Description
U.S. GOVERNMENT LEASE FOR REAL PROPERTY (Short Form) 1. LEASE NUMBER PART I - SOLICITATION/DESCRIPTION OF REQUIREMENTS (To be completed by Government) A. REQUIREMENTS The Government of the United States of America is seeking to lease approximately 3000 rentable square feet of Medical office space located in Georgetown De__. for occupancy not later than January 1, 2011 for a term of 10 years . Rentable space must yield a minimum of 3000 square feet of ANSI/BOMA Office Area (previously Usable) for use by Tenant for personnel, furnishing, and equipment. INITIAL OFFERS ARE DUE ON OR BEFORE CLOSE OF BUSINESS September10 , 2010 B. STANDARD CONDITIONS AND REQUIREMENTS The following standard conditions and requirements shall apply to any premises offered for lease to the UNITED STATES OF AMERICA (hereinafter called the GOVERNMENT): Space offered must be in a quality building of sound and substantial construction, either a new, modern building or one that has undergone restoration or rehabilitation for the intended use. The Lessor shall provide a valid Certificate of Occupancy for the intended use of the Government and shall meet, maintain, and operate the building in conformance with all applicable current (as of the date of this solicitation) codes and ordinances. If space is offered in a building to be constructed for lease to the Government, the building must be in compliance with the most recent edition of the building code, fire code, and ordinances adopted by the jurisdiction in which the building is located. Offered space shall meet or be upgraded to meet the applicable egress requirements in National Fire Protection Association (NFPA) 101, Life Safety Code or an alternative approach or method for achieving a level of safety deemed equivalent and acceptable by the Government. Offered space located below-grade, including parking garage areas, and all areas referred to as "hazardous areas" (defined in NFPA 101) within the entire building (including non-Government areas), shall be protected by an automatic sprinkler system or an equivalent level of safety. Additional automatic fire sprinkler requirements will apply when offered space is located on or above the 6th floor. Unrestricted access to a minimum of two remote exits shall be provided on each floor of Government occupancy. Scissor stairs shall be counted as only one approved exit. Open-air exterior fire escapes will not be counted as an approved exit. Additional fire alarm system requirements will apply when offered space is located 2 or more stories in height above the lowest level of exit discharge. The Building and the leased space shall be accessible to workers with disabilities in accordance with the Americans With Disabilities Act Accessibility Guidelines (36 CFR Part 1191, App. A) and the Uniform Federal Accessibility Standards (Federal Register vol. 49, No. 153, August 7, 1984, reissued as FED. STD. 795, dated April 1, 1988, and amended by Federal Property Management Regulations CFR 41, Subpart 101-19.6, Appendix A, 54 FR 12628, March 28, 1989). Where standards conflict, the more stringent shall apply. The leased space shall be free of all asbestos containing materials, except undamaged asbestos flooring in the space or undamaged boiler or pip-e insulation outside the space, in which case an asbestos management program conforming to Environmental Protection Agency guidance shall be implemented. The space shall be free of other hazardous materials according to applicable Federal, State, and local environmental regulations. Services, utilities, and maintenance will be provided daily, extending from 0700 am to 1800 p.m. except Saturday, Sunday, and Federal holidays. The Government shall have access to the leased space at all times, including the use of electrical services, toilets, lights, elevators, and Government office machines without additional payment. 2. SERVICES AND UTILITIES (To be provided by Lessor as part of rent) 1 HEAT 1 TRASH REMOVAL 0 ELEVATOR SERVICE 1 INITIAL & REPLACEMENT 1 ELECTRICITY 1 CHILLED DRINKING WATER 1 WINDOW WASHING LAMPS, TUBES & BALLASTS 0 POWER (Special Equip.) 1 AIR CONDITIONING Frequency ___1 yr_ 0 PAINTING FREQUENCY 1 WATER (Hot & Cold) 1 TOILET SUPPLIES 1 CARPET CLEANING Space __________ 1 SNOW REMOVAL 1 JANITORIAL SERV. & SUPP. Frequency 1 per year Public Areas __________ 3. OTHER REQUIREMENTS Offerors should also include the following with their offers: Lessor shall provide forty nine ( 49 ) parking spaces to lease. NOTE: All offers are subject to the terms and conditions outlined above, and elsewhere in this solicitation, including the Government's General Clauses and Representations and Certifications. 4. BASIS OF AWARD 0 THE ACCEPTABLE OFFER WITH THE LOWEST PRICE PER SQUARE FOOT, ACCORDING TO THE ANSI/BOMA Z65.1-1996 DEFINITION FOR BOMA USABLE OFFICE AREA, WHICH MEANS "THE AREA WHERE A TENANT NORMALLY HOUSES PERSONNEL AND/OR FURNITURE, FOR WHICH A MEASUREMENT IS TO BE COMPUTED." 