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RESOLUTION NO. 7616
A RESOLUTION APPROVING A LEASE AGREEMENT BETWEEN PUEBLO, A
MUNICIPAL CORPORATION, AND THE UNITED STATES OF AMERICA, AND
AUTHORIZING THE PRESIDENT OF CITY COUNCIL TO EXECUTE SAME,
Be it resolved by the City Council of Pueblo, Colorado, that:
SECTION 1
A certain Lease Agreement, a copy of which is attached hereto and made a part hereof by
reference, after having been approved as to form by the City Attorney, by and between the
City of Pueblo, a Municipal Corporation, and the United States of America, relating to the
rental of office space in the Airport Terminal building, located at Pueblo Memorial Airport, be
and the same is hereby approved; subject to the conditions as set forth in said Lease
Agreement.
SECTION 2
The President of City Council is hereby authorized to execute said Lease Agreement on behalf
of Pueblo, a Municipal Corporation, and the City Clerk shall affix the Seal of the City thereto
and attest the same.
SECTION 3
All net proceeds derived from said Lease Agreement will be used for the operation,
maintenance, and improvement of the Airport.
Introduced APRIL 24, 1995
ATTEST:
i
By JOHN CALIFANO
Councilperson
APPROVED:
d 4-' � u
President of City Council
U.S. GOVERNMENT LEASE FOR REAL PROPERTY t. LEASE NUMCER
(Short Form) I DTFA11 -95 -L -15154
PART I - SOLICITATION /DESCRIPTION OF REQUIREMENTS (To be completed by Government)
A. REQUIREMENTS
The Government of the United States of America is seeking to lease approximately
net usable square feet of
office
space located in Terminal Building
Pueblo Airport for occupancy not later than June 28, 1995 (date).
S. STANDARD CONDITIONS AND REQUIREMENTS
The following standard conditions and requirements shall apply to any premises offered for lease to the UNITED
STATES OF AMERICA (hereinafter called the GOVERNMENT):
First class office space is required. Space offered must be in a quality building of sound and substantial
construction, either a new, modern building or one that has undergone first class restoration or rehabilitation for
the intended use.
The Lessor shall provide a valid Occupancy Permit for the intended use of the Government and shall operate the
building in conformance with local codes and ordinances.
The Building and the leased space shall be accessible to the handicapped in accordance with the Uniform Federal
Accessibility Standards (41 CFR 101 -19.6, App. A).
The leased space shall be free of all asbestos containing materials, except undamaged vinyl asbestos floor tile in
the space or undamaged boiler or pipe insulation outside the space.
Services, utilities, and maintenance will be provided daily, extending from 6:30 a.m. to 5:00 p.m.
except Saturday, Sunday, and Federal holidays. The Government shall have access to the leased space at all times,
including the use of electrical services, toilets, lights, elevators, and Government office machines without additional
payment.
2. SERVICES AND UTILITIES (To be provided by Lessor as part of rent.)
HEAT
ELECTRICITY
POWER (Special Equip.)
WATER (Hot & Cold)
S NOW REMOVAL
1 OTHER REQUIREMENTS
TRASH REMOVAL U ELEVATOR SERVICE U INITIAL & REPLACEMENT U OTHER (Specify
CHILLED DRINKING WATER ® WINDOW WASHING LAMPS, TUBES & BALLASTS belov.)
AIR CONDITIONING Frequency ❑ PAINTING FREQUENCY
TOILET SUPPLIES ® CARPET CLEANING Space
JANITORIAL SERV. & SUPP. Frequency Public Areas
Space is calculated as follo:As:
Office 180 square feet
Office 254 Square feet
Reception 546 Square feet
Hall 40 Square feet
Storage .212 Square feet
Restrooms 260 Square feet (non — exclusive)
Total 1,490 Square Feet (rounded)
Annual rental is computed as follows:
1,230 SF @ $13.57 P.A.S.F. $16,691.10
260 SF @ $6.79 P.A.S.F. 1,765.40
10 Parking Spaces @ $120 each 1,200.00 Total $19,656.50
CAUTION: All offers are subject to the terms and conditions outlined above, and elsewhere in this solicitation, including the
Government's General Clauses and Representations and Certifications.
3. BASIS OF AWJARO
In THE ACCEPTABLE OFFER WITH THE LOWEST PER NET USABLE SQUARE FOOT PRICE.
