Form 12000WH Prelease FPLS Evaluation (May. 2014) (3).docx

PRELEASE

FIRE PROTECTION AND LIFE SAFETY EVALUATION FOR A WAREHOUSE BUILDING

(THIS FORM IS REQUIRED WHEN THE OFFERED SPACE IS NOT EXEMPT FROM THE GSA FIRE PROTECTION AND LIFE SAFETY PRELEASE REVIEW AS PER PARAGRAPH 3.06(I) OF THE REQUEST FOR LEASE PROPOSALS (RLP)

The prelease form contains one part that must be completed based on the area of the offered space proposed to be leased to the Government. Part A must be completed when any portion of offered space is located above the ground floor or when an offered space is less than 40,000 square feet in area. Part A shall be completed by the Offeror or their authorized representative.

Fundamental Code Requirements

a. A warehouse building is defined as a building that is built for materials storage and handling operations with features such as concrete floors, unfinished ceilings, industrial lighting, overhead doors, minimal HVAC, large column spacing, and special floor load capacities.

b. The offered warehouse building shall be evaluated for compliance with the most recent edition of the building and fire code adopted by the jurisdiction in which the warehouse building is located; with the exception that the technical egress requirements of the building shall be evaluated based on the egress requirements of the most recent edition of the National Fire Protection Association (NFPA) 101, Life Safety Code. (Note: a building with a Certificate of Occupancy indicating that a building fully complies with the International Building Code shall be deemed to comply with this requirement.) All areas that do not meet the above stated criteria shall be identified as to the extent that they do comply.

PART A

The Offeror or their representative shall complete Part A. Part A consists of a series of short answer and Yes/No/NA applicable questions related to general warehouse building information and fire protection and life safety systems. Upon completion of Part A, the Offeror must sign and date the “Offeror’s Statement”. Part A is applicable to any portion of offered space located in a warehouse building above the ground floor or when offered space is less than 40,000 square feet in area. Note: The Offeror may need to obtain additional information from the Government to complete Sections IV, V, and VI of this form.

I. WAREHOUSE BUILDING ADDRESS

Warehouse Building Name:

9-Digit Zip Code:

II. GENERAL WAREHOUSE BUILDING INFORMATION

III. OTHER USES IN WAREHOUSE BUILDING (Check All That Apply)

Percentage of Offered Space: ____%

Percentage of Offered Space: ____% |_| Other (list) Percentage of Offered Space: ____%

IV. STORAGE COMMODITY CLASSIFCATION (PER INTERNATIONAL FIRE CODE)

a. a. Is the proposed storage considered a Class I commodity?

b. b. Is the proposed storage considered a Class II commodity?

c. c. Is the proposed storage considered a Class III commodity?

d. c. Is the proposed storage considered a Class IV commodity?

e. d. Is the proposed storage considered a Group A Plastic commodity?

f. c. Is the proposed storage considered a Group B Plastic commodity?

g. d. Is the proposed storage considered a Group C Plastic commodity?

V. STORAGE CONFIGURATION

h. a. Is the proposed storage to be configured in a solid pile arrangement?

i. b. Is the proposed storage to be configured in a palletized arrangement?

j. c. Is the proposed storage to be configured in a shelf arrangement?

k. d. Is the proposed storage to be configured in a rack array arrangement?

VI. STORAGE HEIGHTS

Please indicate the available height for storage in respect to the following storage configurations:

Note: The maximum height at which the commodity can be stored above the floor and still maintain the necessary clearance from structural members and the required clearance below the sprinklers.

l. a. Storage arranged in solid pile configurations.

m. b. Storage arranged in palletized configurations.

n. c. Storage arranged in shelf configurations.

o. d. Storage arranged in rack configurations

VII. AUTOMATIC FIRE SPRINKLER SYSTEM

p. a. Is an automatic fire sprinkler system installed throughout the warehouse building?

q. b. If an automatic fire sprinkler system is installed, have early suppression fast-response sprinklers been installed in the warehouse building?

r. c. If automatic fire sprinklers are installed within the warehouse building, is the automatic fire sprinkler system maintained in accordance with NFPA 25, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems?

VIII. AUTOMATIC FIRE SPRINKLER SYSTEM – DESIGN CRITERIA

Existing Fire Sprinkler Design Criteria

s. System Demand at Base of Riser (GPM) at a Residual Pressure (PSI)

t. Fire Sprinkler Density

u. Designated Area of Discharge

Proposed Fire Sprinkler Design Criteria

v. System Demand at Base of Riser (GPM) at a Residual Pressure (PSI)

w. Fire Sprinkler Density

x. Designated Area of Discharge

z. Early Suppression Fast-Response Sprinkler K Factor

aa. Design Pressure

IX. SMOKE AND HEAT REMOVAL

a. a. Are smoke and heat vents installed in the warehouse building?

X. FIRE ALARM SYSTEM

b. a. Is a fire alarm system installed in the warehouse building?

c. b. If a fire alarm system is installed in the warehouse building, are audible devices (e.g., horns, bells, speakers, etc.) installed in the offered space?

d. c. If a fire alarm system is installed in the warehouse building, are strobe devices installed in the offered space?

e. d. If a fire alarm system is installed in the warehouse building, is the fire alarm system over 25 years old?

f. e. If a fire alarm system is installed in the warehouse building, does the operation of the fire alarm system automatically notify the local fire department, remote station, or UL listed central station?

f. If a fire alarm system is installed in the warehouse building, is the fire alarm system maintained in accordance with NFPA 72, National Fire Alarm and Signaling Code?

XI.

MEANS OF EGRESS

a. The offered space has unrestricted access to a minimum of two remote exits on each floor of Government occupancy?

XII. EXIT SIGNS

b. Are exit signs installed in the paths of egress travel to the exits?

XIII. ADDITONAL INFORMATION

OFFEROR’S STATEMENT

I hereby attest that the above information is complete and accurate to the best of my knowledge.

Signature: Date:

Printed Name:

Title:

Name of Firm:

Issued 5/5/2014 GSA Form 12000-WH Page 8