1 OFFER MOST ADVANTAGEOUS TO THE GOVERNMENT, WITH THE FOLLOWING EVALUATION FACTORS BEING 1 SIGNIFICANTLY MORE IMPORTANT THAN PRICE ( see page 22 ) 0 APPROXIMATELY EQUAL TO PRICE 0 SIGNIFICANTLY LESS IMPORTANT THAN PRICE 0 (Listed in descending order, unless stated otherwise): PART II - OFFER (To be completed by Offeror/Owner) A. LOCATION AND DESCRIPTION OF PREMISES OFFERED FOR LEASE BY GOVERNMENT B. TERM To have and to hold, for the term commencing on January 1, 2011 and continuing through December 31, 2021 inclusive. The Government may terminate this lease at any time on or after December 31 , 2016 , by giving at least 60 days notice in writing to the Lessor. No rental shall accrue after the effective date of termination. Said notice shall be computed commencing with the day after the date of mailing. C. RENTAL Rent shall be payable in arrears and will be due on the first workday of each month. When the date for commencement of the lease falls after the 15th day of the month, the initial rental payment shall be due on the first workday of the second month following the commencement date. Rent for a period of less than a month shall be prorated. 7. AMOUNT OF ANNUAL RENT 8. 9. MAKE CHECKS PAYABLE TO (Name and address) 10. RATE PER MONTH 11. 10a. NAME AND ADDRESS OF OWNER (Include ZIP code. If requested by the Government and the owner is a partnership or joint venture, list all General Partners, using a separate sheet, if necessary.) PART III - AWARD (To be completed by Government) Your offer is hereby accepted. This award consummates the lease which consists of the following documents: (a) this GSA Form 3626, (b) Representations and Certifications, (c) the Government's General Clauses, and (d) the following changes or additions made or agreed to by you: THIS DOCUMENT IS NOT BINDING ON THE GOVERNMENT OF THE UNITED STATES OF AMERICA UNLESS SIGNED BELOW BY AUTHORIZED CONTRACTING OFFICER. 17a. NAME OF CONTRACTING OFFICER (Type or Print) Michael Bermes 17b. SIGNATURE OF CONTRACTING OFFICER 17c. DATE Description of Services 1.0 SFO Description: The Wilmington Veterans Affairs Medical Center is interested in leasing approximately 3000 rentable square feet of medical office space. The rentable space shall yield a minimum of 3000 ANSI/BOMA Office Area (ABOA)to a maximum of 3000 ANSI/BOMA Office Area square feet, available for use by tenant for personnel furnishing and equipment. 1.1 JANITORIAL SERVICES: The Lessor shall provide janitorial services for the leased space, public areas, entrances, and all other common areas and provide replacement of supplies as designated by VA. All containers for paper products and waste must be approved by VA. Paper towel dispensers will be electronic, no touch. Trash receptacles in bathrooms and offices will allow for disposal without touching. Cleaning shall be performed during normal clinic hours. The Lessor shall maintain the leased premises, including outside areas in a clean condition and shall provide supplies and equipment. The following compendium of janitorial schedule describes the level of services intended to be performed by the Lessor. Performance will be based on the Contracting Officer's evaluation of results, not the frequency or method of performance. DAILY a) Sweep-entrance, lobbies, corridors, exam rooms, office areas, storage rooms etc. Floors shall be free of trash and foreign matters. No dirt shall be left in corners, under furniture or behind doors. b) Waiting rooms-shall be free of all paper, trash, empty bottles or cans, and other discarded materials. There shall be no evidence of wads of gum, spots of tar, cigarette butts, wet areas, or other foreign substances on tables, counters, chairs or floors. All surfaces shall be cleaned with an approved germicidal solution. c) Vacuum-all carpet areas. Carpets shall be clean and free of dust balls, dirt, and other debris and stains. d) Spot cleaning-of furniture, walls, windows, doors and door hardware. Smudges, marks, and spots shall be removed without causing unsightly discoloration. e) Restrooms-sweep and mop or scrub toilet rooms. Clean all toilets, urinal, and sinks. All product holders and fixtures shall be clean and bright, and their shall be no dust, spots, stains, rust, green mold, encrustation, or excess moisture. Replenish all paper and soap supplies as needed. All surfaces shall be cleaned with an approved germicidal solution approved by the VA. f) Dispose of all trash and garbage generated in or about the building. Wash inside and outside or steam clean the receptacles used for collection of daily remnants from food or snacks. g) Dust all horizontal surfaces that are readily available and visibly require dusting. h) Mop all resilient floors in lobbies, entrances, corridors, and exam rooms. A damp mop shall be used with an approved GERMICIDAL SOLUTION. The Contracting Officer's Technical Representative (COTR) shall prescribe cleaning methods and germicidal solutions. i) Police the driveway, designated VA parking, and sidewalks, with particular attention to cigarette butts. j) ALL SURFACES SHALL BE CLEANED WITH A HOSPITAL GRADE DISINFECTANT. WEEKLY a) Dust all vertical surfaces and under surfaces of furniture (knee walls, chair rungs, tables, table legs, etc.). Dust pictures, file cases, and bookcases. b) Damp mops and spray buff all hard and resilient floors. Floors shall be free of streaks; mop strands marks and skipped areas. Wall baseboards and other surfaces shall be free of splashing and markings from the equipment used to clean. The finished area shall have uniform luster. QUARTERLY a) Perform high dusting or vacuuming to include removal of all dust, cob-webs, soot, or other foreign substance from walls, ceilings, fans, light fixtures(inside and out), ventilation or air conditioning outlets, tops of partitions, clocks, ceiling diffusers, lockers, plants, wall plaques, drapes and drape rods, window blinds, overhead pipes, and any other wall or ceiling mounted item. b) Drapery/Window Treatments (IF ANY) shall be free of dust. AS NEEDED BUT NO LESS THAN TWICE A YEAR a) Strip and Wax floors as needed and or determined by VA. Surface scrub top layers of floor finish and add new coat of finish. Wall baseboards and other surfaces shall be free of splashing and marks from the equipment. The finish area shall have a uniform luster. b) Windows shall be damp wiped on both sides of glass in doors, partitions, bookcases and other glass within approximately 7" (inches) of the floor. Glass shall be clean and free of dirt, dust, streaks, watermarks, spots, grime, and any cloudiness. c) Rugs will be shampooed twice a year and spot cleaned as needed. 1.2 PEST CONTROL: Control pests as appropriate, using Integrated Pest Management techniques and maintaining documentation of an aggressive pest control program i.e. monthly spraying for insects in accordance with VA regulatory requirements. In addition routine call back within 24 hours if the staff notices any infestation, insects, rodents or other animal life. 1.3 PROPERTY MANAGEMENT: Property Management is to be all inclusive to include routine maintenance such as replacement of bulbs, fixtures, plumbing issues, and routine required preventive maintenance such as changing filters, repair of halls, walls, flooring, tiles, leaks and all repairs and maintenance that may be required to continue the daily operation of the clinic. All areas are to be covered by the Property management company and they are responsible for coordination with the landlord, any vendor that may have equipment under warranty and the Wilmington VA engineering service and COTR. Property Management response time is no more than 1 hour for an emergency such as running water, leaky roof to no more than 24 hours for non-emergent issues such as regulating temperature, replacing bulbs, tiles etc. All materials and labor are at the cost of the Property Management Company. Any work to be performed must be scheduled through the VA and it is possible for some projects/repairs that may create noise or dust that the work will have to be performed during business hours. 1.4 AS REQUIRED: Remove snow and ice from entrances, exterior walks, and parking lot of the building prior to operating hours and monitored throughout the day; provide initial supply of snow salt as required for all VA entrances, exterior walks, and VA designated parking spaces. 1.5 DRINKING FOUNTAINS: The Lessor shall provide a minimum of one chilled drinking fountain on the floor where the Government occupies space. A self contained water purification system, with a dedicated water line and electrical outlet is required in the waiting room area. A water fountain may also be located where designated by the VA in the clinic area. 52.212-2 - Evaluation - Commercial Items (Jan 1999) (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following non-price factors shall be used to evaluate offers: Location, Facility, Availability, Past Performance and Energy Efficiency. All five non-price factors are equal in importance. When combined, all non-price factors are significantly more important than Price. The following factors will be used in evaluating Technical Proposals: (i) Location: Offeror shall propose a facility within described area; Facility MUST BE located within Georgetown DE. city limits to receive consideration. Evaluation will examine walking distance from mass transit, easy access to major roadways, and if the site is easily accessible to veterans both locally and from the freeway. Site placement shall allow for a large independent "Veterans Affairs Outreach Clinic" sign to assist patients in locating the clinic. (ii) Facility: a. Condition of Building: Evaluation of building condition includes, but is not limited to: Is building already constructed to VA clinical office standards? Is building handicapped-accessible? Are there sufficient windows for lighting purposes? Are handrails installed in bathrooms and throughout the building? Is the building located on the main floor? (Preferred: Main floor locations) Is the building located on one floor, or split between two or more levels? (Preferred: One floor) Is the waiting room of sufficient size to be easily accessible by patients and caregivers? Does the facility have a fully sprinkler suppression system in place? Does the facility have a separate employee's entrance? b. Capability of Proposed Space to Meet Existing Requirements: Evaluation of space capability