❑ OFFER 6tOST ADVANTAGEOUS TO THE GOVERNMENT. WITH PRICE BEING ❑ EQUAL TO ❑ LESS IMPORTANT THAN
nic' FOLLOWING EVALUATION FACTORS (Listed in descending order, unless stated otherwise):
GENERAL SERVICES ADMINISTRATION GSA Forn, 3626 (8-92)
PART II - OFFER (To be completed by Offeror /Owner)
A. LOCATION AND DESCRIPTION OF PREMISES OFFERED FOR LEASE BY GOVERNMENT
5. NAME AND ADDRESS OF BUILDING (Include ZIP Code) 6. LOCATIONS) IN BUILDING
Airport Terminal Building a. FLOOR(S) b. ROOM NUMSER(S)
Pueblo Airport
Pueblo, CO 81001 First See Attached Floorplan
C. NET USABLE SO. FT. d. TYPE
® GENERAL OFFICE OTHER (Specify)
1,490 WAR
S. TERM
To have and to hold, for the term commencing on or about June 5, 1995 and continuing
through September 30, 1995 i nclusi ve.
C. RENTAL
Rent shall be payable in arrears and will be due on the first workday of each month. VVXr� 2t, �ft�4XXc�d4i�iG�rGiY�1S aK24>?6
XriUlCJdJQkKDt�JCDC9t1(J Ei +��tXtXXt�e'Cd/�16D(tGXil�6J6i( tai] LDlu�2lfi4'�K�L3[ylf9(e16�t)tif �ICQf�ClltYd(, t[ dCJ fl�eCf (dtXa[J(�Egd(a1�rXdfJt1(�C QED( dPoYIaOJ (�Cd(r9tl(Xd4Dblfn)idre,�Cf41�
A9lTIQ 9�fcR 9l9('�9��RJ�9(11�7E 9�DC�PIC R RA 7(9E�C9�4C���(�7C �UC'DPJQJQ'1C�@� i�Xi X?X9C)[D��X
7. AMOUNT OF ANNUAL RENT 19. MAKE CHECKS PAYABLE TO (Name and address)
R1q_ _ I City of Pueblo
8. RATE PER MONTH Pueblo Municipal
I Ca. NAIAE AND ADDRESS OF OWNER (Include ZIP Code. If requested by the Government and the owner is a partnership or joint venture, list all General Partners. using a separate sheer
it necessary.)
City of Pueblo
Pueblo, CO 81001
10b. TELEPHONE NUMBER OF OWNER 11. TYPE OF INTEREST IN PROPERTY OF PERSON SIGNING
( 719) 948 -3355 1 OWNER 19 AUTHORIZED AGENT 11 OTHER (Specify)
12. NAME OF OWNER OR AUTHORIZED AGENT 13. TITLE OF PERSON SIGNING
Christian Weaver I President of City Council
1 - SIGN—ATU5V OWNER OR AUTHORIZED AGENT 115. DATE I 1 d. OFFER REMAINS OPEN UNTIL ::30 P.i.t.
APRIL 24, 1995
(Date)
L� PART III - AWARD (To be completed by Government)
Your offer is hereby accepted. This award consummates the lease which consists of the following documents: (a) this GSA Fcr : :.
36213, !b) Representations and Certifications, (c) the Government's General Clauses, and (d) the following changes or additions ntacie
or agreed to by you:
Attachment A - Other Requirements
Attachment B - Sketch of Space
Attachment C - Vehicle Parking Spaces
GSA FORM
THIS DOCUMENT IS NOT BINDING ON THE GOVERNMENT OF THE UNITED STATES OF AMERICA UNLESS SIGNED BELOW BY
AUTHORIZED CONTRACTING OFFICER.
ATTACHMENT A
to
Lease No. DTFA1 1-95L- 15154
RENEWAL OPTION
This lease may, at the option of the Government, be renewed from year to year and otherwise
upon the terms and conditions herein specified. The Government's option shall be deemed
exercised and the lease renewed each year for one (1) year unless the Government gives the
Lessor sixty (60) days written notice that it will not exercise its option before this lease or any
renewal thereof expires; PROVIDED, that no renewal shall extend the period of occupancy of the
premises beyond the 30th day of September 2002; AND PROVIDED FURTHER, that adequate
appropriates are available from year to year for the payment of rentals.
TERMINATION
The Government may terminate this lease at any time after the 30th day of September, 1995, by
giving ninety (90) days notice in writing to the other party and no rental shall accrue after the
effective date of termination. Said notice shall be sent by certified or registered mail.
