFERS 2. STATEMENT DATE
3. RENTABLE AREA (SQ. FT.) 3A. ENTIRE BUILDING 3B. LEASED BY GOV'T
4. BUILDING NAME: BUILDING STREET: .
CITY: STATE: ZIP CODE:
SECTION I - ESTIMATED ANNUAL COST OF SERVICES & UTILITIES FURNISHED BY LESSOR AS PART OF RENTAL CONSIDERATION
SERVICES AND UTILITIES LESSOR'S ANNUAL COST FOR:
ENTIRE BUILDING
(a)
GOV'T-LEASED
AREA
(b)
GOV’T USE ONLY (c)
A. CLEANING, JANITOR AND/OR CHAR SERVICE
5. SALARIES
6. SUPPLIES (wax, cleansers, cloths, etc.)
7. CONTRACT SERVICES (Window washing, waste and snow removal)
B. HEATING
8. SALARIES
9. FUEL ("x" one) ___OIL ___GAS ___COAL ___ELECTRIC
10. SYSTEM MAINTENANCE AND REPAIR
C. ELECTRICAL
11. CURRENT FOR LIGHT AND POWER (Including elevators)
12. REPLACEMENT OF BULBS, TUBES, STARTERS
13. POWER FOR SPECIAL EQUIPMENT
14. SYSTEM MAINTENANCE AND REPAIR (Ballasts, fixtures, etc.)
D. PLUMBING
15. WATER (For all purposes) (Include sewage charges)
16. SUPPLIES (Soap, towels, tissues not in 6 above)
17. SYSTEM MAINTENANCE AND REPAIR
E. AIR CONDITIONING
18. UTILITIES (Include electricity, if not in C11)
19. SYSTEM MAINTENANCE AND REPAIR
F. ELEVATORS
20. SALARIES (Operators, starters, etc.)
21. SYSTEM MAINTENANCE AND REPAIR
G. MISCELLANEOUS
22. BUILDING ENGINEER AND/OR MANAGER
23. SECURITY (Watchmen, guards, not janitors)
24. SOCIAL SECURITY TAX AND WORKMEN'S
COMPENSATION INSURANCE
25. LAWN AND LANDSCAPING MAINTENANCE
26. OTHER (Explain on separate sheet)
27. TOTAL $0.00 $0.00 $0.00
SECTION II - ESTIMATED ANNUAL COST OF OWNERSHIP EXCLUSIVE OF CAPITAL CHARGES
28. REAL ESTATE TAXES
29. INSURANCE (Hazard, liability, etc.)
30. BUILDING MAINTENANCE AND RESERVES FOR
REPLACEMENT
31. LEASE COMMISSION
32. MANAGEMENT
33. TOTAL $0.00 $0.00 $0.00
LESSOR'S CERTIFICATION - The amounts entered in Columns (a) and (b) represent my best estimate as to the annual costs of services, utilities and ownership.
TITLE NAME SIGNATURE DATE
34A. (Check one)
34B. 34C. 34D.
35A. (Check one)
35B. 35C. 35D.
File details come from the government source that posted it. Updated .