S02-Form 1364 Proposal to Lease Space Exhibit F.pdf
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- Attached to
- New Campbell County CBOC
- Solicitation number
- 36C24924R0042-A
About this file
This document is a Proposal to Lease Space (GSA Form 1364) in response to Request for Lease Proposals (RLP) Number 36C24924R0042 for a new Community Based Outpatient Clinic (CBOC) for the Department of Veterans Affairs in the general area of LaFollette, TN.
The key details are:
- The VA seeks to lease approximately 5,000 ABOA/6,750 RSF of contiguous space with a minimum of 25 on-site parking spaces, preferably on the first floor of the building.
- The space will be used as a CBOC to provide Veteran outpatient care in the local area. It must be in a Class A/4-5 CoStar rated building that complies with all current building, seismic, and accessibility code requirements and is not in a flood zone.
- A full-service lease up to 10 years will be considered, with the lessor responsible for all utilities, janitorial services, supplies, facility maintenance, etc.
- Offerors must provide details on shell rent, operating costs, tenant improvements, building-specific amortized capital, parking rates, and any other financial terms.
- The offer includes information on the building, property, and owner/offeror, as well as options for renewal and step rent increases.
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Text version
RLP NO. 36C24924R0042
PAGE 1 ____ LESSOR _____ GOV
GSA 1364 (REV. 1/2023) PAGE 1
a. Architectural/Engineering fees will be (choose one): b. Lessor's Project Management fee will be:
The RLP outlines how fees may apply. Fees are not applicable for turnkey pricing.
Percent of Total Construction Costs: % Percent of Total Construction Costs
Dollar Amount per ABOA SF: $
Flat Fee: $
SECTION I - BUILDING OVERVIEW Exhibit F
1. Building Name 2. Building Street Address
3. City, State and 9-Digit ZIP Code 4. Number of Floors in Building
5. Total Rentable Square Feet (RSF) in Building
Building Space Breakout
a. General Purpose/Office: b. Warehouse: c. Other:
6. Total ANSI/BOMA Occupant
Area (ABOA) Square Feet
(SF) in Building
7. Building
Common Area
Factor (CAF)
8. Total Building Parking Under Offeror's Control
a. Total Surface b. Total Structured c. Is all the parking onsite? d. Number of spaces required by local code, if applicable:
YES NO
(Parking spaces and associated costs offered to meet the requirements outlined in the RLP shall be detailed in Box 20).
SECTION II - PRIMARY OFFER DETAILS
9. ABOA SF of Offered Space 10. RSF of Offered Space 11. CAF of Offered Space 12. Floor(s) and/or Suite(s) of Offered Space
13. Full Term of the Lease
Months
14. Firm Term of the Lease
Months
After the Firm Term, the Government may terminate the Lease by providing advanced written notice to the Lessor. Indicate the minimum number of days the Government must provide prior written notice by.
15. Number of
Days Notice
RENT TABLE
Enter initial rental figures only. Scheduled step rents for Shell rent and
Parking rates must be entered in Section VI, Addendum.
16. Shell Rent
The initial Shell Rent is a total annual dollar amount of
Does the initial Shell Rent offered change during the term of the lease?
X.
Annual Rent
Y.
Annual Rate
$ Per RSF
Z.