PARKING
The Lessor shall provide four (4) parking spaces on the air side adjacent to the office and three
(3) parking spaces outside the Air Operations Area (adjacent and southwest of the leased
premises) at no cost. Additionally, ten parking spaces will be provided directly in front of the
leased premises at a monthly fee of $10 each. These spaces shall be marked "FAA USE ONLY ".
The parking spaces are shown on Attachment C.
Attachment B
Office Floor Plan
Lease No. DTFAII -95- -15154
�l
lil
Office
180 sq.ft.
(carpet)
Office
254 sq.ft.
(carpet) �
Storage
212 sq.ft.
(tile)
Hall
40
q.ft
carpi
Reception
546 sq.ft.
(carpet)
= RECEP
Q
N
EE _
0
115 i'"�T1
Attachment C
Vehicle Parking Spaces
Lease No. DTFAII -95 -15154
I Office Storage
180 sq.ft. 212 sq.ft.
(carpet) I (tile) l+
i i iI
� Hall 1
h 40 ;
��(carpe�CJ� I�
Office
(carper)
j
x (carpe[) c
C i{
I� Reception
546 sq.ft.
(carpet)
XIX
I
i
I
UJC .? I
Vl. �
O d
N
t �^
I (
THESE SPACES TO BE
MARKED "FAA USE ONLY"
*parking spaces not to scale
Lease No. DTFA11 -95 -L -15154
GENERAL CLAUSES
(Acquisition of Leasehold Interests in Real Property Not To Exceed S25,000)
1. The Government reserves the right, at any time after the lease is signed and during the term of the lease, to inspect
the leased premises and all other areas of the building access to which is necessary to ensure a safe and healthy work
environment for the Government tenants and the Lessor's compliance with the provisions of this lease.
2. If the building is partially or totally destroyed or damaged by fire or other casualty so that the leased space is
untenantable as determined by the Government, the Governmenipy�grfli &p,te the lease upon 15 calendar days written
notice to the 6 a �g11c?,further rental will be due.
3. The Lessor shall maintain the demised premises, including the building and all equipment, fixtures, and
appurtenances furnished by the Lessor under this lease, in good repair and tenantable condition.
4. In the event the Lessor fails to perform any service, to provide any item, or meet any requirement of this lease, the
Government may perform the service, provide the item, or meet the requirement, either directly or through a contract.
The Government may deduct any costs incurred for the service or item, including administrative costs, Irom the rental
payments.
5. 52.252 -2 CLAUSES INCORPORATED BY REFERENCE (JUN 1988)
This contract incorporates one or more clauses by reference with the same force and effect as if they •:sere cpi ien in full
text. Upon request the Contracting Officer will make their full text available.
6. The following clauses and provisions are incorporated by reference:
FAR 52.203 -1
OFFICIALS NOT TO BENEFIT (APR 1984)
GSAR 552 -203 -5
COVENANT AGAINST CONTINGENT FEES (FEB 1990)
FAR 52.203 -7
ANTI- KICKBACK PROCEDURES (OCT 1988)
FAR 52.215 -1
EXAMINATION OF RECORDS BY COMPTROLLER GENERAL (APR 1984)
(Applies to leases over S10,000)
FAR 52.222 -26
EQUAL OPPORTUNITY (APR 1984) (Applies to leases over 510,000)
FAR 52222 -35
AFFIRMATIVE ACTION FOR SPECIAL DISABLED AND VIETNAM ERA
VETERANS (APR 1984) (Applies to leases over 510,000)
FAR.52.222 -36
AFFIRMATIVE ACTION FOR HANDICAPPED WORKERS (APR 1984)
(Applies to leases over 52,500)
FAR 52.222 - ,37 EMPLOYMENT REPORTS ON SPECIAL DISABLED VETERANS AND VETER-A. `JS
OF THE VIETNAM ERA (JAN 1988) (Applies to leases over 510,000)
GSAR 552.23 -71 PROMPT PAYMENT (APR 1989)
FAR 52.233 -1 DISPUTES (DEC 1991)
The information collection requirements contained in this solicitation /contract, that are not required Ly regu!aticn,
been approved by the Office of Management and Budget pursuant to the Paperwork Reduction Act and asZz:gned
OMB Control No. 3090 -0163.
iMmA�s: k
74 0 r vet►
REPRESENTATIONS AND CERTIFICATIONS (Acquisition Solicitation Number Dated
of Leasehold Interests in Real Property) DTFA11-95 -L -15154
Complete appropriate boxes, sign the form, and attach to offer.
