Form GSA 1217 at a glance
What it is: GSA 1217 is the Lessor's Annual Cost Statement.
Who signs: 34. Signature of: Legal Agent or Owner.
A filled-in Form GSA 1217 example: a building owner fills out the cost statement
How to fill out Form GSA 1217, box by box
Request for Lease Proposals (RLP), Statement Date and Building Name and Address
Enter the Government lease or Request for Lease Proposals (RLP) number, if available.
Enter the date that your statement was prepared and signed.
Identify the property by name and address.
Rental Area (Square Feet): Entire Building and Leased by Government
In 3A, enter a computation of the rentable area (multiple tenancy basis) for the entire building.
The rentable area shall be computed by measurement to the inside finish of permanent outer building walls to the inside finish of corridor walls (actual or proposed) or to other permanent partitions, or both.
Rentable space is the area for which a tenant is charged rent.
In 3B, enter a computation of the rentable area to be rented to the Government.
For the area rented to the Government, follow the procedure as outlined in 3A, except that measurements are to be made only to the center of the partitions which separate the area to be rented by the Government from adjoining rented or rentable areas.
Lessor's Annual Cost For Services and Utilities: (a) Entire Building and (b) Government-Leased Area
Enter your best cost estimate, or the actual cost from the previous year, for each service and utility furnished by you as part of the rental consideration, in 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 by the Government is not furnished throughout the building, or the cost of a service or utility furnished to the Government space exceeds the cost of the same service or utility furnished to other rented space, explain on a separate sheet.
In the event that your records are not maintained for each item contained in Section I, 5 through 26, the total for a major category (A through F) may be entered under the category heading in columns (a) and (b) in lieu of the specific items.
For convenience, each major category has been divided into separate items such as salaries and supplies so that they may be entered when applicable.
System maintenance and repairs includes the annual cost of such items as oiling, inspecting, cleaning, regulating, and routine replacement costs.
More rules for Form GSA 1217
9. Fuel ("X" one): Electric, Oil, Gas or Coal.
Items 28 through 32 will be useful in the Government's determination of the fair market value of the space to be rented and shall be completed irrespective of whether Section I is applicable.
28. Real Estate Taxes: include all applicable real estate taxes imposed upon the property.
29. Insurance (Hazard, Liability, etc.): enter the annual cost of fire, liability, and other insurance carried on the real estate.
30. Building Maintenance and Reserves for Replacement: enter the annual cost of wages, materials, and outside services used in repairs and maintenance of the building itself and all similar repairs and maintenance costs not included in Section I (Heating, Electrical, Plumbing, Air Conditioning, and Elevators).
31. Lease Commission: enter any lease commission which you may be responsible for due to the Government leasing action.
32. Management: include administrative expenses such as agency fees, legal fees, auditing, and advertising. Do not include financial charges such as income or corporate taxes or organization expense.
In 34. - 35., complete the Lessor certification.
35A, 35B and 35C ask for TYPED NAME AND TITLE, SIGNATURE and DATE.
It will take 2 hours to read the instructions, gather the facts, and answer the questions.
Common questions about Form GSA 1217
Who signs it?
34. Signature of: Legal Agent or Owner.
What am I certifying when I sign?
In the Lessor's Certification, the amounts entered in Columns (a) and (b) represent the best estimate as to the annual costs of services, utilities, and ownership.
Sources
[1] Form GSA 1217 (REV. 11/2016), Lessor's Annual Cost Statement, U.S. General Services Administration (the Official source link on this page).