Annual Rate
$ Per ABOA SF
YES NO
17. Operating Costs (Refer to Line 27 on the GSA 1217)
The Operating Cost base is a total annual dollar amount of
18. Tenant Improvement (TI) Rent
a. TI Allowance per ABOA SF: $ (stated in RLP; leave blank for turnkey)
b. Total TI: $ ('a' above multiplied by offered ABOA SF or turnkey price)
c. Amortization Interest Rate: % d. Amortization Period in Months:
19. Building Specific Amortized Capital (BSAC) Rent
a. BSAC Amount per ABOA SF: $
b. Total BSAC: $
(if stated in RLP)
('a' above multiplied by offered ABOA SF or total cost)
c. Amortization Interest Rate: % d. Amortization Period in Months:
20. Parking Required by the RLP
a. General $ per space per month b. Number of
Surface: Spaces Offered:
c. General
Structured:
e. Reserved per space per month
d. Number of
Spaces Offered:
f. Number of $0.00
Surface:
$ per space per month
Spaces Offered:
g. Reserved $ per space per month h. Number of
Structured: Spaces Offered:
21. Rent for Non-Standard Circumstances
The RLP requires a non-standard rental component applicable only under specific conditions outlined in the Lease called:
Not Applicable
22. TOTAL INITIAL RENT
23. Fee Schedule
PROPOSAL TO LEASE SPACE
(See Paperwork Reduction Act Statement in Section V)
This Offer is in response to Request for Lease
Proposals (RLP) Number: 36C24924R0042
OMB Control Number: 3090-0086
Expiration Date: 1/31/2026
____ LESSOR _____ GOV
GSA 1364 (REV. 1/2023) PAGE 2
31. Heating, Ventilation, and Air Conditioning (HVAC) Overtime Rate
a. $ rate per hour -PER-
b. Select one of the options below: c. Total Number
Zone Floor Space of Zones, Floors, or Spaces
d. If the Government used 1 hour of overtime HVAC for the entire offered space, it would owe:
(Multiply 31a times 31c)
Land Site Size: SF or Acres Total Land Costs: $
(Choose one)
SECTION III - ADDITIONAL FINANCIAL ASPECTS OF THE OFFER
24. Are you offering free rent? a. If yes, enter the number of b. What rent components are included in the free rent?
YES NO
free months being offered.
months
Shell
Operating Costs
TI
BSAC
Parking
Non-Standard
27. Commissions If applicable, enter the commission distribution and ATTACH BROKER COMMISSION
AGREEMENT.
a. Tenant's Representative Commission %
b. Owner's Representative Commission %
28. Adjustment for Vacant
Premises
$ per ABOA SF
29. Adjustment for Reduced
Services
$ per ABOA SF
30. Tax Parcel Percent of Government Occupancy Explain complex tax
a. RSF of Tax Parcel RSF parcel arrangements in
b. Percent of Occupancy % Section VI, Addendum.
SECTION IV - BUILDING AND PROPERTY INFORMATION
32. In what year was the original building construction completed and ready for initial occupancy?
33. Provide the year and a brief description of the last major building renovation, if applicable.
34. Select the approximate level of construction necessary to meet the building shell requirements:
a. Improvements to the existing Building will be required to meet the Lease shell requirements.
The total approximate construction cost to achieve Lease shell standards is: $
b. The building already meets all the Lease shell requirements; no improvements are necessary.
c. The requirements of the Lease will be satisfied through the construction of a new building.
35. What are the building’s normal hours of operations for HVAC included in the Operating Costs?
Start
End
Monday - Friday
Start
End
Saturday
Start
End
Sunday
36. With regard to Fire Protection and Life Safety:
a. The Property meets the Lease fire protection/life safety standards.
b. The Property will be improved to meet the Lease fire protection/life safety standards.
c. The Property does NOT meet the Lease fire protection/life safety standards and will NOT be upgraded.
37. With regard to Accessibility (Architectural Barriers Act Accessibility Standard - ABAAS):
a. The Property meets the Lease accessibility standards.
b. The Property will be improved to meet the Lease accessibility standards.
c. The Property does NOT meet the Lease accessibility standards and will NOT be upgraded.
38. With regard to Asbestos-Containing Material (ACM): (Select all that apply)
a. The Building contains no ACM.
b. The Building contains undamaged, nonfriable ACM.
c. The Building contains thermal system insulation ACM which is not damaged or subject to damage by routine operations.
d. The Building contains ACM that does not fall within any of the above categories.
e. The Building contains ACM; abatement will be completed prior to occupancy.
39. With regard to Flood Plains:
a. The Property is in a base (100 year) floodplain.
b. The Property is in a 500 year floodplain.
c. The Property is NOT in a floodplain.
25. Are you offering free space?
YES NO
a. If yes, how much free space, in addition to the space offered in Box 9 above, is being offered?
ABOA SF
26. Are you offering renewal options?
YES NO
If yes, fill out 'Renewal
Options' in Section VI, Addendum.
GSA 1364 (REV. 1/2023) PAGE 3
Offeror's Signature Date Signed
40. With regard to Seismic Safety of the Building:
a. The RLP does NOT contain seismic requirements.
b. The Building either fully meets RLP seismic requirements or meets an exemption.
c. The Building will be retrofitted to meet RLP seismic requirements it does not currently meet.
d. The Building will be constructed to meet RLP seismic requirements.
e. The Building will NOT meet RLP seismic requirements.
