EXHIBIT Q - ADA Certification.pdf

PDF 152 KB Posted

Attached to
New Lease for VA Clinic (CBOC) Tarrant County, Texas
Solicitation number
36C24W26R0055
Issued by

About this file

This is an ADA Certification form (Exhibit Q) required for federal lease solicitations. The form serves as a certification and declaration document for lessors submitting offers for real property leases to the federal government.

The form contains two primary sections. Section 1 requires the lessor to certify handicapped accessibility compliance by confirming that all requirements set forth in the Solicitation for Offers will be met, with checkboxes to indicate either full compliance ("All sections will be met") or partial non-compliance ("All sections are not met"), with space to specify deficiencies if applicable. Section 2 requires the Lessor/Payee Declaration, capturing critical identification and contact information that would appear on the resultant lease contract, including separate fields for lessor and payee information (name, address, city/state, zipcode, email, telephone, and fax). The form also requires the offeror's signature, company name, and Unique Entity Identification (UEI) Number, with space for the date of submission. Initials from both the lessor and government representative are required at the bottom of the form.

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Other files

File Type Posted
EXHIBIT R - PFD Tarrant County CBOC.pdf PDF
S03 - Solicitation Amendment 0004 - Government Responses to Offerors Questions.pdf PDF
S03 - Solicitation Amendment 0003 - Government Responses to Offerors and RLP Solicitation Deadline Date Extended.pdf PDF
S03 - Solicitation Amendment 0002 - Government Responses to Offerors and RLP Solicitation Deadline Date Extended.pdf PDF
RLP 36C24W26R0055 - Solicitation Amendment 0001 - Government Responses to Offeror Questions.pdf PDF
36C24W26R0055 - RLP - AUG 2026.pdf PDF
EXHIBIT B - Agency Specific Requirements.pdf PDF
EXHIBIT B1 - Agency Specific Requirements - Document Hyperlinks.pdf PDF
EXHIBIT C - Security Requirements (FSL Level II).pdf PDF
EXHIBIT O - VHA Infection Control Risk Assessment ICRA 2023-1.0.pdf PDF
EXHIBIT P - VHA PCRA 31May2023-Final.pdf PDF
36C24W26R0055 - RLP - AUG 2026.pdf PDF
EXHIBIT D - 3516 Solicitation Provisions - MAR 2026.pdf PDF
EXHIBIT I - Security Unit Price List FSL II - Oct 2024.xlsx XLSX spreadsheet
EXHIBIT J - Tarrant County Wage Determination - Building.pdf PDF
EXHIBIT M - Pre-Lease Building Security Plan.pdf PDF
EXHIBIT A - Lease No- 36C24W26L0044 - Tarrant County Lease Proposal.pdf PDF
EXHIBIT F - Form 1364 Proposal to Lease Space.pdf PDF
EXHIBIT H - Prelease FPLS Evaluation Form 12000 - Parts A and B.pdf PDF
EXHIBIT L - FAR 52.204-24 Representation Digital Rev 10 20.pdf PDF
EXHIBIT N - Life Safety and Environment of Care Document List and Review Tool 10-2023 (R0).pdf PDF
EXHIBIT E - 3517B General Clauses - APR 2026.pdf PDF
EXHIBIT G - Form 1217 - Lessor Annual Cost Statement.pdf PDF
EXHIBIT K - Delineated Area Map.pdf PDF
Show all 24

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Text version

EXHIBIT Q – ADA CERTIFICATION

INITIALS: LESSOR: ________ GOVERNMENT: ________

ADA CERTIFICATION

1. HANDICAPPED ACCESSIBILITY:

By submission of this offer, the lessor certifies that all requirements set forth in the Solicitation for Offers will be met unless otherwise stated.

_____All sections will be met _____All sections are not met (please specify below)

2. LESSOR/PAYEE DECLARATION

In the event the offer being submitted herein is the successful offer, the Lessor/Payee name and address to be reflected on the resultant Lease Contract would be as follows:

LESSOR

NAME: __________________________________

ADDRESS: __________________________________

CITY/STATE: __________________________________

ZIPCODE: __________________________________

EMAIL: __________________________________

TELEPHONE: __________________________________

FAX: __________________________________

OFFEROR’S SIGNATURE (Owner or Agent)

NAME OF COMPANY

UNIQUE ENTITY IDENTIFICATION (UEI Number)

PAYEE

DATE

File details come from the government source that posted it. Updated .