The Offeror makes the following Representations and Certifications. NOTE. The "Offeror," as used on this form, is the owner of the
property offered, not an individual or agent representing the owner.
1. 552.219 -1 SMALL BUSINESS CONCERN REPRESENTATION (MAY 1991) (VARIATION)
The Offeror represents and certifies as part of its offer that it [ is, (4 is not a small business concern. "Small business concern,"
as used in this provision, means a concern, including its affiliates, that is independently owned and operated, not dominant in the field cf
operation in which it is bidding on Government contracts, and qualified as a small business under the size standards in this solicitation.
2. SMALL BUSINESS SIZE STANDARD (MAR 1992)
The small business size standard applicable to this acquisition is annual average gross receipts of S10 million or less for the
preceding three fiscal years.
3. 52.219 -2 - SMALL DISADVANTAGEO BUSINESS CONCERN REPRESENTATION (FEB 1990
(a) Representation. The Offeror represents that it ( j is, % ] is not a small disadvantaged business concern.
(b) Definitions.
"Asian Pacific Americans," as used in this provision, means United States citizens whose origins are in Japan, China, the
Philippines, Vietnam, Korea, Samoa, Guam, the U.S. Trust Territory of the Pacific Islands (Republic of Palau), the Nortnern Mariana
Islands, Laos, Kampuchea (Cambodia), Taiwan, Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Republic of tale Marshall
Islands, or the Federated States of Micronesia.
"Indian tribe," as used in this provision, means any Indian tribe, band, nation, or other organized group or community of Indians,
including any Alaska Native Corporation as defined in 13 CFR 124.100 which is recognized as eligible for the special programs and
services provided by the U.S. to Indians because of their status as Indians, or which is recognized as such by the State in which suc.
tribe, band, nation, group, or community resides.
"Native Americans," as used in this provision, means American Indians, Eskimos, Aleuts, and native Hawaiians.
'Native Hawaiian Organization,' as used in this provision, means any community service organization serving Native Hawaiia r,
and chartered as a net -'or - profit organization by, the State of Hawaii, which is controlled by Native Hawaiians, and wness business
activities will principally benefit such Native Hawaiians. .
"Small business concern," as used in this provision, means a concern, including its affiliates, that is independently owned and
operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under
the criteria and size standards in 13 CFR 121.
"Small disadvantaged business concern," as used in this provision, means a small business concern that (a) is at least 51 percent
unconditionally owned by one or more individuals who are both socially and economically disadvantaged, or a publicly owned business
having at least 51 percent of its stock unconditionally owned by one or more socially and economically disadvantaged individuals and
(b) has its management and daily business controlled by one or more such individuals. This term also means a small business concern
tnat is at least 51 Percent unconditionally owned by an economically disadvantaged Indian tribe or Native Hawaiian Organization, cr a
publicly owned businass having at least 51 percent of its stock unconditionally owned by one of these entities •,vnich has .ts
management and daily business controlled by members of an economically cisadvantaged Indian tribe or Native Hawaiian
Orgarnzation, and which meets the requirements of 13 CFR 124.
"Subcontinent Asian Americans,' as used in this provision, means United States citizens whose origins are in India, Pakistan,
Bangladesh, Sri Lanka, Bhutan, or Nepal.
(c) Qualified groups. The Offeror shall presume that socially and economically disadvantaged individuals include Black
Americans, Hispanic Americans, Native Americans, Asian - Pacific Americans, Subcontinent Asian Americans, and other individuals
found to be qualified by SBA under 13 CFR 124. The Offeror shall presume that socially and economically disadvantaged entities also
include Indian tribes and Native Hawaiian Organizations.
irvmAt_s: G� -
sssor overn
GSA FORM 3. 9 18 PAGE t (RE/ 3192)
4. 52.219--'- WOMEN -OWNED SMALL BUSC`ESS REPRESENTA70N 1 ,APR 1964)
(a) Representation. The Offeror represents that it ( ] is, ()Q is not a women -owned small business concern.
(b) Definitions.
"Small business concern,' as used in this provision, means a concern including its affiliates, that is independently owned and
operated, not dominant in the field of operation in which it is bidding an Government contracts, and qualified as a small business.uncar
the criteria and size standards in 13 CFR 121.
