EXHIBIT E GSA FORM 1364A-1.pdf

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Lease Office Space in Holdrege Nebraska
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NRCS-NE-12-0046
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Other versions and copies of GSA Form 1364A

File Revision Posted Attached to
Exhibit_B-GSA_Form_1364A-Simplified_Proposal_to_Lease_Space_for_La_Grande _09Aug2013.pdf Aug 9, 2013 USDA Requires Approximately 2, 850-3, 000 ABOA SF of Leased Space in La Grande, Oregon
Exhibit_C-GSA_Form_1364A-1 _Simplified_Proposal_To_Lease_Space_Data_Sheet_for_La_Grande _OR _09Aug2013.pdf Aug 9, 2013 USDA Requires Approximately 2, 850-3, 000 ABOA SF of Leased Space in La Grande, Oregon
GSA_FORM_1364A_(7-19-2012).pdf Jul 19, 2012 5 YEAR LEASE WITH 5 YEAR OPTION
GSA_FORM_1364A_(7-19-2012).pdf Jul 19, 2012 OFFICE SPACE LEASE
Pt 08B(1)--GSA Form 1364A - Dec 2004.doc Dec 2004 TRAVERSE CITY, MI CBOC Clarification #1
EXHIBIT - E - GSA FORM 1364A.pdf Revision not stated X1DB--Lease: Replacement Lease for Sebring CBOC
Exhibit A GSA FORM 1364A.pdf Revision not stated X1AA--New Replace Childress Clinic Lease
Exhibit B GSA FORM 1364A-1.pdf Revision not stated X1AA--New Replace Childress Clinic Lease
Exhibit A GSA FORM 1364A.pdf Revision not stated X1DB--Time extension
Exhibit B GSA FORM 1364A-1.pdf Revision not stated X1DB--Time extension
S02_Exhibit_G_-__Lease_Proposal_Data_(GSA_FORM_1364A).pdf Revision not stated Everett CBOC
F-GSA_Form_1364A_10_18.pdf Revision not stated Evanston CBOC- Succeeding Lease
G-GSA_Form_1364A-1.pdf Revision not stated Evanston CBOC- Succeeding Lease
gsa_Form1364A_10_17.docx Revision not stated OFFICE SPACE
gsa_Form1364A_10_17.docx Revision not stated OFFICE SPACE
gsa_Form1364A_10_17.docx Revision not stated Office Space
GSA_FORM_1364A.pdf Revision not stated Request for Lease Proposal- Office Space located in Mineral County, WV
GSA_Form_1364A-1.pdf Revision not stated Request for Lease Proposal- Office Space located in Mineral County, WV
EXHIBIT B GSA FORM 1364A-1.PDF Revision not stated Lease Office Space in West Point
EXHIBIT A GSA FORM 1364A WEST POINT.pdf Revision not stated Lease Office Space in West Point
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Page 1 of 3 GSA Form 1364A-1, Simplified Lease Proposal Data (REV 9/30/11)

GSA FORM 1364A-1

SIMPLIFIED LEASE PROPOSAL DATA

RLP NO.

DATE:

1 Offeror's Interest in the Property:

[ ] Fee owner [ ] Other:

Attach evidence of Offeror's interest in property (e.g., deed) and representative's authority to bind Offeror.

2 Flood Plains:

The Property is [ ] in a base (100-year) flood plain [ ] in a 500-year flood plain [ ] not in a flood plain.

(See RLP Section 2, Flood Plains.)

3 Seismic Safety: The Building

[ ] Fully meets [ ] Substantially meets (Outside Reg 8, 9, 10) [ ] Does not meet RLP seismic requirements.

(See RLP Section 2, Seismic Safety.) Attach appropriate documentation.

4 Historic Preference: The Building is a

[ ] Historic property within a historic district.

[ ] Non-historic property within a historic district.

[ ] Historic property outside of a historic district.

[ ] None of the above.

(See RLP Section 2, Historic Preference.) Attach appropriate documentation.

5 Asbestos: The Property

[ ] Contains no ACM, or contains ACM in a stable, solid matrix that is not damaged or subject to damage.

[ ] Contains ACM not in a stable, solid matrix.

(See RLP Section 2, Asbestos.)

6 Fire/Life Safety:

The Property [ ] Meets [ ] Does not meet Lease fire/life safety standards.

(See RLP Section 2, Fire Protection and Life Safety)

7 Accessibility:

The Property [ ] Meets [ ] Does not meet Lease accessibility standards.

(See RLP Section 2, Accessibility.)

8 Security:

Attach Pre-Lease Building Security Plan.

(See RLP Section 2, Security)

9 ENERGY STAR®: The Building

[ ] Has received the ENERGY STAR® Label within the past twelve months. Date:

[ ] Has not received the ENERGY STAR® Label within the past twelve months; the Offeror has evaluated energy savings measures and [ ] Determined that none are cost effective.