includes, but is not limited to: Determination if the proposed space provides at least 9500 Net Useable Square Feet under ANSI/BOMA standards. Determination whether the hallways, doorways, exam rooms and other areas wide enough to accommodate gurneys and wheelchairs. Whether the building already wired for computer access with sufficient computer drops. Determination if the building is already sufficiently plumbed and wired with electricity. Determination if there is sufficient parking available (49 spaces), including handicapped parking and a handicapped drop-off zone near the entrance(s). Determination if there sufficient restrooms for patients and staff. Evaluation if there are sufficient handicapped-accessible restrooms. (iii) Availability: In this factor, evaluation will be based on the date and time that the proposed facility is available for the Government to begin seeing patients. Evaluation will consider work to be performed (build-out time and expense) or if the facility is "move-in ready". Facilities requiring less time and money for preparation will be rated more favorably than those requiring more build-out expense. (iv) Past Performance: Offerors are to adequately describe relevant experience that is similar in scope and magnitude to this requirement. Provide three (3) references, preferably of Government work, performed in the last five (5) years. Proposals are to provide description of services provided in contracts. (v) Energy Efficiency: Evaluation of this factor to be based on compliance with the following: FAR 52.223-15 "Energy Efficiency in Energy-Consuming Products" FAR 52.223-16 "IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (Dec 2007)" FAR 52.223-17 "Affirmative Procurement of EPA-Designated Items in Service and Construction Contracts (May 2008)" (These regulations can be viewed online at http://farsite.hill.af.mil.) (vi) Price: Price will be evaluated as its own factor and will be worth somewhat less than the Technical Factors above. Proposals shall include all services as outline in the Schedule. The total price shall be inclusive of all base year Contract Line Item Numbers (CLINs) and option year CLINs. The Contract Specialist will perform a price analysis to determine the reasonableness of proposed price in accordance with FAR 15.404-1(B)(2). The Government will utilize a comparison of proposed prices received in response to the solicitation. Normally, adequate price competition establishes price reasonableness (see FAR 15.403-1(c)(1)). (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. (End of Provision) GSA FORM 3516(REV1 2/7) GENERAL CLAUSES (Simplified Leases) 1. The Government reserves the right, at any time after the lease is signed and during the term of the lease, to inspect the leased premises and all other areas of the building to which access is necessary to ensure a safe and healthy work environment for the Government tenants and the Lessor's performance under this lease. 2. If the building is partially or totally destroyed or damaged by fire or other casualty so that the leased space is untenantable as determined by the Government, the Government may terminate the lease upon 15 calendar days written notice to the Lessor and no further rental will be due. 3. The Lessor shall maintain the demised premises, including the building, building systems, and all equipment, fixtures, and appurtenances furnished by the Lessor under this lease, in good repair and tenantable condition. Upon request of the Contracting Officer, the Lessor shall provide written documentation that building systems have been maintained, tested, and are operational. 4. In the event the Lessor fails to perform any service, to provide any item, or meet any requirement of this lease, the Government may perform the service, provide the item, or meet the requirement, either directly or through a contract. The Government may deduct any costs incurred for the service or item, including administrative costs, from rental payments. 5. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (VARIATION) (DEC 2003) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make the full text available, or the full text may be found as GSA Form 351 7C at http://www.cjsa.cjov/Ieasinqform. 6. The following FAR clauses are incorporated by reference: FAR 52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APRIL 1985) FAR 52.203-7 ANTI-KICKBACK PROCEDURES (JULY 1995) FAR 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (SEPT 2007) FAR 52.204-3 TAXPAYER IDENTIFICATION (OCT 1998) FAR 52.204-7 CENTRAL CONTRACTOR REGISTRATION (APRIL 2008) FAR 52.209-5 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED DEBARMENT, AND OTHER RESPONSIBILITY MATTERS (APRIL 2010) FAR 52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED,OR PROPOSED FOR DEBARMENT (SEPT 2006) FAR 52.215-2 AUDIT AND RECORDS-NEGOTIATION (MAR 2009) FAR 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (MAY 2004) FAR 52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS (MAY 2004) FAR 52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN (APRIL 2008) FAR 52.219-16 LIQUIDATED DAMAGES-SUBCONTRACTING PLAN (JAN 1999) FAR 52.222-21 PROHIBITION OF SEGREGATED FACILITIES (FEB 1999) FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999) FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APRIL 1984) FAR 52.222-26 EQUAL OPPORTUNITY (MARCH 2007) FAR 52.222-35 EQUAL OPPORTUNITY FOR SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, AND OTHER ELIGIBLE VETERANS (SEPT 2006) FAR 52.222-36 AFFIRMATIVE ACTION FOR WORKERS WITH DISABILITIES (JUN 1998) FAR 52.222-37 EMPLOYMENT REPORTS ON SPECIAL DISABLED VETERANS,VETERANS OF THE VIETNAM ERA, AND OTHER ELIGIBLE VETERANS(SEPT 2006) FAR 52.223-6 DRUG-FREE WORKPLACE ( MAY 2001) FAR 52.232-23 ASSIGNMENT OF CLAIMS (SEP 1999) FAR 52.233-1 DISPUTES (JUL 2002) FAR 52.233-2 SERVICE OF PROTEST (SEPT 2006) 7. The following GSAR clauses are incorporated by reference: GSAR 552-203-5 COVENANT AGAINST CONTINGENT FEES (FEB 1990) GSAR 552-203-70 PRICE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY (SEP 1999) GSAR 552.219-72 PREPARATION, SUBMISSION, AND NEGOTIATION OF SUBCONTRACTING PLANS (JUN 2005) GSAR 552.219-73 GOALS FOR SUBCONTRACTING PLAN (JUN 2005) GSAR 552.232-75 PROMPT PAYMENT (SEPT 1999) GSAR 552.232-76 ELECTRONIC FUNDS TRANSFER PAYMENT (MAR 2000) 552.270-4 DEFINITIONS.. (SEPT 1999) 552.270-5 SUBLETTING AND ASSIGNMENT. (SEPT 1999) 552.270-6 MAINTENANCE OF BUILDING AND PREMISES-RIGHT OF ENTRY. (SEPT 1999) 552.270-7 FIRE AND CASUALTY DAMAGE. (SEPT 1999) 552.270-8 COMPLIANCE WITH APPLICABLE LAW. (SEPT 1999) 552.270-9 INSPECTION-RIGHT OF ENTRY. (SEPT 1999) 552.270-10 FAILURE IN PERFORMANCE. (SEPT 1999) 552.270-11 SUCCESSORS BOUND. (SEPT 1999) 552.270-12 ALTERATIONS. (SEPT 1999) 552.270-13 PROPOSALS FOR ADJUSTMENT. (SEPT 1999) 552.270-14 CHANGES. (SEPT 1999) 552.270-15 LIQUIDATED DAMAGES. INSERT THIS CLAUSE IN SOLICITATIONS AND CONTRACTS IF YOU HAVE A CRITICAL REQUIREMENT TO MEET THE DELIVERY DATE AND YOU CANNOT ESTABLISH AN ACTUAL COST FOR THE LOSS TO THE GOVERNMENT RESULTING FROM LATE DELIVERY. (SEPT 1999) 552.270-16 ADJUSTMENT FOR VACANT PREMISES. (SEPT 1999) 552.270-17 DELIVERY AND CONDITION. (SEPT 1999) 552.270-18 DEFAULT IN DELIVERY-TIME EXTENSIONS. (SEPT 1999) 552.270-19 PROGRESSIVE OCCUPANCY. (SEPT 1999) 552.270-20 PAYMENT. (SEPT 1999) 552.270-21 EFFECT OF ACCEPTANCE AND OCCUPANCY. (SEPT 1999) 552.270-22 DEFAULT BY LESSOR DURING THE TERM. (SEPT 1999) 552.270-23 SUBORDINATION, NONDISTURBANCE AND ATTORNMENT (SEPT 1999) 552.270-24 STATEMENT OF LEASE. (SEPT 1999) 552.270-25 SUBSTITUTION OF TENANT AGENCY. (SEPT 1999) 552.270-26 NO WAIVER. (SEPT 1999) 552.270-27 INTEGRATED AGREEMENT. (SEPT 1999) 552.270-28 MUTUALITY OF OBLIGATION. (SEPT 1999) 552.270-29 ACCEPTANCE OF SPACE. (SEPT 1999) The information collection requirements contained in this solicitation/contract, that are not required by regulation, have been approved by the Office of Management and Budget pursuant to the Paperwork Reduction Act and assigned the 0MB Control No. 3090-0163. REPRESENTATIONS AND CERTIFICATIONS (Short Form) Complete appropriate boxes, sign the form, and attach to offer. The Offeror makes the following Representations and Certifications. NOTE: The "Offeror, " as used on this form, is the owner of the property offered, not an individual or agent representing the owner. 1. SMALL BUSINESS REPRESENTATION (JAN 2007) (a) (1) The North American Industry Classification System (NAICS) code for this acquisition is 531190. (2) The small business size standard is $19.0 Million in annual average gross revenue of the concern for the last 3 fiscal years. (3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees. ( b) Representations. (1) The Offeror represents as part of its offer that it [] is, [] is not a small business concern. (2) [Complete only if the Offeror represented itself as a small business concern in para graph (b)(1) of this provision.] The Offeror represents, for general statistical purposes, that it [] is, [] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002. (3) [Complete only if the Offeror represented itself as a small business concern in paragraph (b)(1) of this pro vision.) The Offeror represents as part of its offer that it [] is, [us not a women-owned small business concern. (4) [Complete only if the Offeror represented itself as a small business concern in paragraph (b)(1) of this provision.] The Offeror represents as part of its offer that it [] is, [Jis not a veteran-owned small business concern. (5) [Complete only if the Offeror represented Itself as a veteran-owned small business concern in paragraph (b)(4) of this provision.) The Offeror represents as part of its offer that it [1 is, [us not a service-disabled veteran-owned small business concern. (6) [Complete only if the Qiferor represented itself as a small business concern in paragraph (b)(1) of this provision.] The Offeror represents, as part of its offer, that- (i) It [] is, []is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR part 126; and (ii) It [] is, [] is not a joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (b)(6)(i) of this provision is accurate for the HUBZone small business concern or concerns that are participating in the joint venture. [The Offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture: __________ .] Each HUBZone small business concern participating in the joint venture shall submit a separate signed copy of the HUBZone representation. 