Exhibit J- Seismic Forms.pdf

Date:

CERTIFICATE OF SEISMIC COMPLIANCE

BENCHMARK BUILDING

Exhibit J - 36C24925R0019

Seismic Form A

This affirms that ____________ served as an engineer in charge of the seismic evaluation of the building located at _____________ _

The building has the following characteristics:

ASCE Building Type: No. of Stories: Approx. Area:

Building Design Code: Year of Design Code: Year of Construction:

On the basis of the building characteristics and to the extent permitted by this level of evaluation, it is my opinion that the subject Building qualified as a Benchmark Building as indicated in ASCE/SEI 31, Table 1-1

Engineer's Name:

Firm:

Address:

Telephone:

License No.:

License State:

Expiration Date:

Affix Stamp and Sign Here

Lessor Government

CERTIFICATE OF SEISMIC COMPLIANCE

EXISTING BUILDING

Exhibit J - 36C24925R0019

Seismic Form B

This affirms that ____________ served as an engineer in charge of the seismic evaluation of the building located at ____________ _

The building has the following characteristics:

ASCE Building Type: No. of Stories: Approx. Area:

Building Design Code: Year of Design Code: Year of Construction:

I have evaluated this building at the Life Safety Performance Level as set forth in the ICSSC RP 8, Standards of Seismic Safety for Existing Federally Owned and Leased Buildings, using ASCE/SEI 31 methodology:

Tier 1 Evaluation

Tier 2 Evaluation

Tier 3 Evaluation

__ Other (please explain below)

Documentation of this evaluation must be attached to this Certificate

On the basis of the building characteristics and to the extent permitted by this level of evaluation it is my opinion that subject Building (check one) __ does, __ does not meet the Life Safety Performance Level of

ICSSC RP 8.

Affix Stamp and Sign Here

Engineer's Name:

Firm:

Address:

Telephone:

License No.:

License State:

Expiration Date:

Comments:

Attach: ASCE/SEI 31 Checklist(s) Structural, Nonstructural, and Geologic Site Hazards and Foundation.

BUILDING RETROFIT FOR NEW CONSTRUCTION

PREAWARD COMMITMENT

PART1

PREAWARD COMMITMENT TO RETROFIT BUILDING:

Date:

Exhibit J - 36C24925R0019

Seismic Form C

This affirms that ____________ shall serve as engineer in charge of the seismic retrofit of the building located at . The retrofit must be designed to meet the Basic

Safety Objective, as set forth in ASCE/SEI 41 Seismic Rehabilitation of Existing Buildings.

In accordance with the requirements of this Standard and the seismic paragraph in the Request for Lease Proposals (RLP), our offer includes a commitment to retrofit the building to satisfy all of the Basic Safety Objective requirements of ASCE/SEI 41. The offer includes a Tier 1 report with all supporting documents, a narrative explaining the process, scope of renovations, and a schedule for the seismic retrofit. Documentation shall be provided before award that demonstrates the seismic retrofit will meet the seismic standards and be completed within the time frame required.

PART2

PREAWARD COMMITMENT TO CONSTRUCT A NEW BUILDING:

Date:

This affirms that ____________ will serve as engineer in charge of the structural design of the building located at . The criteria for design must be the __ edition of the ______ building code.

In accordance with the requirements of this code, we prepared a quality assurance plan that included requirements for testing and inspection critical elements of the structure and also periodic observation by our staff. We reviewed special inspection and testing reports prepared by the inspection agency and contractor submittals. On the basis of this, and to the extent permitted by this level of construction surveillance, it is my opinion that the Building was designed and constructed in conformance with the requirements of the above code.

The building has the following characteristics:

ASCE Building Type:

Building Design Code:

I Signature:

No. of Stories: Approx. Area:

Year of Design Code: Year of Construction:

OFFEROR

I Name of Signer:

Exhibit J - 36C24925R0019

Seismic Form D

OFFEROR'S REPRESENTATION OF EXEMPTION FROM SEISMIC STANDARDS

I represent that my building is exempt from the requirement of RP 8 because:

I Signature:

The Building is located in an area of medium seismicity and the Building will have less 10,000 Net Usable Square Feet (NUSF) of space leased to the Federal Government upon commencement of the lease term.

The Building is located in an area of high to very high seismicity, and it is a one-story building with a steel light frame or wood construction with less than 3,000 NUSF of space in the building.

OFFEROR

I Name of Signer.

Lessor Government ---- ----

Pre-Occupancy Certificate:

CERTIFICATE OF SEISMIC COMPLIANCE

RETROFITTED BUILDING

Exhibit J - 36C24925R0019

Seismic Form E

This affirms that ____________ served as the engineer in charge of the structural retrofit of the building located at . The standard for design was the Basic Safety

Objective, as set forth in ASCE/SEI 41 Seismic Rehabilitation of Existing Buildings.

In accordance with this Standard, we prepared a quality assurance plan which required staff to observe, test, and inspect the seismic retrofit work. We have also reviewed special inspection and testing reports prepared by the inspection agency and contractor submittals. On the basis of this, and to the extent permitted by this level of construction surveillance, it is my opinion that the Building was designed and constructed to conform with the requirements of the Standard listed above.

The buildinQ has the followinQ characteristics:

ASCE Building Type: No. of Stories: Approx. Area:

Building Design Code: Year of Design Code: Year of Construction:

Retrofit Design Standard: Year of Retrofit Standard: Year of Retrofit:

Documentation of this retrofit must be available to Department of Veteran Affairs.

On the basis of the above, it is my opinion that subject Building (check one) __ does, __ does not meet the Basic Safety Objective - Performance Level as set forth in ASCE/SEI 41, Seismic Rehabilitation of Existing Buildings.

Engineer's Name:

Firm:

Address:

Telephone:

License No.:

License State:

Expiration Date:

Affix Stamp and Sign Here

CERTIFICATE OF SEISMIC COMPLIANCE

NEW BUILDING

Exhibit J - 36C24925R0019

Seismic Form F

PRE-OCCUPANCY CERTIFICATE:

Date:

This affirms that ____________ served as engineer in charge of the structural design of the building located at . The criteria for design were the __ edition of the _____ code.

In accordance with the requirement, we prepared a quality assurance plan, which requires staff to observe, test, and inspect the structure's critical elements. We have also reviewed special inspection and testing reports prepared by the inspection agency and contractor submittals. On the basis of this, and to the extent permitted by this level of construction surveillance, it is my opinion that the Building was designed and constructed to conform with the requirements of the code listed above.

The building has the following characteristics:

ASCE Building Type: No. of Stories:

Building Design Code: Year of Design Code:

Engineer's Name:

Firm:

Address:

Telephone:

License No.:

License State:

Expiration Date:

Comments:

Approx. Area:

Year of Construction:

Affix Stamp and Sign Here