GSA 1364A Simplified Lease Proposal

OMB Control Number: 3090-0086
Expiration Date: 11/30/2019

EXHIBIT A TO LEASE NUMBER GSSIMPLIFIED LEASE PROPOSAL

DATED:

IN RESPONSE TO REQUEST FOR LEASE PROPOSALS (RLP) NUMBER

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 1.5 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.

SECTION I - BUILDING INFORMATION
A. BUILDING NAME

NUMBER OF FLOORS

TOTAL PARKING FOR BUILDING

2

6

B. BUILDING STREET ADDRESS

LIVE FLOOR LOAD

3
1

C. CITY

E. 9-DIGIT ZIP CODE

F. CONGRESSIONAL
DISTRICT

7

TOTAL RENTABLE AREA (SQ
FT)

4

SURFACE:

CONSTRUCTION TYPE

(LBS / SQ

FT)

D. STATE

STRUCTURED:

A. BUILDING BUSINESS HOURS (MON - FRI)

8

BUILDING AGE (YEARS)

B. BUILDING BUSINESS HOURS (SAT - SUN)

5

SECTION II - SPACE OFFERED AND RATES
FLOOR LOCATION

SUITE NUMBER

ANSI/BOMA SQ FT

TYPE OF SPACE

FLOOR LOCATION

SUITE NUMBER

ANSI/BOMA SQ FT

TYPE OF SPACE

9
FIRM TERM

TYPE OF
SPACE

NON-FIRM TERM

OPTION TERM

ANSI/ BOMA
AREA (SQ FT)

COMMON
AREA
FACTOR

RENTABLE
SQ FT (RSF)
AxB=

RENTAL RATE
(PER RSF/YR)

ANNUAL RENT
CxD=

RENTAL RATE
(PER RSF/YR)

ANNUAL RENT
CxF=

RENTAL RATE
(PER RSF/YR)

ANNUAL RENT
CxH=

A

B

C

D

E

F

G

H

I

10

OFFICE

$

$

$

$

$

$

11

OTHER

$

$

$

$

$

$

12

TOTAL

13

12E ÷ 12A =
13A

COMPOSITE ABOA PER SQ FT RATES

A. RATE ADJUSTMENT FOR VACANT SPACE: $

16
17

Floor $

$
12I ÷ 12A =
13C

$

$

B. FREE RENT INCLUDED IN OFFER
1. months free rent (includes shell, operating, TI and BSAC rent)
2. Other rental concessions structured as follows
3. None

B. AREAS REQUIRING 24 HOUR HVAC (LAN, ETC.) $

A. HOURLY RATE FOR OVERTIME HVAC:
Zone $

12G ÷ 12A =
13B

$
/ ABOA
SF

14

15

$

$

ABOA SF*

*Only applies when the Government requires separate reimbursement for 24 hour HVAC as described under
Section 1 of the Lease. Otherwise, include this cost in the operating rent as described under Section 6 of the Lease.

Entire space $

NUMBER OF PARKING SPACES OFFERED TO GOVERNMENT:

A. STRUCTURED:

CHARGE FOR SPACES OFFERED TO GOVERNMENT (IF NOT IN RENT):

B. STRUCTURED: $

RIGHT TO USE OF ROOFTOP AREA FOR ANTENNAS AND ASSOCIATED RIGHTS IN BUILDING

C. SURFACE:
/ MO

D. SURFACE: $

INCLUDED

/ MO

NOT INCLUDED

SECTION III - OWNER/OFFEROR INFORMATION
A. OFFEROR (NAME AND COMPLETE MAILING ADDRESS)

B. OFFEROR'S AUTHORIZED REPRESENTATIVE (IF APPLICABLE)
(NAME AND COMPLETE MAILING ADDRESS)

C. DUNS NUMBER

18

19

TELEPHONE NUMBER

21

OFFEROR'S FORM OF BUSINESS:

20
INDIVIDUAL

GENERAL SERVICES ADMINISTRATION

Lessor

E-MAIL ADDRESS

PARTNERSHIP

CORPORATION - SPECIFY STATE:

Government:

GSA 1364A (REV. 11/2016)

EXHIBIT A TO LEASE NUMBER GSSECTION IV - OFFER
22
23

RLP AMENDMENTS ACKNOWLEDGED (INITIAL)

NO. 1

NO. 2

NO. 3

NO. 4

NO. 5

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

SECTION V - PROPOSED ADDITIONAL TERMS, CONDITIONS
OFFEROR WILL COMPLETE THE FOLLOWING FIRE/LIFE SAFETY, ACCESSIBILITY, AND ENERGY SAVINGS IMPROVEMENTS AS
REQUIRED IN THE LEASE:

24

ADDITIONAL TERMS AND CONDITIONS WITH RESPECT TO THIS OFFER:

25

Lessor

Government:

GSA 1364A (REV. 11/2016) BACK