EXHIBIT L (2) - space requirements SF81 Rad Onc.pdf
Standard Form PDF 144 KB Posted
- Solicitation number
- 36C25525R0016
About this file
The document is a Standard Form 81 (SF-81) Request for Space submitted by the Kansas City VA Medical Center to the General Services Administration (GSA) for a new facility. The request is for 13,155 square feet of space, including 13,005 square feet for a laboratory and clinic and 150 square feet for automated data processing, with 30 parking spaces. The proposed term of occupancy is from June 2026 to June 2036, with a total of 10 personnel to be housed in the Kansas City Metro Area. The geographic service area is defined as North I-70, East Hwy 71, South I-435, West I-35 & Hwy 69, indicating a specific regional requirement for a radiation therapy clinic lease associated with VA Healthcare services.
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Text version
REQUEST FOR SPACE
(See instructions on reverse)
1. DATE
GENERAL SERVICES ADMINISTRATION
PUBLIC BUILDINGS SERVICE
2. AGENCY REQUEST NO. 3. LOCAL AGENCY CONTACT (Name) PHONE NO. PHONE NO.4. AGENCY MARKET SURVEY REPRESENTATIVE (Name)
7. FOR:
ZIP CODE
CITY & STATE
NO., STREET
AGENCY
6. FROM:
ZIP CODE
CITY & STATE
NO., STREET
5. TO:
8. TYPE OF REQUEST
FROM (mo. & yr.) TO (mo. & yr.)
9a. GEOGRAPHIC SERVICE AREA
11. TOTAL NO. OF PERSONNEL TO BE HOUSED
13. SPECIAL REQUIREMENTS AND SERVICES (see attached)
SIGNATURE
SIGNATURE OF AUTHORIZED GSA OFFICIAL
SPACE REQUEST NO.
NAME OF GSA REGIONAL CONTACT
DATE RECEIVED
PHONE NO.
STANDARD FORM 81 (REV. 2-89)
Prescribed by GSA-FPMR (41 CFR) 101-17
PRINT NAME AND TITLE
PHONE NO. DATE
PRINT NAME AND TITLE
ATTACHMENT(S)
9b. DELINEATED AREA
NO. OF YEARS FIRM TERM
INITIAL
EXPANSION
10. TERM OF OCCUPANCY
CONTINUING REQUIREMENTS
REDUCTION
AGENCY
ADDRESS
ZIP CODE
BUREAU CODE
12. SPACE REQUIREMENTS
TYPE OF SPACE
PRIMARY OFFICE
AREA
NO. OF
PERSONNEL
SQ. FT.
PER PERSON
SQ. FT. TOTALS
OFFICE SUPPORT
AREA
OFFICE SPACE
SUBTOTAL
ST 1 GENERAL STORAGE
WAREHOUSE STORAGEST 2
SP 1
SP 2
SP 3
SP 4
SP 5
SP 6
SP 7
ST 2 INSIDE PARKING (No. of spaces)
LABORATORY & CLINIC
FOOD SERVICE AREA
STRUCTURALLY CHANGED
AUTOMATED DATA PROCESSING
CONFERENCE & TRAINING
LIGHT INDUSTRIAL
QUARTERS/RESIDENTIAL HOUSING
OUTSIDE PARKING (No. of spaces)
TOTAL PARKING SPACES (Lines o, p)
GENERAL SERVICES ADMINISTRATION
SPECIAL SUBTOTAL (Lines e-k)
TOTAL SPACE REQUIRED (Lines a, d, & l)
OPEN LAND (Total acres)
STORAGE SUBTOTAL (Lines b, c) a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
q.
14. AGENCY CERTIFICATION
15. FOR GSA USE ONLY
(Action by Authorized GSA Official)
GOV'T CONTROLLED SPACE TO BE ASSIGNED
NO GOV'T SPACE AVAILABLE LEASING ACTION PLANNED
UNIQUE AGENCY SPACE DETERMINED - SEE ATTACHED
AGENCY AUTHORIZED TO ACQUIRE SPACE UNDER ITS OWN AUTHORITY
COMMENTS ATTACHED
I certify that this request is accurate and complete; is for the minimum amount of space required; is in compliance with FPMR 101-17, including all laws and executive orders governing the location of space; and that funds are available for payment of rent, moving expenses, telecommunication expenses, and any related reimbursable costs.
