Streamlined_Lease_Proposal_1364B_-__FSA_Mitchell_County_GA.pdf

GSA FORM 1364B, PART 1

STREAMLINED LEASE PROPOSAL

REQUEST FOR LEASE PROPOSALS NO.

FSA Mitchell County GA DGA0490

DATE: 5-31-2015

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 DESCRIPTION OF SPACE OFFERED (ANSI/BOMA SPACE TYPE(S), SQUARE FOOTAGE, LOCATION(S) IN BUILDING, FLOOR(S), SUITE NO(S)., ETC.)

TYPE OF

SPACE

ANSI/

BOMA

AREA

(SQ FT)

A

COMMON

AREA

FACTOR

B

RENTABLE

AREA

(SQ FT)

A x (1+B) =

C

FIRM TERM NON-FIRM TERM OPTION TERM

RENTAL RATE

(PER SQ FT/YR)

D

ANNUAL RENT

C x D =

E

RENTAL RATE

(PER SQ FT/YR)

F

ANNUAL RENT

C x F =

G

RENTAL RATE

(PER SQ FT/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 A. RATE ADJUSTMENT FOR VACANT SPACE: $ / ABOA SF / YR B. BASE OPERATING COSTS: $ / ABOA SF / YR

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 PERCENTAGE OF OCCUPANCY TO CALCULATE SHARE OF INCREASES TO REAL ESTATE TAXES: %

17 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

18 RIGHT TO USE OF ROOFTOP AREA FOR ANTENNAS AND ASSOCIATED RIGHTS IN BUILDING [ ] INCLUDED [ ] NOT INCLUDED

SECTION III – OWNER/OFFEROR INFORMATION

19 A. OFFEROR

(NAME AND COMPLETE MAILING ADDRESS)

B. OFFEROR'S AUTHORIZED REPRESENTATIVE (IF APPLICABLE)

(NAME AND COMPLETE MAILING ADDRESS, EMAIL)

20 TELEPHONE NUMBER

21 DUNS NUMBER

22 TAXPAYER ID

23 OFFEROR'S FORM OF BUSINESS: [ ] INDIVIDUAL [ ] PARTNERSHIP [ ] CORPORATION – SPECIFY STATE:

SECTION IV - OFFER

24 RLP AMENDMENTS ACKNOWLEDGED (INITIAL) NO. 1 NO. 2 NO. 3 NO. 4 NO. 5

25 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

GSA FORM 1364B (REV 11/12)

SECTION V – PROPOSED ADDITIONAL TERMS, CONDITIONS

26 OFFEROR WILL COMPLETE THE FOLLOWING FIRE/LIFE SAFETY, ACCESSIBILITY, AND ENERGY SAVINGS IMPROVEMENTS AS

REQUIRED IN THE LEASE:

27 ADDITIONAL TERMS AND CONDITIONS WITH RESPECT TO THIS OFFER:

PAGE 2 OF 4 GSA FORM 1364A (REV 11/12)

GSA FORM 1364B, PART 2

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

� RLP does not contain seismic requirements. No documentation required.

� RLP contains seismic requirements. The Building

� Fully meets seismic requirements or meets an exemption under the RLP

� Does not meet seismic requirements, but will be retrofitted to meet seismic requirements

� Will be constructed to meet seismic requirements

� Will not meet 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 and Life Safety, Accessibility.)

7 Accessibility:

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

(See RLP Section 2, Fire and Life Safety, Accessibility.)

8 ENERGY STAR®: The Building

[ ] Has received the ENERGY STAR® Label within the past t welve 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 3 OF 4 GSA FORM 1364B (REV 11/12)

GSA FORM 1364B, PART 2

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) $ $ $

11 Tenant Improvement Rent $ $ $

12 Operating Costs $ $ $

13 Building Specific Amortized Capital Rent $ $ $

14 Total $ $ $

OTHER SPACE

Firm Term

A

Non-Firm Term

B

Option Term

C

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

16 Tenant Improvement Rent $ $ $

17 Operating Costs $ $ $

18 Building Specific Amortized Capital Rent $ $ $

19 Total $ $ $

20 Tenant Improvement cost (or Allowance)

$ Interest rate to amortize Tenant Improvements

Building Specific Amortized Capital costs

$ Interest rate to amortize Building Specific Amortized Capital costs

OTHER INFORMATION SUPPLIED WITH THIS PROPOSAL

21 A. SIGNATURE

B. NAME

C. TITLE

D. DATE

PAGE 4 OF 4 GSA FORM 1364B (REV 11/12)