SOLICITATION FOR OFFER
OUTPATIENT CLINIC, [INSERT LOCATION] SFO NO. V101-183R-XXX-XXX-XX
INSTRUCTIONS
FOR
LESSOR'S ANNUAL COST STATEMENT
GSA FORM 1217
In acquiring space by lease, it is the established policy of GSA to enter into leases only at rental charges which are consistent with prevailing scales in
the community for comparable facilities.
by the Government is not furnished throughout the building,
ITEM NUMBER
or the cost of a service or utility furnished to the
Government space exceeds the cost of the same service or
1.
Enter the Government lease or Solicitation for Offers
utility furnished to other rented space, explain on a
number, if available.
separate sheet. For convenience, each major category has
been divided into separate items such as salaries and
2.
Enter the date that your statement was prepared and
supplies so that they may be entered when applicable.
signed.
However, in the event that your records are not maintained
for each item contained in Section I, 5 through 26, the total
3.
A.
Enter in this block a computation of the rentable area
for a major category (A through F) may be entered under
(multiple tenancy basis) for the entire building. The
the category heading in columns (a) and (b) in lieu of the
rentable area shall be computed by measurement to the
specific items. System maintenance and repairs includes
inside finish of permanent outer building walls to the inside
the annual cost of such items as oiling, inspecting,
finish of corridor walls (actual or proposed) or to other
cleaning, regulating, and routine replacement costs.
permanent partitions, or both. Rentable space is the area
for which a tenant is charged rent. It is determined by the
building owner and may vary by city or by building within
the same city. The rentable space may include a share of
building support/common areas such as elevator lobbies,
SECTION II
building corridors, and floor service areas. Floor service
ESTIMATED ANNUAL COST OF OWNERSHIP EXCLUSIVE OF
areas typically include restrooms, janitor rooms, telephone
CAPITAL CHARGES
closets, electrical closets, and mechanical rooms. The
rentable space generally does not include vertical building
Items 28 through 32 will be useful in the Government's determination
penetrations and their enclosing walls, such as stairs,
of the fair market value of the space to be rented and shall be
elevator shafts, and vertical ducts.
completed irrespective of whether Section I is applicable, as follows:
B.
Enter in this block a computation of the rentable area to be
28.
Include all applicable real estate taxes imposed upon the
rented to the Government. For this area, follow the
property.
procedure as outlined above, except that measurements
are to be made only to the center of the partitions which
29.
Enter the annual cost of fire, liability, and other insurance
separate the area to be rented by the Government from
carried on the real estate.
adjoining rented or rentable areas.
30.
Enter the annual cost of wages, materials, and outside
4.
Identify the property by name and address.
services used in repairs and maintenance of the building
itself and all similar repairs and maintenance costs not
included in Section I above (Heating, Electrical, Plumbing,
Air Conditioning, and Elevators). This includes major
repairs and changes in the nature of a permanent
SECTION I
improvement such as annual cost to replace relatively
ESTIMATED ANNUAL COST
short-lived items such as boilers, compressors, elevators,
OF SERVICES AND UTILITIES
and roof coverings.
5. - 26.
The services and utilities listed in this section are required
31.
Enter any lease commission which you may be responsible
in most of our rented space whether furnished by the
for due to the Government leasing action.
Government or the Lessor.
32.
Include administrative expenses such as agency fees, legal
Carefully review the Solicitation for Offers and/or the
fees, auditing, and advertising. Do not include financial
proposed lease to identify those services and utilities to be
charges such as income or corporate taxes or organization
furnished by you as part of the rental consideration. Then
expense.
enter your best cost estimate, or the actual cost from the
previous year, for each of these services and utilities in
34./35.
Complete Lessor certification.
column (a) for the entire building and in column (b) for the
area to be rented to the Government. If any service or
utility
furnished
for
the
space
rented
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