[ ] Determined that the following are cost effective (List):

(See RLP Section 2, Energy Security and Independence Act.) Attach Appropriate Documentation.

Page 2 of 3 GSA Form 1364A-1, Simplified Lease Proposal Data (REV 9/30/11)

GSA FORM 1364A-1

SIMPLIFIED LEASE PROPOSAL DATA

RLP NO.

DATE:

PROPOSED RENT COMPONENTS

OFFICE AREA

Firm Term ($/RSF/Yr)

A

Non-Firm Term

B

Option Term

C

10 Building Shell Rent (Incl. Real Estate Taxes) (See page 3 addendum, Shell Definitions)

11 Turnkey Tenant Improvement Rent (See block 20 below for additional cost and amortization rate breakdown)

12 Operating Rent $ $ $

13 Turnkey Security Upgrade Rent (See block 21 below for additional cost and amortization rate breakdown)

14 Total $ $ $

OTHER SPACE

Firm Term

A

Non-Firm Term

B

Option Term

C

15 Building Shell Rent (Incl. Real Estate Taxes) $ $ $

16 Turnkey Tenant Improvement Rent (See block 20 below for additional cost and amortization rate breakdown)

17 Operating Rent $ $ $

18 Turnkey Security Upgrade Rent (See block 21 below for additional cost and amortization rate breakdown)

19 Total $ $ $

20 Tenant Improvement Costs

$ Interest rate to amortize Tenant Improvements

21 Security Upgrade Costs

Interest rate to amortize Security Upgrade Costs

OTHER INFORMATION SUPPLIED WITH THIS PROPOSAL:

If GSA is using an authorized contractor real estate broker in this transaction, Offeror must enter here the commission rate offered to its representative, and the commission rate offered to GSA’s Broker, and attach the commission agreement between Offeror and GSA’s Broker.

22 [ ] The information contained in this 1364A-1 Lease Proposal Data Form is proprietary to Offeror.

BY SUBMITTING THIS OFFER, THE OFFEROR AGREES UPON ACCEPTANCE OF THIS PROPOSAL BY THE HEREIN SPECIFIED DATE, TO LEASE TO THE UNITED STATES OF AMERICA, THE PREMISES DESCRIBED, UPON THE TERMS AND CONDITIONS AS SPECIFIED HEREIN, IN FULL COMPLIANCE WITH AND ACCEPTANCE OF THE AFOREMENTIONED REQUEST FOR LEASE PROPOSALS, WITH ATTACHMENTS.

24 A. SIGNATURE

B. NAME

C. TITLE

D. DATE

Page 3 of 3 GSA Form 1364A-1, Simplified Lease Proposal Data (REV 9/30/11)

Addendum: Shell Definitions

Base Building Tenant Areas

Base structure and building enclosure components (windows with exterior finishes) are complete.

Broom-clean concrete floor slab, with level floor not varying more than ¼ inch over 10-foot horizontal run, in accordance with American Concrete Institute Standards.

Base building electrical and mechanical systems (e.g., central fire alarm, chiller plant, and cooling tower) are complete and functional.

Gypsum wallboard, spackled and prime painted on exterior perimeter walls and interior core walls, is installed.

All common areas, such as lobbies, elevators, fire egress corridors and stairwells, garages, and service areas are complete. (Circulation corridors are provided as part of the base building only on multi-tenanted floors where the corridor is common to more than one tenant. On single tenant floors, only the fire egress corridor necessary to meet code is provided as part of the shell.)

2’ x 2’ suspended acoustical ceiling with 2’ x 2’ parabolic fluorescent (or other building standard, such as 2’ x 4’ fixtures) installed in the ceiling grid for an open office plan at the rate of one fixture per 80 USF, is installed.

Building common restrooms are complete and operational.

Common corridor stud walls, without gypsum board on demised tenant premises side and without suite entry door, are installed.

Building cores on each floor with assignable space contain the following: tappable domestic water riser, service sanitary drain, sanitary vent, ready for extension to tenant-demised areas.

Electrical power distribution panels and circuit breakers available in an electrical closet, with capacity at 277/480 volt and 120/208 volt, 3-phase, 4-wire providing 7 watts per USF.

Designated connection point to the central fire alarm system for extension to tenant-demised areas.

Distribution backboard within a wire closet for connection to tenant’s telephone lines. Vertical conduit (empty sleeve) through building core, available for tenant wiring and cabling.

Central heating, ventilation, and air conditioning (HVAC) systems are installed and operational, including, as appropriate, main and branch lines, variable air volume boxes, dampers, flex ducts and diffusers, for open office layout. Conditioned air through medium pressure ductwork at a rate of .75 cfm per square foot of usable area is provided.

Sprinkler mains and distribution piping in a protection layout (open plan) with heads turned down, concealed with an escutcheon or trim plate, are installed.

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