Lease Proposal Form (2).doc

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Attached to
DOC Onsite Gastrointestinal Services RFI
Solicitation number
1489
Issued by
Middlesex County, Connecticut

About this file

This is a Lease Proposal Form issued by the Connecticut Department of Administrative Services, Leasing and Property Transfer division, designed for property owners and authorized agents to submit offers for space leasing opportunities to the state. The form requests comprehensive information about available properties, including details on building characteristics, accessibility, mechanical systems, parking facilities, and the specific space available for lease across multiple floors. Prospective lessors must provide evidence of property compliance with ADA and other applicable codes, submit recent photographs, neighborhood maps, typical floor plans, and any available marketing materials. The form requires submission to the Department of Administrative Services at 450 Columbus Boulevard, Suite 1402, Hartford, Connecticut 06103, with signed certification from the property owner or authorized agent.

The proposal requests pricing information on base rent (per net usable square feet per year), standard allowance for tenant improvements, and operating expenses, with specification of which party (lessor or lessee) bears responsibility for each operating expense category including heat, utilities, janitorial services, building maintenance, groundskeeping, security, and parking. Property owners or their authorized agents must certify under penalty of law that all statements are complete, true, and made in good faith; the state will only negotiate with owners or their authorized agents and will not consider proposals from option holders. A Notice of Listing Agreement is required if a real estate agent is presenting the property on behalf of the owner, and the agreement must specify the effective dates and any special conditions or restrictions applicable to the lease proposal.

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Text version

PROPOSAL TO LEASE SPACE

STATE OF CONNECTICUT

DEPARTMENT OF ADMINISTRATIVE SERVICES

Attn: Leasing and Property Transfer, Suite 1402

450 Columbus Boulevard, Hartford, CT 06103

Solicitation Number Date Due Back Principal Contact

Phone Number

LP-

Owner(s) of the Property as recorded in Town Land Records

Address of Owner(s)

Property Offered (Street Address, Town)

Zoning

Lot Size

Frontage (feet)

Accessibility to Public Transportation

Topography of Site

Flood Zone and Other Limiting Conditions

Parking Offered

Owned______ On-Site_______ Parking Garage________ Levels________

Total Spaces Provided_____ Not Owned_____ Off-Site____

Off-Site Location_______________________________

Building Offered: Rental_________ Office___________ Industrial_________ Other____________

Year Built ________ Year Renovated ______

Describe What Renovated______________________________________

Complies with ADA?_________ Other Codes?___________________________________

Type of Structure (e.g.Steel)___________ Exterior Walls (e.g.Brick)________________

No. Stories________________

Type of Roof Cover (e.g.shingles)___________ Age of Roof _____ Sprinkler System: Wet___ Dry___ None________

Number of Elevators: Passenger _____ Freight ____

Load Capacity of Floors _________________PPSF

Security System (e.g. electronic, personnel): Describe:____________________________________________________

Heating System: Type______________ No. Zones_____ Fuel_________ Age (yrs.)______ When updated?_______

Air Conditioning (if applicable): Type____________________ No. Zones______ Fuel____________ Age_________

Total Bldg. Gross Sq.Ft.(GSF)_______ Total Bldg. Net Usable Sq.Ft.(NUSF)________ Total NUSF per floor_______

(Note: See below for definition of Net Usable Square Feet.)

Indicate evidence of energy conservation measures _______________________________________________________.

Amount of Space Available for Lease: 1)_______NUSF on the ____ floor 2)_______NUSF on the _______ floor

3)__________NUSF on the _____ floor 4)__________NUSF on the ______ floor 5)_______NUSF on the ____ floor

Definition of Net Usable Square Feet: The interior floor area of a building, used for office and other purposes, within the area leased by a tenant which is for its exclusive use: any space shared in common with other tenants, such as, entrance and elevator lobbies; hallways, bathrooms, or used by management for other tenants, such as janitorial or electronic/mechanical closets, is not part of net usable area: if these areas are for the sole use of a tenant, they may be counted in that tenant’s net usable area. The measurement includes structural elements of the building found in the tenant’s space, such as columns and projections necessary to the building but excludes vertical space penetrations of the building such as elevators, stairwells, air shafts and stacks. Measurement of net usable space is to the dominant (over 50%) inside face, such as window glass of the exterior wall; to the midpoint of a wall separating a tenant from an adjacent tenant; and to the inside face of a common corridor, elevator shaft, stairway or similar space.

