EXHIBIT A GSA FORM 1364A HOLDREGE.pdf
GSA Form PDF 64 KB Posted
- Attached to
- Lease Office Space in Holdrege Nebraska
- Solicitation number
- NRCS-NE-12-0046
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Exhibit A 1364
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Lessor _______ Government:_______
EXHIBIT A TO LEASE NO. 57-6526-12-804
GSA FORM 1364A
SIMPLIFIED LEASE PROPOSAL
REQUEST FOR LEASE PROPOSALS NO.
NRCS-NE-12-0046
DATE:
SECTION I – BUILDING INFORMATION
1 A. BUILDING NAME
2 NUMBER OF FLOORS 6 TOTAL PARKING FOR BUILDING
STRUCTURE: SURFACE:
B. BUILDING STREET ADDRESS
3 LIVE FLOOR LOAD
(LBS / SQ FT)
7 CONSTRUCTION TYPE
C. CITY
D. STATE
4 TOTAL RENTABLE AREA
(SQ FT)
8 A. BUILDING BUSINESS HOURS (MON – FRI)
E. 9-DIGIT ZIP CODE
F. CONGR.
DISTRICT
5 BUILDING AGE (YRS)
B. BUILDING BUSINESS HOURS (SAT – SUN)
SECTION II – SPACE OFFERED AND RATES
9 FLOOR
LOCATION
SUITE NO. ANSI/BOMA SQ FT TYPE OF
SPACE
FLOOR
LOCATION
SUITE NO. ANSI/BOMA SQ FT TYPE OF SPACE
TYPE OF
SPACE
ANSI/
BOMA
AREA
(SQ FT)
A
COMMON
AREA
FACTOR
B
RENTABLE
SQ FT
(RSF)
A x B =
C
FIRM TERM NON-FIRM TERM OPTION TERM
RENTAL RATE
PER RSF/YR
D
ANNUAL RENT
C x D =
E
RENTAL
RATE
(PER
RSF/YR)
F
ANNUAL RENT
C x F =
G
RENTAL
RATE
(PER
RSF/YR)
H
ANNUAL RENT
C x H =
I
10 OFFICE $ $ $ $ $ $
11 OTHER $ $ $ $ $ $
12 TOTAL $ $ $
13 COMPOSITE ABOA PER SQ FT RATES 12E ÷ 12A = 13A $
12G ÷ 12A
= 13B $ 12I ÷ 12A = 13C $
14 RATE ADJUSTMENT FOR VACANT SPACE: $ / RENTABLE SF
15 HOURLY RATE FOR OVERTIME HVAC:
Zone $_____ Floor $ ______ Entire space $_____
Rate for 24/7 LAN $/sf/yr _____
The cost for overtime or 24/7 HVAC must be paid separately from the rent. Do not include these costs in the rent the offered rental rate or base operating expenses.
16 NUMBER OF PARKING SPACES OFFERED TO GOVERNMENT: A. STRUCTURE: C. SURFACE:
CHARGE FOR SPACES OFFERED TO GOVERNMENT (IF NOT IN RENT): B. STRUCTURE: $ / MO D. SURFACE: $ / MO
17 RIGHT TO USE OF ROOFTOP AREA FOR ANTENNAS AND ASSOCIATED RIGHTS IN BUILDING � INCLUDED � NOT INCLUDED
SECTION III – OWNER/OFFEROR INFORMATION
18 A. OFFEROR
(NAME AND COMPLETE MAILING ADDRESS)
B. OFFEROR'S AUTHORIZED REPRESENTATIVE (IF APPLICABLE)
(NAME AND COMPLETE MAILING ADDRESS)
19 TELEPHONE NUMBER
EMAIL ADDRESS
21 OFFEROR'S FORM OF BUSINESS: � INDIVIDUAL � PARTNERSHIP � CORPORATION – SPECIFY STATE:
SECTION IV – OFFER
22 RLP AMENDMENTS ACKNOWLEDGED (INITIAL) NO. 1 NO. 2 NO. 3 NO. 4 NO. 5
23 On behalf of the Offeror, the undersigned offers to lease to the Government the Premises described in Sections I and II, together with all other rights indicated therein, at the rental and other rates stated, on the terms and conditions set forth in the referenced Request for Lease Proposals and this Proposal. This Offer shall remain open for a period of 60 days.
A. SIGNATURE
B. NAME C. TITLE D. DATE
Lessor _______ Government:_______
GSA FORM 1364A (REV 9/30/11)
EXHIBIT A TO LEASE NO. 57-6526-12-804
SECTION V – PROPOSED ADDITIONAL TERMS, CONDITIONS
24 OFFEROR WILL COMPLETE THE FOLLOWING FIRE/LIFE SAFETY, ACCESSIBILITY, AND ENERGY SAVINGS IMPROVEMENTS AS
REQUIRED IN THE LEASE:
25 ADDITIONAL TERMS AND CONDITIONS WITH RESPECT TO THIS OFFER:
PAGE 2 OF 2 GSA FORM 1364A (REV 9/30/11)
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