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GENERAL SERVICES ADMINISTRATION |
1. LEASE OR BID INVITATION NO. |
2. STATEMENT DATE |
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PUBLIC BUILDINGS SERVICE |
XXXXX |
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1 Jan 1998 |
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LESSOR'S ANNUAL COST STATEMENT |
3. NET RENTABLE |
3A. ENTIRE BUILDING |
3B. LEASED BY GOV'T |
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IMPORTANT D Read "Instructions" on reverse of form. |
AREA (Sq ft.) |
203,850 |
203,850 |
203,850 |
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4. BUILDING NAME AND ADDRESS (No., street, city, State and zip code no.) |
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SECTION I D ESTIMATED ANNUAL COST OF SERVICES AND UTILITIES |
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FURNISHED BY LESSOR AS PART OF RENTAL CONSIDERATION |
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SERVICES AND UTILITIES |
LESSOR'S ANNUAL COST FOR |
FOR GOVERNMENT |
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(a) ENTIRE BUILDING |
(b) GOV'T LEASED AREA |
USE ONLY (c) |
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A. CLEANING, JANITOR AND/OR CHAR SERVICE |
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5. SALARIES |
130,460 |
130,460 |
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6. SUPPLIES (Wax, cleaners, cloths, etc.) |
22,424 |
22,424 |
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7. CONTRACT SERVICES (Window washing, waste and snow removal) |
18,347 |
18,347 |
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B. HEATING |
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8. SALARIES |
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9. FUEL ("X" ONE) | |OIL| |GAS| |COAL| |ELECTRIC |
109,716 |
109,716 |
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10. SYSTEM MAINTENANCE AND REPAIR |
8,154 |
8,154 |
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C. ELECTRICAL |
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11. CURRENT FOR LIGHT AND POWER (including elevators) |
117,588 |
117,588 |
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12. REPLACEMENT OF BULBS, TUBES, STARTERS |
4,077 |
4,077 |
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13. POWER FOR SPECIAL EQUIPMENT |
- |
- |
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14. SYSTEM MAINTENANCE AND REPAIR (Ballasts, fixtures, etc.) |
12,231 |
12,231 |
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D. PLUMBING |
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15. WATER (For all purposes) (Include sewer charges) |
50,963 |
50,963 |
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16. SUPPLIES (Soap, towels, tissues not in 6 above) |
- |
- |
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17. SYSTEM MAINTENANCE AND REPAIR |
4,077 |
4,077 |
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E. AIR CONDITIONING |
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18. UTILITIES (Include electricity, if not in C 11) |
250,524 |
250,524 |
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19. SYSTEM MAINTENANCE AND REPAIR |
24,462 |
24,462 |
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F. ELEVATORS |
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20. SALARIES (Operators, starters, etc.) |
- |
- |
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21. SYSTEM MAINTENANCE AND REPAIR |
22,424 |
22,424 |
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G. MISCELLANEOUS |
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22. BUILDING ENGINEER AND/OR MANAGER |
79,502 |
79,502 |
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23. SECURITY (Watchman, guards, not janitors) |
10,193 |
10,193 |
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24. SOCIAL SECURITY TAX AND WORKMEN'S COMPENSATION INSURANCE |
8,154 |
8,154 |
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25. LAWN AND LANDSCAPING MAINTENANCE |
42,809 |
42,809 |
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26. OTHER Emergency generator |
4,077 |
4,077 |
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27. Total |
$ |
920,182 |
$ |
920,182 |
$ |
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SECTION II D ESTIMATED ANNUAL COSTS OF OWNERSHIP EXCLUSIVE OF CAPITAL CHARGES |
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28. REAL ESTATE TAXES |
254,813 |
254,813 |
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29. INSURANCE (Hazard, liability, etc.) |
28,539 |
28,539 |
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30. BUILDING MAINTENANCE AND RESERVES FOR REPLACEMENT |
140,857 |
140,857 |
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31. MANAGEMENT |
106,002 |
106,002 |
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32. Total |
$ |
$ 530,211 |
$ 530,211 |
$ |
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LESSOR'S CERTIFICATION D The amounts entered in |
33. SIGNATURE OF |
x |
OWNER |
LEGAL AGENT |
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Columns (a) and (b) represent my best estimate as to |
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the annual costs of services, utilities and ownership. |
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SECTION III D APPROVAL OF STATEMENT BY AUTHORIZED GOVERNMENT REPRESENTATIVES |
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The undersigned certify that the amount shown in Item 27(c) represents the reasonable value of the srvices and utilities |
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which amount may be properly decuted in determining net rent. |
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TYPED NAME AND TITLE |
SIGNATURE |
DATE |
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34A. |
34B |
34C. |
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Donald E. Parker |
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35A. |
35B. |
35C. |
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Owner |
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GSA Form 1217 |
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