"Women- owned," as used in this provision, means a small business that is at !asst 51 percent owned by a woman or women who
are U.S. citizens and who also control and operate the business.
5. 52.222 -22 - PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (APR 1984)
The Offeror represents that —
(a) It (A has, ( ] has not participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this
solicitation, the clause originally contained in Section 310 of Executive Order No. 10925, or the clause contained in Section 201 of
Executive Order No. 11114;
(b) It DQ has, (] has not filed all required compliance reports; and
(c) Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained
before subcontract awards. (Approved by OMB under Control Number 1215-0072.)
6. 52.222 -25 - AFFIRMATIVE ACTION COMPLIANCE (APR 1984)
(Applies to contracts which include the clause at FAR 52.222 -26, Equal Opportunity)
The Offeror represents that —
(a) It M has developed and has on file, [ ] has not developed and does not have on file, at each establishment affirmative action
programs required by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or
(b) It [ ] has not previously had contracts subject to the written affirmative ac;icn programs requirement of the rules and
regulations of the Secretary of Labor. (Approved by OMB under Control Number 12154072.)
7. 52.222 -21 - CERTIFICATION OF NONSEGREGATED FACILITIES (APR 1984)
(a) "Segregated facilities," as used in this provision, means any waiting rooms, work areas, rest rooms and washrooms,
restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains,
recreation or entertainment areas, transportation, and housing facilities provided for employees, that are segregated by explicit direc:�re
or are in fact segregated on the basis of race, color, religion, or national origin because of habit, local custom, or otherwise.
(b) By the submission of this offer, the Offaror certifies that it does not and will not maintain or provide for its employees any
segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at _:.y
location under its control where segregated facilities are maintained. The Offeror agrees that a breach of this certification is a violation of
the Equal Opportunity clause in the contract.
(c) The Offeror further agrees that (except where it has obtained identical certifications from proposed subcontractors for scecific
time periods) ;t'Nill—
(1) Obtain identical certifications from proposed subcontractors before the award of subcontracts under which the
subcontractor will be subject to the Equal Opportunity clause;
R Retain the certifications in the files; and
Forward the following notice to the proposed subcontractors (except h the proposed subcontractors have submitted
identical certifications for speck time periods).
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CER T iFiCATIONS OF NONSEGREGATED FACILITIES.
A Certification of Nonsegregated Facilities must be submitted before the award of a subcontract under which the subcontractor will be
subject to the Equal Opportunity clause. The certification may be submitted either fcr each subcontract or for all subcontracts during a
period (i.e., quarterly, semiannually, or annually).
INrriALS: &
essor ove ent
GSA FORM 351 ?AGE 2 ,R/ 1421
NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
(Approved by OMB under Control Number 1215-0072.)
8. 552.203 - : - CONTINGENT FE= REPRESENTATION AND AGREEMENT (MAY 1989)
(a) Representation. The Off aror represents that, except for full -time bona fide employees working solely for the Offercr or bona
fide established real estate agents or brokers maintained by the Offeror for the purpose of securing business, the Offercr —
(Note: The Offeror must check the appropriate boxes. For interpretation of the term "bona fide employee or agency," see paragraph (b)
of the Covenant Against Contingent l=ees clause.]
(1) [ j Has, DQ has not, employed or retained any company or persons to solicit or obtain this lease; and
2 (] Has, [X has not, paid or agreed to pay to any person or company employed or retained to solicit or obtain this contr ac:
any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.
(b) Agreement. The Offeror agrees to provide information relating to the above Representation as requested by the Contracting
Officer and, when subparagraph (a)(1) or (a)(2) is answered affirmatively, to promptly submit to the Contracting Officer
(1) A completed Standard Form 119, Statement of Contingent or Other Fees, (SF 119); or
(2 A signed statement indicating that the SF 119 was previously submitted to the same contracting office, including the date
and applicable solicitation or contract number, and representing that the prior SF 119 applies to this offer or quotation.
9. 52.203-02- CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)
(a) The Offerer certifies that—
(1) The prices in this offer have been arrived at independently, without, for the purpose of restrictin competition, any
consultation, communication, or agreement with any other Offeror or competitor relating to (i) those prices, (ii the intention to submit an
offer, or (iii) the methods or factors used to calculate the prices offered;
(2) The prices in this offer have not been and will not be knowingly disclosed by the Offeror, directly or indirectly, to any oth
Offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated
solicitation) unless otherwise required by law; and
(3) No attempt has been made or will be made by the Offeror to induce any other concern to submit or not to submit an offar
for the purpose of restricting competition.