2.52.222-22- PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999) (Applicable to leases over $10,000.) The Offeror represents that- (a) It [J has, [1 has not participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this solicitation; (b) It [] has, [1 has not filed all required compliance reports; and (c) Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained before subcontract awards. (Approved by 0MB under Control Number 121 5-0072.) 3.52.222-25- AFFIRMATIVE ACTION COMPLIANCE (APR 1984) (Applicable to leases over $10,000 and which include the clause at FAR 52.222-26, Equal Opportunity.) The Offeror represents that- (a) It [1 has developed and has on file, [] has not developed and does not have on file, at each establishment affirmative action programs required by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or (b) It [1 has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (Approved by 0MB under Control Number 121 5-0072.) 4.52.203-11- CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (SEP 2005) (Applicable to leases over $100,000.) (a) The definitions and prohibitions contained in the clause, at FAR 52.203-1 2, Limitation on Payments to Influence Certain Federal Transactions, included in this solicitation, are hereby incorporated by reference in paragraph (b) of this certification. (b) The Offeror, by signing its offer, hereby certifies to the best of his or her knowledge and belief that on or after December 23, 1989, - (1) No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with the awarding of a contract; (2) If any funds other than Federal appropriated funds (including profit or fee received under a covered Federal transaction) have been paid, or will be paid, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with this solicitation, the Offeror shall complete and submit, with its offer, 0MB standard form LLL, Disclosure of Lobbying Activities, to the Contracting Officer; and (3) He or she will include the language of this certification in all subcontract awards at any tier and require that all recipients of subcontract awards in excess of $100,000 shall certify and disclose accordingly. (c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section 1352, title 31, United States Code. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure form to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure. 5.52.204-3- TAXPAYER IDENTIFICATION (OCT 1998) (a) Definitions. "Common parent," as used in this provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the Offeror is a member. "Taxpayer Identification Number (TIN)," as used in this provision, means the number required by the Internal Revenue Service (IRS) to be used by the Offeror in reporting income tax and other returns. The TIN may be either a Social Security Number or an Employer Identification Number. (b) All Offerors must submit the information required in paragraphs (d) through (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the IRS. If the resulting contract is subject to the payment reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the Offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract. (c) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the Offeror's relationship with the Government (31 U.S.C. 7701 (c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the Offeror's TIN. (d) Taxpayer Identification Number (TIN). [] TIN: __________________ [] TIN has been applied for. [J TIN is not required because: [1 Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [] Offeror is an agency or instrumentality of a foreign government; [] Offeror is an agency or instrumentality of the Federal government; (e) Type of organization. []SoIe proprietorship;[J Government entity (Federal, State, or local); El Partnership; El Foreign government; [J Corporate entity (not tax-exempt); [J International organization per 26 CFR 1.6049-4; [1 Corporate entity (tax-exempt); [1 other (I) Common Parent. [] Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision. [1 Name and TIN of common parent: Name TIN 6. 52.204-6- Data Universal Numbering System (DUNS) Number (OCT 2003) (a) The Offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation "DUNS" or "DUNS+4" followed by the DUNS number or "DUNS+4" that identifies the Offeror's name and address exactly as stated in the offer. The DUNS number is a nine-digit number assigned by Dun and Bradstreet, Inc. The DUNS+4 is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the Offeror to establish additional CCR records for identifying alternative Electronic Funds Transfer (EFT) accounts (see Subpart 32.11) for the same parent concern. (b) If the Offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to obtain one. (1) An Offeror may obtain a DUNS number- (i) If located within the United States, by calling Dun and Bradstreet at 1-866-705-5711 or via the Internet at http://www.dnb.com or (ii) If located outside the United States, by contacting the local Dun and Bradstreet office. The Offeror should be prepared to provide the following information: (i) Company legal business name. (ii) Tradestyle, doing business, or other name by which your entity is Commonly recognized. (iii) Company physical street address, city, state and zip code. (iv) Company mailing address, city, state and zip code (if separate from physical). (v) Company telephone number. (vi) Date the company was started. (vii) Number of employees at your location. (viii) Chief executive officer/key manager. (ix) Line of business (industry). (x) Company Headquarters name and address (reporting relationship within your entity). 