Seismic Forms (A-D).pdf
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This is an appendix containing seismic safety certification forms for federal building leases administered by the General Services Administration (GSA). The document provides four standardized forms (Seismic Forms A through D) that offerors must complete to demonstrate compliance with seismic safety standards for leased buildings.
Seismic Form A is a Certificate of Seismic Compliance for Benchmark Buildings, completed by a licensed engineer confirming that a building qualifies as a Benchmark Building per ASCE/SEI 31, Table 1-1, based on building characteristics including ASCE Building Type, number of stories, construction year, and design code. Seismic Form B is a Certificate of Seismic Compliance for Existing Buildings, requiring an engineer to evaluate the building at the Life Safety Performance Level using ASCE/SEI 31 methodology (Tier 1, 2, or 3 evaluation) and confirming whether the building meets the standards outlined in ICSSC RP 8. Seismic Form C contains two parts: Part 1 is a Preaward Commitment to Retrofit Building, wherein an engineer commits to redesign an existing building to meet the Basic Safety Objective per ASCE/SEI 41, with supporting documentation and retrofit schedule provided before award; Part 2 is a Preaward Commitment to Construct a New Building, where an engineer certifies that a new building was designed and constructed in conformance with applicable building codes, including quality assurance and inspection procedures. Seismic Form D is an Offeror's Representation of Exemption from Seismic Standards, allowing offerors to claim exemption based on two criteria: buildings in medium seismicity areas with less than 10,000 ABOA SF leased to the Federal Government, or one-story buildings with steel light frame or wood construction with less than 3,000 ABOA SF in high to very high seismicity areas. All forms require engineer stamp, signature, license information, and project location details. The document was last revised September 18, 2012.
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Other files
| File | Type | Posted |
|---|---|---|
| Proposed Site Parking Plan(s)-Exhibit D.docx | DOCX document | |
| NGIC_Warehouse_Summary_Requirement Exhibit A.pdf | ||
| In Lease 2661 Template.pdf | ||
| Exhibit F - Offer Form.docx | DOCX document | |
| Exhibit G - Representations Certifications.pdf | ||
| 3517A General Clauses.pdf | ||
| Proposed Floor Plan-Exhibit C.docx | DOCX document | |
| Delineated Area Maps - Exhibit B.pdf | ||
| RLP Template Updated 19 FEB 26.pdf |
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Text version
Appendix G:Seismic Safety in Leasing
Attachment 2: Seismic Offer Forms
PBS Leasing Desk Guide G-17 This page last revised: 9/18/2012
SEISMIC FORM A
CERTIFICATE OF SEISMIC COMPLIANCE
BENCHMARK BUILDING
Date: __________
This affirms that ________________________ served as engineer in charge of the seismic evaluation of the building located at ______________________________________________.
The building has the following characteristics:
ASCE Building Type: No. of Stories: Approx. Area:
Building Design Code: Year of Design Code: Year of Construction:
On the basis of the building characteristics and to the extent permitted by this level of evaluation, it is my opinion that the subject Building qualifies as a Benchmark Building as indicated in ASCE/SEI 31, Table 1-1.
Affix Stamp and Sign Here
Engineer’s Name:
Firm:
Address:
Telephone:
License No.:
License State:
Expiration Date:
G-18 PBS Leasing Desk Guide This page last revised: 9/18/2012
SEISMIC FORM B
CERTIFICATE OF SEISMIC COMPLIANCE
EXISTING BUILDING
Date: __________
This affirms that ________________________ served as engineer in charge of the seismic evaluation of the building located at ______________________________________________.
The building has the following characteristics:
ASCE Building Type: No. of Stories: Approx. Area:
Building Design Code: Year of Design Code: Year of Construction:
I have evaluated this building at the Life Safety Performance Level as set forth in the ICSSC RP 8, Standards of Seismic Safety for Existing Federally Owned and Leased Buildings, using ASCE/SEI 31 methodology:
___Tier 1 Evaluation
___Tier 2 Evaluation
___Tier 3 Evaluation
___Other (please explain below)
Documentation of this evaluation must be attached to this Certificate.
On the basis of the building characteristics and to the extent permitted by this level of evaluation it is my opinion that subject Building (check one) does / does not meet the Life Safety Performance Level of ICSSC RP 8.
Affix Stamp and Sign Here
Engineer’s Name:
Firm:
Address:
Telephone:
License No.:
License State:
Expiration Date:
Comments:
Attach: ASCE/SEI 31 Checklist(s) Structural, Nonstructural, and Geologic Site Hazards and Foundation.
PBS Leasing Desk Guide G-19 This page last revised: 9/18/2012
SEISMIC FORM C
BUILDING RETROFIT OR NEW CONSTRUCTION
PREAWARD COMMITMENT
PART 1
PREAWARD COMMITMENT TO RETROFIT BUILDING:
Date: __________
This affirms that _________________________ shall serve as the engineer in charge of the seismic retrofit of the building located at ________________________. The retrofit must be designed to meet the Basic Safety Objective, as set forth in ASCE/SEI 41 Seismic Rehabilitation of Existing Buildings.
In accordance with the requirements of this Standard and the seismic paragraph in the Request for Lease Proposals (RLP), our offer includes a commitment to retrofit the building to satisfy all of the Basic Safety Objective requirements of ASCE/SEI 41. The offer includes a Tier 1 report with all supporting documents, a narrative explaining the process, scope of renovations, and a schedule for the seismic retrofit.
Documentation shall be provided before award that demonstrates the seismic retrofit will meet the seismic standards and be completed within the time frame required.
PART 2
PREAWARD COMMITMENT TO CONSTRUCT A NEW BUILDING:
Date: __________
This affirms that _________________________ will serve as the engineer in charge of the structural design of the building located at ________________________. The criteria for design must be the ______ edition of the _____________________ building code.
In accordance with the requirements of this code, we prepared a quality assurance plan that included requirements for testing and inspecting critical elements of the structure and also periodic observation by our staff. We reviewed special inspection and testing reports prepared by the inspection agency and contractor submittals. On the basis of this, and to the extent permitted by this level of construction surveillance, it is my opinion that the Building was designed and constructed in conformance with the requirements of the above code.
The building has the following characteristics:
Building Type: Building Height: Approx. Area:
Building Design Code: Year of Design Code: Year of Construction:
OFFEROR
SIGNATURE NAME OF SIGNER
G-20 PBS Leasing Desk Guide This page last revised: 9/18/2012
SEISMIC FORM D
OFFEROR’S REPRESENTATION OF EXEMPTION FROM SEISMIC STANDARDS
Date: __________
I represent that my building is exempt from the requirements of RP 8 because:
The Building is located in an area of medium seismicity and the Building will have less than 10,000 ABOA SF of space leased to the Federal Government upon commencement of the lease term.
The Building is located in an area of high to very high seismicity, and it is a one-story building with a steel light frame or wood construction with less than 3,000 ABOA SF of space in the building.
OFFEROR
SIGNATURE NAME OF SIGNER
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