EXHIBIT G - FPLS Pre-Lease Review Request Form (May 2015).docx
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- Attached to
- General Services Administration (GSA) seeks to lease the following space in Washington DC
- Solicitation number
- 3DC0646
About this file
This document is a Request for Prelease Fire Protection & Life Safety Package Review form. It describes the required components of the fire protection and life safety submittal package, including forms, floor plans, and maintenance records, that must be provided to the Regional Fire Protection Engineer for review prior to leasing a building.
The related federal contract opportunity is for the General Services Administration (GSA) to lease between 50,000 to 53,000 ABOA square feet of office space in Washington, D.C. The lease term is 20 years firm, with an estimated lease commencement date of July 1, 2027. The building must meet specific requirements such as availability of green/recreational space, ability to achieve residential use permit, and accommodate a single government user with control of the lobby area. The full set of requirements and forms are provided as an attachment to the solicitation.
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Text version
TRANSMITTAL REQUEST FOR
PRELEASE FIRE PROTECTION & LIFE SAFETY PACKAGE REVIEW
Date Submitted:
To: (Name of Program Manager or Name of Regional Fire Protection Engineer)
From: (Name of Leasing Specialist Requesting Review)
Date Review Needed By:
(Required within 5 business days after receipt of the complete fire protection review package from the GSA Leasing Specialist).
| Building Name: | ||
| Building Address: | City: | |
| State: | Zip: | Name of Agency: |
Floor and Associated Gross Square Feet of Offered Leased Space:
Agencies Intent on Usage of Offered Leased Space (e.g., office space - 6,000 square feet, conference rooms – 3 at 800 square feet each, training room – 1 at 1,500 square feet , etc.):
| Check All That Apply: |
| Fire Protection and Life Safety Submittal Package Requirements: |
GSA Form 12000, Prelease Fire Protection and Life Safety Evaluation for an Office Building PART A or PART B PART A (Offered space located below the 6th floor) PART B (Offered space located on or above the 6th floor)
| |_| |
| Copy of Valid Certificate of Occupancy -or- Copy of Report Prepared by Licensed Fire Protection Engineer Verifying the Offered Space Meets All Applicable Local Codes and Ordinances |
(If a Valid Certificate of Occupancy is Unavailable or the Local Jurisdiction Does Not Issue Certificates of Occupancy)
Scaled Floor Plan Drawings (1/8 inch scale, minimum) Floor(s) of Space Being Offered for Government Lease –and- Floor Plan of Street Level (Both floor plans are required to be submitted)
| |_| |
| Copy of Previous Year’s Fire Alarm System Maintenance Record Showing Compliance with the Requirements of NFPA 72 (If a system is installed in the building) |
| |_| |
| Copy of Previous Year’s Sprinkler System Maintenance Record Showing Compliance with the Requirements of NFPA 25 (If a system is installed in the building) |
****NOTE: INCOMPLETE SUBMITTAL PACKAGES WILL BE RETURNED WITHOUT REVIEW****
Date Received:
Fire Protection & Life Safety Package Submittal Review:
| Approved: |
| |_| |
| Approved with Comments*: |
| |_| |
| Disapproved/Resubmit with Comments*: |
| |_| |
*NOTE: See attached comments.
Name of Regional Fire Protection Engineer Who Performed Review:
Telephone Number:
Date Review Completed:
May 2015
File details come from the government source that posted it. Updated .