03/07/2024
03/07/2024
Charles Rone
Kansas City VA Medical Center 4801 Linwood Blvd1500 Bannister Rd
Kansas City, MO 64131 Kansas City, MO 64128
Kansas City Metro Area
North I-70, East Hwy 71, South I-435, West I-35 & Hwy 69
Alan Gifford816-714-8701
816-714-8701
913-946-1135
06/203606/2026
Charles M Rone, Facility Planner
CHARLES
RONE
Digitally signed by CHARLES RONE Date: 2024.12.16 11:27:28 -06'00'
13,005.00
150.00
30.00
13,155.00
13,155.00
30.00
INSTRUCTIONS
Submitting the SF-81 Submit the SF-81 in triplicate, accompanied by a completed SF-81A, Space Requirements Worksheet, Space Requirements Questionnaire and any additional documentation to fully support the agency's space needs. Failure to provide complete and accurate information will delay processing and may result in return of the SF-81 for correction, update and resubmission.
The SF-81 must be submitted by the office which has authority to obligate funds to reimburse GSA for all applicable costs associated with the delivery of space.
Agency field components which do not have delegated authority to obligate funds must coordinate submission and approval of the SF-81 with offices which have this authority. A GSA Form 2957, Reimbursable Work Authorization, should be submitted when applicable.
Item 1. Date form is prepared.
Item 2. Agency established request number Item 3. Name and phone number of the local agency official who is knowledgable of the request and will serve as the agency's point of contact for this project.
Item 4. Name and phone number of agency representative who will work with GSA if a market survey is conducted. This individual must have the authority to determine acceptability of the building and/or sites and their location.
Item 5. GSA regional office which has jurisdiction for geographical area where space is required.
Item 6. Name and address of organization making the request.
Item 7. Name of agency, and bureau code of the organization which will occupy the space (e.g., regional office, district office, field office) if different than information provided in block 6. City and state where the space is requested.
Item 8. Type of request. Initial: A request for new space that is not associated with an existing assignment. Expansion: A request for additional space associated with an existing assignment. Continuing requirements: A space action required for a lease renewal, succeeding lease, lease extension or move.
Reduction: A space action that requires regional Real Estate Division effort to effect the partial or total termination of an assignment.
Item 9a. and 9b. Geographic/Delineated area that the agency will service. The geographic area (State, city, county, zip code, etc.) for which an agency/bureau has operational responsibility as well as the specific delineated area as identified and justified by the requesting agency. GSA review of the delineated area shall be limited to ensuring that the delineated area will provide adequate competition and the maximum use of existing Government controlled space (see Item 14 Agency Certification).
Item 10. Period of time the organization will use the space and the suggested number of years for a firm term period. This time period must be representative of the longest period for which the agency can commit. "Indefinite" and "ASAP" are not acceptable responses.
Item 11. Total number of personnel to occupy the requested space. ("Personnel" means the peak number of persons to be housed, regardless of how many workstations are provided for them. In addition to permanent employees of the agency, personnel includes temporaries, part-time, seasonal, contractual employees and budgeted vacancies.)
Item 12, line a. This line identifies the Office Space Subtotal. The Office Space Subtotal is determined by entering the amount of space required for the primary office area and adding this to the amount required for the office support area. "Primary Office Area" is the primary people occupied area in which an activity's normal operational functions are performed.
Item 12, lines b, c. Amount of general and warehouse storage space is required. (See items 12, line o for ST 2 inside parking).
Item 12, line d. Total amount of storage space required (Add lines b and c).
Item 12, lines e-k. Amount of special space required.
Item 12, line l. Total amount of special space required (Add lines e through k).
Item 12, line m. Total amount of Office, Storage and Special space required. (Add lines a, d, and l).
Item 12, line n. Total acres needed. For amounts less than 1 acre, 1 acre equals 43,560 square feet.
Item 12, line o, p. Agency's inside and outside parking requirement. Certification that the parking is necessary for the efficient operation of the agency mission is required. One parking space equals 300 square feet. Please indicate the number of spaces.
Item 12, line q. Total parking spaces required. (Add lines o and p).
Item 13. This item refers to the specific architectural, mechanical, electrical, structural, and other special requirements related to each of the types of space requested in Item 12. These include security; electrical; HVAC; floor loading; sound conditioning; fire and safety; and the need for after hours building access, utilities, and cleaning services. Such requirements must be fully defined by area, including computer rooms, laboratories, conference rooms, etc.
These requirements must be specified in detail on the Space Requirements Questionnaire and SF-81A. Check box in Item 13 to indicate if this information is attached.
Agency Certification Item 14. The certification must be signed by an authorized agency official.
Item 15. GSA will evaluate the request in terms of the space available in its inventory and determine the appropriate action. If GSA determines that space requested is unique agency space, GSA will take no action until the agency has concurred with that designation. GSA will assign a space request number which will be used to track the request until it is satisfied.
Name and phone number of the GSA regional official who is knowledgable of the request and will serve as GSA's point of contact.
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