PROPOSAL TO LEASE SPACE – PAGE 2

Proposal:

1. TENANT IMPROVEMENTS:

Standard allowance for tenant improvements included in Base Rent $__________________________ per NUSF

2. BASE RENT before tenant improvements but including standard allowance $___________________ per NUSF per year.

3. OPERATING EXPENSES: Who pays for operating expenses?

Expense
Check Lessor or Lessee
If Lessee’s responsibility, estimate cost per square foot
Lessor
Lessee

Heat

Water

Hot Water

Electricity

Air Conditioning

Window Washing – Interior/Exterior

Elevator

Janitorial-Lessee Area

Janitorial-Common Area

Building Maintenance-Lessee Area

Building Maintenance-Common Area

Rubbish Removal/recycling-Lessee Area

Rubbish Removal/recycling-Common Area

Dumpster(s)

Groundskeeping

Security Service

Pest Control

Lamp Replacement-general

Task Lighting

Ballast Replacement

Snow/Ice Removal and Sanding

Parking

4. Total Base Rent and Operating Expenses paid by Lessee ___________

Other Conditions (such as date space will be available) ________________________________________________________________________________________________________

Attach the following 1. Recent photograph of property 2. Map of neighborhood showing location of building to this proposal: 3. Typical floor plan 4. Flyer or brochure, if available

CERTIFICATE

I, the undersigned, hereby certify that I am an owner or agent of record for an owner of the property which is being offered in this proposal and that the statements made by me on this proposal are complete and true to the best of my knowledge and are made in good faith. I understand that if I knowingly make any misstatement of fact, I am subject to disqualification and other penalty imposed by law. (Note: Read this proposal and your answers carefully before signing.) Only signed proposals will be considered. If you are a real estate agent, please include a “Notice of Listing Agreement” authorizing you to present this property. By statute, the State of Connecticut will deal only with owners or their authorized agents. Responses from option holders cannot be considered.

SIGNED

DATE

NOTICE OF LISTING AGREEMENT

RETURN TO:

STATE OF CONNECTICUT

DEPARTMENT OF ADMINISTRATIVE SERVICES

450 COLUMBUS BOULEVARD

ATTN: LEASING AND PROPERTY TRANSFER, SUITE 1402

__________________, 20____

INSTRUCTIONS

This form is to be submitted when an agent has been authorized by the owner(s). The State of Connecticut, by statute, will deal only with owners or their authorized agents. OPTION HOLDERS CANNOT BE CONSIDERED.

PARTIES AND PROPERTY

I/We [Owner(s)] ____________________________________________________________, give

[agent(s)] _________________________________________________ the right to lease my/our property located at (listed property) _____________________________________________, CT.

Solicitation No. LP Date/Time due back:

OWNER(S) AND AGENT(S) AGREEMENT:

The parties agree that:

This agreement will go into effect on ________________________________________, 20____ and will remain effective through and including ______________________________, _______

SPECIAL INFORMATION (any restrictions, special conditions specific to proposal).

STATEMENTS REQUIRED BY LAW

I, the undersigned, hereby certify that I am an agent of record for the owner(s) of the property which is being offered in the proposal.

By: [Authorized representative(s)]________________________________________________

Number and Street:____________________________________________________________

City, State, Zip:_______________________________________________________________

Date:___________________

Owner(s): ___________________________________________________________________

Number and Street:____________________________________________________________

City, State, Zip:_______________________________________________________________

Date:___________________

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