(b) Each signature on the offer is considered to be a certification by the signatory that the signatory—
(1) Is the person in the Offeror's organization responsible for determining the prices being offared in this bid or proposal,
that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) above; or
(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have nct
panictated, and vrll rot oartic4ata in any action contrary to subparagraphs (a)(1) through (a)(3) above
T.Pwj C A n„i g 1 Py, City Manager [insert full name of persons) in the Off arors organization responsible for
determining tna prices o� area in this bid or proposal, and the title of his or her position in the Offeror's organization];
(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2) (i) above have not participated, an
will not participate. in any action contrary to subparagraphs (a)(1) through (a)(3) above; and
(iii) As an agent, has not personally participated, and will not participate, in action contrary to subparagraphs (a)(1)
through (a) (3) above.
(c) If the Off aror deletes or modifies subparagraph (a) (2) above, the Off aror must furnish with its offer a signed statement setting
forth in detail the circumstances of the disclosure.
10. 52.203 -11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS
(APR 1991) (DEVIATION)
(Applies to !eases •.vhicn exceed $100,000.)
(a) The definitions and prohibitions contained in the clause, at FAR 52.203 -12, Limitation on Payments to Influence Certain Fade, w
Transactions, are hereby incorporated by reference in paragraph (b) of this certification.
(b) The offeror, by signing its offer, hereby certifies to the best of his or her knowledge and belief that on or after December 23,
1989,— -
(1) No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress on his or her behalf in connection with the awarding of a contract resulting from this solicitation.
(2) If any funds other than Federal appropriated funds (including profit or fee received under a covered Federal transaction)
have been paid, or will be paid, to any person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with this
solicitation, the offeror shall complete and submit, with its offer, OMB standard form LLL, Disclosure of Lobbying Activities, to the
Contracting Officer; and
INITIALS: 3
C sscr je
GSA FORM 351 8 PAGc 3 (REF/ 8«-
(3) He or she will include the language cf'hls ceni'catlon in all subcontract awards at any tier and require that all recipients cf
subcontract awards in excess of $100,000 shall certify and disclose accordingly.
(c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section
1352, title 31. United States Code. Any person who makes an expenditure prohibited under this provision or who fails to file or amend
the disclosure form to be filed or amended by this provision, shall be subject to a civil penalty of not less than S10,000, and not more
than $100,000, for each such failure.
11. 52.2095 - CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED DEBARMENT, AND OTHER
RESPONSIBILITY MATTERS (MAY 1989)
(a) (1) The Offeror certifies, to the best of its knowledge and belief, that—
(1) The Offeror and /or any of its Principals—
(A) Are ( ] are not X] presently debarred, suspended, proposed for debarment, or declared ineligible for the award of
contracts by any Federal agency;
(B) Have (]have not (X), within a three -year period preceding this offer, been convicted of or had a civil judgment
rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a
public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers;
or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving
stolen property; and
(C) Are (] are not ()q presently indicted for, or otherwise criminally or civilly charged by a governmental entity with,
commission of any of the offenses enumerated in subdivision (a)(1)(i)(3) of this provision.
(ii) The Offeror has (] has not D], within a three year period preceding this offer, had one or more contracts terminated
for default by any Federal agency.
(2) 'Principals," for the purposes of this certification, means officers; directors; owners; partners; and, persons having primary
management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a subsidiary,
division, or business segment, and similar positions).
THIS CERTIFICATION CONCERNS A MATTER WITHIN THE JURISDICTION OF AN AGENCY OF THE UNITED STATES AND THE
MAKING OF A FALSE, FICTITIOUS, OR FRAUDULENT CERTIFICATION MAY RENDER THE MAKER SUBJECT TO PROSECUTION
UNDER SECTION 1001, TITLE 18 UNITED STATES CODE.
(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror
learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withhcldiny of an 2 %varc
ur•Cer this sollc :t_tion. However, the certification will be considered in connection with a c3terminaticn of ti'3 &sro(s res.ccrisibl :'/.
Failure of the 0-3ror to furnish a certification or provide such additional information as requested by . is Contracting Officer may rencaF
the Offeror nonresoonsible.
d) Nothing contained in the foragcing shall be construed to require establishment of a system of records in order to render, In
good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required tc
exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when
making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies
available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.
