Office Space Lease Specifications Questionnaire - Free Download | Page 2
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OFFICE SPACE LEASE SPECIFICATIONS QUESTIONNAIRE
Page 2 of 2
Site Name:
14. Will an uninterruptible power supply (UPS) be provided by the lessor [ ] Yes [ ] No
If Yes, list equipment to be connected to the UPS system:
15. Are separate meters necessary for electrical or other utility requirements [ ] Yes [ ] No
16. Do you require a computer equipment room [ ] Yes [ ] No
If Yes, answer the following questions:
A. Approximate size of room:
sqft.
B. What live load should the floor support lbs/sqft.
C. What are the maximum and minimum temperatures required Max:
Min:
D. What are the maximum and minimum humidity ranges required Max: Min:
E. Will these environmental conditions be required 24 hours a day [ ] Yes [ ] No
F. Are cable runs to remote terminals required [ ] Yes [ ] No
G. Does this room require a telephone outlet or special telephone line [ ] Yes [ ] No
H. How many people will normally be present in this room
On a separate piece of paper, list each piece of equipment to be located in the computer equipment room. Include
operating BTUs of heat output and complete electrical requirements of each item.
17. List any additional special requirements (continue on separate sheet if necessary):
18. Please list any comments concerning the current lessor, services provided, and lease terms (continue on separate
sheet if necessary):
19. If this is a continuing requirement for space already occupied, provide cost estimate for relocating operations. This
cost estimate should be itemized (i.e. moving, cabling, etc.):
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
CERTIFICATION OF FUNDS AVAILABLE
I have reviewed the information contained in this request for space in view of the Balanced Budget and Emergency Deficit
Control Act of 1985 (Gramm-Rudman-Hollings). I certify that I have considered the impact of the Act and that agency
funds are available.
Accounting Information:
Typed Name of Agency Certifying Official:
Signature of Certifying Official Date
Form Updated 02/04
