JULY 2005
SOLICITATION FOR OFFERS
OUTPATIENT CLINIC
SFO NO. V101-183R-xxx-xxx-xx
[INSERT LOCATION OF FACILITY]
EXHIBIT I
MAINTENANCE COST WORKSHEET
34. SOLICITATION FOR OFFERS
35. Annual Operating Expenses (from Part I, Line 33 above)
Replacement
Useful Life
ANNUAL
Reserve
COST
(Years)
A. Exterior and Grounds
36. Parking Lot and Road Repair and/or Resurfacing
37. Sidewalks
38. Landscaping / Lawn Care (Equipment)
39. Exterior Painting
40. Windows
41. Roof
B. Building and Equipment
42. Doors
43. Floor Coverings (other than Carpeting)
44. Carpeting
45. Interior Painting
46. Wall Coverings
47. Ceilings
48. Blinds / Drapes
49. Dock Leveler
50. Elevators
51. HVAC (include refrigeration equipment and cooling towers)
52. Air Handling Equipment
53. Exhaust Systems
54. Special HVAC Systems
55. Plumbing Systems (supply, waste and vent)
56. Hot Water Heater
57. Fire Protection (automatic sprinklers)
58. Electrical Systems (distribution and power)
59. Generator
60. Fire Alarm System Switches
61. Communications and Signal Systems
62. Security System
63. Light Fixtures
64. Schedule B Special Requirement Items
C. Other / Miscellaneous (attach additional sheets if necessary)
65.
66.
67.
68.
69.
70. Subtotal Capital Reserve (Add Lines 36 to 69. Enter result here and on Line 30 of GSA Form
1217)
Part II Schedule A Page 5 of 9
Lessor __________ Gov't. __________
__________ of __________ Pages
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