EXHIBIT E GSA FORM 1364A-1.pdf
GSA Form PDF 106 KB Posted
- Attached to
- Lease Office Space in Holdrege Nebraska
- Solicitation number
- NRCS-NE-12-0046
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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.
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