12. ASBESTOS REPRESENTATION (MAR 1992)
The Offaror represents and cartifies as part of its offer that the space offarad for lease, common building areas, ventilation systems
and zones serving the space offered, and the area above suspended ceilings and engineering space in the same ventilation zones as
the space offered —
(a) [ ] Does, (M does not include asbestos - containing materials (ACM). ACM as used in this provision is defined as any materia:s
with a concentration of 1 percent or greater by dry weight of asbestos fibers.
(b) If any of the above areas include ACM, please indicate whether the materials are
(1) friable [ ] Yes [ ] No
2 non - friable, in good condition, and located in
a place where they are not likely to be disturbed
during the term of any ensuing lease contract Yes No
(3) in a solid matrix, already in place, and in good condition f Yes f I'No
INITIALS: 3
s 4. ) , vern
GSA FCRM ; °t 3 FAGS 4 (Re/ 9 -1 SLI
13. CERTIFICATION FOR PASTOR PRESENT HAZARDOUS WASTE OPERATIONS (NOV 1987)
To the best', of his or her knowledge, the Offeror raoresents and certifies, as part of the offer t - at the site upon which space is offarz.-
for lease to the Government —
(a) ( J Was, ()I was not a site used for any of the operations listed in item b below.
(b) Was a site used for any or all of the following operations:
1
generation of hazardous waste
[ j Yes [ ] No
2
treatment, temporary /permanent storage, or
disposal of solid or hazardous wave
[ J Yes
[ ] No
(3)
storage of hazardous substances or
petroleum products
j Yes
] No
4
used /wave oil storage or reclamation units
[ Yes
((([ No
5
laboratory or rifle range
( Yes
No
6
chemical manufacturing /storage
( Yes
No
military or intelligence weapons
or ammunition training or testing
(] Yes
(] No
(8)
orcnance and /or weapons production,
vorage, or handling
[ j Yes
(J No
(c) If any at the aoove operations ever occurred at the site, the Offaror certifies that appropriate cleanup or cthar action (j was,
was not performed in accorcanca with the local, state and Federal la s.
14. RADON CERT1FiCATION Initials" v �" 6
(b) The highest radon level measured was
(c) The measurement method used was
Radon Measuring: At the request of the
Government and based upon reasonable
grounds, Lessor will, at its expense,
measure the leased premises for radon and
provide the results thereof to the
Government.
15. 52.223 - CcRTIFiCATION REGARDING A DRUG -FREE WORKPLACE (.:UL 1990)
(a) Definitions. As used in this provision, "Controlled substance means a cortrolled substance in schedules I through V of se ~:c
202 at the Controlled Substances Act (21 U.S.C. 812) and as further defined in regulation at 21 CFR 1308.11 - 1308.15.
"Conviction" means a finding of guilt (including a plea of nolo contenders) or imposition of sentence, or both, by any judicial 'cc:/
charged with the responsibility to determine violations of the Federal or State criminal drug statutes.
"Criminal drug statutes" means a Federal or non - Federal criminal statute involving the manufacture, distribution• dispensing,
possession or use of any controlled substance.
Drug -fres WCIr place' mears the sit-a(s) for the performance of wor:< done by the Contractor in connacticn with a specific cents-_-
at which ampicyses of the Contractor are prohibited from engaging in the unlawful manufacture, distribution, dispers:-g, pcssessc•-.
use of a controiled substance.
"Employee" means an employee of a Contractor directly engaged in the performance of work under a Government contract.
Directly engaged is defined to include all direct cost employees and any other Contractor employee who has other than a minimal
impact or involvement in contract performance.
"Individual" means an Offeror /contractor that has no more than one employee including the Offeror /contractor.
(b) By submission of its offer, the Offeror, if other than an individual, who is making an offer that equals or exceeds 525.000,
cenifies and agrees that, with respect to all employees of the Offeror to be employed under a contract resulting from this solicitation,
that, no later than 30 calendar days after contract award (unless a longer period is agreed to in writing), for contracts of 30 calendar as ./s
or more performance duration, or as soon as possible, for contracts of less than 30 calendar days performance duration, but in any
case, by a date prior to when performance is expected to be completed, it will -
IN71ALS: a
eS r
,-C.% G - ,CU 14 1A =11 7= = r:C/ 2 =?
(1) Publish a :statement � ioti its errP;oy'ays that the uniawfu! manufacture distribution, dis a ,sing, possession, o use el h
controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for
violations of such prohibition;
(2) Establish an ongoing drug -free awareness program to inform such employees about -
i) The dangers of drug abuse in the workplace;
ii) The contractor's policy of maintaining drug -free workplace:
iii) Any available drug counseling, rehabilitation, and employee assistance programs; and
iv) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace.
(3) Provide all employees engaged in performance of the contract with a copy of a statement required by subparagraph (b)(1)
of this clause;
(4) Notify such employees in writing in the statement required by subparagraph (b)(1) of this provision that, as a condition cf
continued employment on the contract resulting from this solicitation, the employee will -
I) Abide by the terms of the statement; and
ii) Notify the employer in writing of the employee's conviction under a criminal drug statute for a violation occurring in the
workplace Jaw than 5 calendar days after such conviction;
(5) Notify the contracting officer in writing within 10 calendar days after receiving notice under subdivision (b)(4)(i) of this
provision, from an employee or otnerwise receiving actual notice of such conviction. The notice shall include the position and title cf :-a
employee; and
(6) Within 30 calendar days after receiving notice under subdivision (b)(4)(ii) of this provision of a conviction, take cne cf the
following actions with respect to any employee who is convicted of a drug abuse violation occurring in the workplace:
� i) Taking appropriate personnel action against such employee, up to and including termination; or
ii) Require such employee to satisfactorily participate in a drug abuse assistance or rehabilitation program approved for
such purposes by a Federal, State, or local health law enforcement, or other appropriate agency.
(7) Make a good faith effort to maintain a drug -free workplace through implementation of subparagraph (b)(1) through (b)(6)
of this clause.
(c) By submission of its off ar, the Off aror, if an individual who is making an offar of any dollar value, certifies and acrees that the
Offeror will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in the
performance of this contract resulting from this solicitation.
(d) Failure of the Offarer to provide the certification required by paragraph (b) or (c) of this provision, renders the O arcr
unqualified and ineligible for award. (See FAR 9.104 -1(g) and 19.602- 1(a)(2)(D.)
(e) In addition to other remedies available to the Government, the certification in paragraphs (b) or (c) of this provision concerns
mater within the jurisdiction of an agency of the Un:ted States and the making of a false. fictitious, or fraudulert cert:ficarcn may rar__
i %a Subject :o prcsacut= under i tie 18, United S tates Coce, Sacticn IG01.
16. 52.204 -3 TAXPAYER IDENTIFICATION (SEP 1989) (VARIATION)
(a) The Offeror is required tc submit taxpayer identification information in order to comply with reporting requiraments of 26 U.S.
6041, 6041A, and 6050M and implementing regulations issued by the Internal Revenue Service (IRS). Failure or refusal by the Offeror:
furnish the information may result in a 20 percent reduction of payments otherwise due under the contract. Taxpayer information on t-=
payee, if different from the offeror, is also required: however, it may be provided at the time of award.
(b) Offeror's Taxpayer Identification Number (TIN).
( J TIN: RA— Annn6 5 . ( ] TIN has been acclied for. ( ] TIN is not required.
(c) Corporate Status.
(] Corporation; [ ] Not a corporate entity; (j Sole propristors„ip [ ] Partnership bd Political subdivision of .
the State of Colorado
(d) Common Parent.
"Common parent,' as used in this solicitation provision, means that corporate entity that owns or controls an affiliated group of
corporations that files its Federal income tax returns on a consolidated basis, and of which the Offeror is a member.
[ Offeror is not owned or controlled by a common parent.
[ Name and TIN of common parent: Name TIN
INf i IAIS: u
essor ove ant GSA FCF.M 25 19 PAGE 3 (rc•/ ?. =:
(a) Payee's Taxpayer Identification Number.
[ ] TIN: . [ ] TIN has bee, applied for. [ ] TIN is not required.
17. OFFEROR'S CONTRACTOR ESTABUSNMENT CODE (MAR 1992)
Enter number, if known:
OFFEROR OR
AUTHORIZED
REPRESENTATIVE
Name and Address (Including ZIP Code)
City of Pueblo
Pueblo Memorial Airport
31201 Bryan Circle
Pueblo, CO 81001
Telephone No.
719 - 948 -3355
4/2 /95
gnature Christian Weaver, President of City Council Date
INITIALS: &
ssor Quern
l
GSA FORM' —"'18 PAGE 7 fRE`/ 8.52