7. DUNS NUMBER (JUN 2004) Notwithstanding the above instructions, in addition to inserting the DUNS Number on the offer cover page, the Offeror shall also provide its DUNS Number as part of this submission: DUNS # 8. CENTRAL CONTRACTOR REGISTRATION (JAN 2007) The Central Contractor Registration (CCR) System is a centrally located, searchable database which assists in the development, maintenance, and provision of sources for future procurements. The Offeror must be registered in the CCR prior to lease award. The Offeror shall register via the Internet at http://www.ccr.gov. To remain active, the Offeror/Lessor is required to update or renew its registration annually. [] Registration Active and Copy Attached 0 Will Activate Registration and Submit Copy to the Government Prior to Award PROVISIONS Rent including CAM charges . RENT COMMENCEMENT: January1, 2011. YEAR # MONTHLY $ YEARLY $ $/S.F. 1 2 3 4 5 6 7 8 9 10 GENERAL SERVICES ADMINISTRATION GSA FORM 1217 PUBLIC BUILDINGS SERVICE 1. SOLICITATION FOR OFFERS VA-246-09-RP-0131 2. STATEMENT DATE LESSOR'S ANNUAL COST STATEMENT IMPORTANT - Read attached "Instructions" 3. RENTABLE AREA (SQ. FT.) 3A. ENTIRE BUILDING 3B. LEASED BY GOV'T 4. BUILDING NAME AND ADDRESS (No., street, city, state, and zip code) SECTION I - ESTIMATED ANNUAL COST OF SERVICES AND UTILITIES FURNISHED BY LESSOR AS PART OF RENTAL CONSIDERATION LESSOR'S ANNUAL COST FOR FOR GOVERNMENT SERVICES AND UTILITIES (a) ENTIRE BUILDING (b) GOV'T-LEASED AREA USE ONLY (c) A. CLEANING, JANITOR AND/OR CHAR SERVICE 5. SALARIES 6. SUPPLIES (Wax, cleansers, cloths, etc.) 7. CONTRACT SERVICES (Window washing, waste and snow removal) B. HEATING 8. SALARIES 9. FUEL ("x" one) OIL GAS COAL ELECTRIC 10. SYSTEM MAINTENANCE AND REPAIR C. ELECTRICAL 11. CURRENT FOR LIGHT AND POWER (Including elevators) 12. REPLACEMENT OF BULBS, TUBES, STARTERS 13. POWER FOR SPECIAL EQUIPMENT 14. SYSTEM MAINTENANCE AND REPAIR (Ballasts, fixtures, etc.) D. PLUMBING 15. WATER (For all purposes) (Include sewage charges) 16. SUPPLIES (Soap, towels, tissues not in 6 above) 17. SYSTEM MAINTENANCE AND REPAIR E. AIR CONDITIONING 18. UTILITIES (Include electricity, if not in C11) 19. SYSTEM MAINTENANCE AND REPAIR F. ELEVATORS 20. SALARIES (Operators, starters, etc.) 21. SYSTEM MAINTENANCE AND REPAIR G. MISCELLANEOUS (To the extent not included above) 22. BUILDING ENGINEER AND/OR MANAGER 23. SECURITY (Watchmen, guards, not janitors) 24. SOCIAL SECURITY TAX AND WORKMEN'S COMPENSATION INSURANCE 25. LAWN AND LANDSCAPING MAINTENANCE 26. OTHER (Explain on separate sheet) 27. TOTAL $ $ $ SECTION II - ESTIMATED ANNUAL COST OF OWNERSHIP EXCLUSIVE OF CAPITAL CHARGES 28. REAL ESTATE TAXES 29. INSURANCE (Hazard, liability, etc.) 30. BUILDING MAINTENANCE AND RESERVES FOR REPLACEMENT 31. LEASE COMMISSION 32. MANAGEMENT 33. TOTAL $ $ LESSOR'S CERTIFICATION - The amounts entered in Columns (a) and (b) represent my best estimate as to the annual costs of services, utilities and ownership. 34. SIGNATURE OF ¨ OWNER ¨ LEGAL AGENT TYPED NAME AND TITLE SIGNATURE DATE 34A. 34B. 34C. 35A. 35B. 35C. FIRESAFETY PRELEASE CERTIFICATION CHECKLIST (OFFICE SPACE LESS THAN 10,000 SQUARE FEET) Building Name __________________________________________________________________________________ Streeet Address __________________________________________________________________________________ City ____________________________ State ___________________ Zip Code: ___________________ Instructions: Complete the following information that applies to the building being offered for lease by the government. If building is not yet constructed, complete the form based upon building plans and specifications. The following information applies to: ___an exisiting building ___a building not yet constructed Building structural support (check one): _____ Combustible (timber, wood, etc.) _____ Noncombustible (concrete, steel, masonry, etc) Other types of uses present in the building (check all that apply): _____ Restaurants _____ Laboratories _____ Storage _____ Retail _____ Other, list Vertical openings between two or more floors: Stairs (check one): ____open ______enclosed with doors Shafts (check one): ____open ______enclosed; describe_____________________________________________________ Other (check one): ____open ______enclosed; describe_____________________________________________________ Sprinklers (check one): _____ None _____ Corridors only _____ All but corridors and lobbies _____ Total building _____ Other; describe locations: _____________________________________________________________________ Fire fighting capability (check one): _____ None _____ Fire extinguishers only _____ Standpipes only _____ Standpipes and fire extinguishers Fire alarm (check one): _____ None _____ Building alarm without automatic fire department notification _____ Building alarm with automatic fire department notification Smoke detectors (check one): _____ None _____ All corridors _____ Total building _____ Other; describe locations: _____________________________________________________________________ Wall interior finish in space being offered for lease (check one): _____ Painted walls of plaster, sheetrock, or masonry _____ Wallpaper or vinyl wall covering _____ Cloth or corkboard _____ Hardwood paneling _____ Other; describe: ______________________________________________________________________________ Floor finish in space being offered for lease (check one): _____ Carpet _____ Tile _____ Concrete _____ Hardwood _____ Other, describe ______________________________________________________________________________ Building site and layout Approximate outside dimensions of building: __________________________________________________ Total ground area of building (square feet): __________________________________________________ Area of proposed lease (square feet): __________________________________________________ Total number of floors in building:___________ Floor(s) of proposed lease: _________________________ Describe building layout, e.g., rectangular, E-shaped, U-shaped, etc.: _________________________________ Exits (check one): _____ No stairway; one floor on grade _____ Stairways as described in the table below - place checks in appropriate boxes except for "Distance to Next Stair" column, which indicates the required walking distance (feet) to the next exit stair: Stair Stairway Enclosure Location of Exit Discharge Distance to Next Stair (feet) Open Separated by doors Inside Building Directly to Outside Example X X 120 No. 1 No. 2 No. 3 No. 4 The example represents an open stair (no doors) which discharges inside the building (perhaps into a lobby). A person must walk approximately 120 feet to reach the next exit stair. Note: fire escapes and ladders must not be counted as exit stairs. Additional information on exits, if any, e.g., sketch of building Asbestos. The building has (check all that apply): ________ No asbestos ________ Asbestos fire proofing or surfacing material ________ Undamaged asbestos floor tile ________ Asbestos pipe or boiler insulation in good condition ________ Other undamaged asbestos; describe:______________________________________________________________ ________ Damaged asbestos, describe:_____________________________________________________________________ ________ Don't know This information provided by the offeror on this form is material facts upon which the Government relies in making an award. The government has the right to require remedy if there is a misrepresentation. The owner or Authorized Representative certifies that all features are in operating order and properly maintained. OWNER OR AUTHORIZED REPRESENTATIVE a. TYPED NAME AND ADDRESS (including ZIP code) b. TELEPHONE NO. (including area code) c. SIGNATURE d. DATE SIGNED 52.252-1 - SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (VARIATION) (DEC 2003) This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available or the full text of a solicitation provision may be accessed electronically as GSA Form 3516A at this address: http://www.qsa .qov/leasinqform. 2. The following provisions are incorporated by reference: GSAR 552.270-1 INSTRUCTIONS TO OFFERORS -- ACQUISITION OF LEASEHOLD INTERESTS IN REAL PROPERTY (MAR 1998) FAR 52.222-24 PREAWARD ON-SITE EQUAL OPPORTUNITY COMPLIANCE EVALUATION (FEB 1999) (Applicable to leases exceeding $10 million) GSAR 552.270-3 PARTIES TO EXECUTE LEASE(SEP 1999) FAR 52.233-2 SERVICE OF PROTEST (AUG 1996) GSAR 552.233-70 PROTESTS FILED DIRECTLY WITH THE GENERAL SERVICES ADMINISTRATION (MAR 2000) FAR 52.215-5 FACSIMILE PROPOSALS (OCT 1997) (Applicable only if facsimile proposals are authorized.) 3. FLOOD PLAINS AND WETLANDS (APR 1984) An award of contract will not be made for a property located within a base flood plain or wetland unless the Government has determined it to be the only practicable alternative. 570.602 GSAR solicitation provisions. Each SFO must include provisions substantially the same as the following, unless you determine that the provision is not appropriate: 552.270-1 Instructions to Offerors-Acquisition of Leasehold Interests in Real Property. Use Alternate I if you decide that it is advantageous to the Government to allow offers to be submitted up to the exact time specified for award. Use Alternate II if the Government intends to award without discussions. These two alternates are not exclusive. 552.270-2 Historic Preference. 552.270-3 Parties to Execute Lease. OFFEROR OR AUTHORIZED REPRESENTATIVE NAME, ADDRESS (INCLUDING ZIP CODE) NAME STREET CITY, STATE, ZIP TELEPHONE NUMBER Date Signature