41. With regard to ENERGY STAR®:
a. The Property has received the ENERGY STAR® Label within the past twelve months.
Date (MM/DD/YYYY):
b. The Property has NOT received the ENERGY STAR® Label within the past twelve months but falls into one of the following categories:
i. New construction
ii. Existing building that cannot obtain label due to insufficient occupancy
iii. Meets one of the statutory exceptions below:
(1) The agency would remain in the building it currently occupies.
(2) The Lease would be in a building of historical, architectural, or cultural significance listed or eligible to be listed on the National Register of Historic Places.
(3) The Lease is for 10,000 RSF or less.
With regard to offerors falling into a statutory exception category above, the Offeror has evaluated energy efficiency and conservation improvements and has determined:
(i) Cost effective improvements have been identified and are attached to this offer.
(ii) There are no cost effective improvements. Supporting documentation is attached to this offer.
42. With regard to Historic Preference:
a. Is the Building a Historic Property? YES NO
b. Is the Building within an Historic District? YES NO
43. With regard to Historically Underutilized Business Zones (HUBZone) Price Evaluation Preference:
a. I am a HUBZone Small Business Concern (SBC) Offeror and I elect to waive the price evaluation preference.
b. I am a HUBZone SBC Offeror and I do NOT waive the price evaluation preference.
c. I am NOT a HUBZone SBC Offeror. The question does not apply.
SECTION V - OWNER IDENTIFICATION AND OFFEROR CERTIFICATION
44. Recorded Owner Name 45. Owner Street Address 46. City, State and 9-Digit ZIP Code 47. Unique Entity Identifier (UEI)
48. Offeror Name 49. Offeror Street Address 50. City, State and 9-Digit ZIP Code 51. Contact Information
a. Email
b. Telephone
52. Offeror's Interest in the Property
Owner (Offeror and Recorded Owner are the same person)
Other (Explain if Other is selected)
Agent / Broker
By submitting this offer, the offeror agrees to lease the premises described within the offer to the United States of America upon the Lease
Contracting Officer's acceptance of the offer. The offeror acknowledges they have read and fully understand the Request for Lease
Proposals and agrees to honor the terms and conditions specified in their offer and to full compliance with and acceptance of the Request for Lease Proposals and its attachments.
By signing this form, you acknowledge having read the RLP with attachments in its entirety. No deviations are allowed unless authorized by the Lease Contracting Officer (LCO).
53. Does your offer request any deviation from the RLP? NO YES - I request a deviation from the LCO
PAPERWORK REDUCTION ACT STATEMENT
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995.
You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0086. We estimate that it will take 2.3 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
A. Step Rent
Add a Step Rent Remove a Step Rent
B. Renewal Options
Add an Option Remove an Option
C. Additional Tax Parcel Information
Add a Building/Tax Parcel Remove a Building/Tax Parcel
D. Additional Remarks or Conditions with Respect to this Offer
SECTION VI - ADDENDUM
Shell Rent and Parking steps should be detailed if the initial amount stated in the Rent Table above does NOT remain the same for the full term of the Lease. Shell Rent step amounts should be stated in Annual Rent for the entire Leased space.
Parking step rents should be stated as a dollar amount per space per month.
Rent Type Beginning Year Through Year Amount Will Be ($) Per
Renewal Options are optional unless required by the RLP. Only renewal options that are required by the RLP will factor into the Government's financial analysis of the Offer.
Option Number Duration in Years Annual Shell Rate per RSF
Number of Days Notice to Exercise Option
Is the offered space part of multiple tax bills or multiple buildings on a single tax parcel? YES NO
If 'YES', use the boxes below to account for the total number of buildings, associated RSF, and tax parcel associated with the overall space offered to the Government. Attach the legal description(s) of the offered property/properties as part of your overall RLP submission.
Building Building RSF Tax Parcel Tax Parcel ID Number
Any deviations from the RLP requirements must be requested prior to the request for final proposal revisions. If the Offeror requests any deviations, GSA at its sole discretion will make the decision whether to accept the deviation.
RLP NO. 36C24924R0042 ___ LESSOR _____ GOV GSA 1364 (REV. 1/2023)
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