SAFETY_Environmental CHECKLIST.pdf

2.6.11 Checklist: Space Safety and Environmental

October 2017 OMB Control No. 2120-0595 Page 1

U.S. Department of Transportation Federal Aviation Administration

CHECKLIST: FAA SAFETY AND ENVIRONMENTAL

CERTIFICATION

INSTRUCTIONS: Complete the following information that applies to the building being offered for lease to the Government.

Building Name: Scotch View Center, Building 1

Street Address 721 Scotch Valley Road

City: Hollidaysburg State: PA Zip Code 16648

Square footage of building 21,000, Square footage of proposed space 765

Total number of floors in building 2, Floors proposed space is on 1

Year building constructed 1990, Year of last major renovation 2015

ITEM CONDITION YES NO

SECURITY Secure access provided (check all that apply):

Controlled Entry Alarm System Guard

Other_______________________

X

FIRE AND LIFE

SAFETY

The building has obtained an Occupancy Permit from the local authority having jurisdiction (provide copy of permit).

OR

Reply to the items below:

Two means of egress are provided from the space offered for lease X

Exits are clearly marked with illuminated exit signs X

If space is above or below grade level, stairwell doors open in direction of egress discharging outside or into a protected fire corridor that discharges outside.

X

Automated sprinklers are provided (Sprinklers are mandatory if any portion of the offered space is on or above the sixth floor or below grade.)

Operable employee alarm system is provided X

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ITEM CONDITION YES NO

SEISMIC

PROTECTION

Space is designed, built and maintained to the requirements of seismic standards (check relevant standard and provide supporting documentation, including government-provided “Life Safety Compliance/Seismic Certification” form):

ICSSC RP-8, Seismic Standards for Existing Federally Owned and Leased Buildings, Dec 2011

American Society for Civil Engineers (ASCE) 31-03, Seismic Evaluation of Existing Buildings

Building qualifies as “Benchmark Building” under RP-8

If answer is no, LOB concurrence will be required prior to lease execution.

ASBESTOS

Space is free of all asbestos-containing materials (check basis of statement and provide supporting documentation):

Asbestos survey

Asbestos-free construction certification

If building is known or presumed to contain asbestos, the lessor has an asbestos management program in place and asbestos locations have proper signage.

RADON The space has been tested for radon and found to test under 4.0 picocuries per milliliter (provide copy of radon test results).

X

DRINKING WATER Building drinking water has been tested and found to meet the standards prescribed in Safe Drinking Water Act (provide copy of water test results).

X

GENERAL

SUSTAINABILITY

Building has third-party sustainability certification. If yes, check which applies:

LEED Energy Star Green Globes

Other, describe_____________

X

ENERGY

CONSERVATION

Building/space uses EnergyStar appliances (e.g., heating and air conditioning equipment, refrigerators, etc.) X X

Other energy conserving measures have been implemented (such as occupancy sensors, energy efficient lighting, weatherization, solar water heaters). If yes, please describe measures below:

X

Space is separately metered to track tenant energy usage X

WATER

CONSERVATION

Building/space uses WaterSense or other water conserving fixtures (e.g., faucets, toilets, etc.) X X

Building landscaping uses native vegetation and/or no irrigation is provided X

Space is separately metered to track tenant water usage X X

OTHER

ENVIRONMENTAL

CONCERNS

Waste recycling is provided X

If janitorial services are provided, green cleaning products are specified and used X

Owner or Authorized Representative Signature The information provided by the offeror on this form is material facts and representations upon which the Government relies for making an award. The Government has the right to require remedy if the information is in any way misrepresented, or inaccurate. The owner or authorized representative certifies that all the features described above are in operating order and properly maintained. Owner/authorized representative acknowledges that this document in no way commits the

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Government to enter into any agreement or contract with this offeror with respect to this or any other property. The information provided will be used by the Government to evaluate potential properties.

OWNER OR AUTHORIZED REPRESENTATIVE NAME AND ADDRESS:

Greg Werstil Manager for Energy Plaza Associates LLC

SIGNATURE:_______________________________________________DATE:____________

Mgr. 10/08/2019