Exhibit G GSA 1217 Operation Cost

Exhibit G

FOR OFFERS

GENERAL SERVICES ADMINISTRATION 1. SOLICITATION

36C24724R0011

PUBLIC BUILDING SERVICE

LESSOR'S ANNUAL COST STATEMENT

IMPORTANT - Read attached "Instructions"

2. STATEMENT DATE

3. RENTAL AREA (SQ. FT.) 3A. ENTIRE BUILDING

3B. LEASED BY GOV'T

23,521

4. BUILDING NAME AND ADDRESS (No., street, city, state, and zip code)

SECTION I - ESTIMATED ANNUAL COST OF SERVICES AND UTILITIES

FURNISHED BY LESSOR AS PART OF RENTAL CONSIDERATION

FOR GOVERNMENT

USE ONLY

LESSOR'S ANNUAL COST FOR

SERVICES AND UTILITIES

(a) ENTIRE BUILDING

(b) GOV'T-LEASED AREA

A. CLEANING, JANITOR AND/OR CHAR SERVICE

5. SALARIES

6. SUPPLIES (Wax, cleaners, cloths, etc.)

7. CONTRACT SERVICES (Window washing, waste and snow removal)

B. HEATING

8. SALARIES

9. FUEL

GAS

OIL

("X" one)

COAL

ELECTRIC

10. SYSTEM MAINTENANCE AND REPAIR

C. ELECTRICAL

11. CURRENT FOR LIGHT AND POWER (Including elevators)

12. REPLACEMENT OF BULBS, TUBES, STARTERS

13. POWER FOR SPECIAL EQUIPMENT

14. SYSTEM MAINTENANCE AND REPAIR (Ballasts, fixtures, etc.)

D. PLUMBING

15. WATER (For all purposes) (Include sewage charges)
16. SUPPLIES (Soap, towels, tissues not in 6 above)

17. SYSTEM MAINTENANCE AND REPAIR

E. AIR CONDITIONING

18. UTILITIES (Include electricity, if not in C11)

19. SYSTEM MAINTENANCE AND REPAIR

F. ELEVATORS

20. SALARIES (Operators, starters, etc.)

21. SYSTEM MAINTENANCE AND REPAIR

G. MISCELLANEOUS

(To the extent not included above)

22. BUILDING ENGINEER AND/OR MANAGER

23. SECURITY (Watchmen, guards, not janitors)

24. SOCIAL SECURITY TAX AND WORKMEN'S COMPENSATION INS.

25. LAWN AND LANDSCAPING MAINTENANCE

26. OTHER (Explain on separate sheet)

27. TOTAL

SECTION II - ESTIMATED ANNUAL COST OF OWNERSHIP EXCLUSIVE OF CAPITAL CHARGES

28. REAL ESTATE TAXES

29. INSURANCE (Hazard, liability, etc.)

30. BUILDING MAINTENANCE AND RESERVES FOR REPLACEMENT

31. LEASE COMMISSION

32. MANAGEMENT

33. TOTAL

LESSOR'S CERTIFICATION - The amounts entered in Columns (a) and (b) represent my best estimate as to the annual costs of services, utilities, and ownership.

34. SIGNATURE OF

TYPED NAME AND TITLE

OWNER

LEGAL AGENT

SIGNATURE

DATE

34A.

34B.

34C.

35A.

35B.

35C.

GENERAL SERVICES ADMINISTRATION

GSA FORM 1217 (REV. 7-94)

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 revailing scales in the community for facilities.

ITEM NUMBER

1.

Enter the Government lease or Solicitation for
Offers number, if available.

2.

Enter the date that your statement was