Attachment J

PRELEASE FIRE PROTECTION AND

LIFE SAFETY EVALUATION

FOR AN OFFICE BUILDING

The prelease form contains two parts that must be completed depending on which floor the proposed offered space is located within a building. Part A must be completed when an offered space is located below the 6th floor of a building. Part A shall be completed by the Offeror or their authorized representative. Part B must be completed when an offered space is located on or above the 6th floor of a building. Part B shall be completed by a professional engineer. The Fundamental Code Requirements apply to Part A and Part B.

a. The offered building shall be evaluated for compliance with the most recent edition of the building and fire code adopted by the jurisdiction in which the building is located; with the exception that the technical egress requirements of the building shall be evaluated based on the egress requirements of the most recent edition of the National Fire Protection Association (NFPA) 101, Life Safety Code. (Note: a building with a Certificate of Occupancy indicating that a building fully complies with the International Building Code shall be deemed to comply with this requirement.) All areas that do not meet the above stated criteria shall be identified as to the extent that they do comply.

b. A fire escape located on the floor(s) where the offered space is located shall not be counted as an approved exit stair.

c. An interlocking or scissor stair located on the floor(s) where the offered space is located shall only count as one exit stair.

d. The number of floors used to determine when Part A or Part B is applicable is based on counting the number of floors starting from the street floor.

GENERAL SERVICES ADMINISTRATION

GSA 12000 (REV. 5/2011)

PART A

The Offeror or their representative shall complete Part A. Part A consists of a series of short answer and yes/no/not applicable questions related to general building information and fire protection and life safety systems. Upon completion of Part A, the Offeror must sign and date the “Offeror’s Statement.” Part A is applicable to offered space located below the 6th floor of the building.

I. Building Address

Building Name:
Building Address:
State:

City:

9-Digit Zip Code:

II. General Building Information
a. Identify each floor on which space is offered and the square footage of space on each floor offered to Government: Floor
Square Feet Per Floor
b. Identify the total number of floors in the building starting at the street floor: