Subject: 

U.S. DEPARTMENT OF THE INTERIOR 

OFFICE OF SURFACE MINING 

RECLAMATION AND ENFORCEMENT 

DIRECTIVES SYSTEM 

Management of Leased Space ' I .~ \ I 

Title: Acting Director 

Subject Number: 

ADS -13 

Transmittal Number: 

893 

Date: i I 1 

1" I , 

1. Purpose. This dire<;!iye establishes policy and procedures for the acquisition and management of leased 

space by Field Unit and Headquarters Managers. This directive supplements 425 DM 1-1, Real 

Property and Space Management, and supersedes Directive ADS-13, dated December 2, 1993. Please 

note: 425 DM 1-1 is currently under revision. Once the DM is released, OSM will update this 

Directive if necessary. 

2. Summary of Changes. This directive reflects updates in the OSM organizational structure and new 

policy, based on the General Services Administration (GSA) New Pricing Policy effective in Fiscal Year 

2000. To facilitate the use of this directive, two distinct matrices were created to list the procedures 

and responsibilities for requesting and relinquishing space, or extending a lease for the OSM field and 

Headquarters installations. In addition, a list of terms is identified below, under Section 3. Definitions, 

for use in managing OSM leased space. It includes new terms which are referenced in GSA's New 

Pricing Policy. The title was also changed to reflect the management of all leased space. 

3. Definitions. 

a. Above Standard Alterations. Refers to alterations beyond what is necessary to prepare an agency's 

space to meet a particular classification (e.g., office, storage, or special) and permit occupancy. 

b. Agency-controlled Space. Refers to Federally-owned, leased, or controlled space acquired or used by 

Federal agencies under any authority other than the Federal Property and Administrative Services Act 

of 1949, as amended. It also includes space for which authorities for acquisition, use, or disposal have 

been delegated to an agency by GSA, such as the OSM Headquarters space which is leased from the 

Department of the Interior. 

c. Federal Propertv Management Regulations (FPMR), 41 CFR Pertains to the management of defense 

material, public buildings and space, supply and procurement, public utilities, transportation, utilization 

and disposal of property, and other programs and activities of the GSA which relate to Federal agencies 

and the public. FPMRs are issued by the GSA Administrator pursuant to the provisions of the Federal 

Property and Administrative Services Act of 1949,63 STAT. 377, as amended, or other applicable law. 

d. General-use Space. Effective in FY 2000, GSA uses this term to refer to office space, special and 

office storage. It also includes space of mission needs such as reception areas and circulation space; 

hearing, meeting, and interview areas; file areas; processing areas; and library and reference areas. 

OSM/103 7/22186 
e. GSA-controlled Space. Refers to space assigned to an agency by GSA by authority of 

the Federal Property and Administrative Services Act of I 949, as amended, or by authority 

of any other statute. It includes any space for which any agency pays GSA directly. 

f. Occupancy Agreement COA). Formal agreement which describes the business terms 

including the financial specifics and responsibilities governing the relationship between 

GSA and the customer agency for a given space assignment. The OA also recognizes that a 

tenant agency has a right of occupancy for a specified duration. The OA is not a lease, nor 

is it a document, for detailing building rules and regulations. 

g. Occupiable Area. Refers to that portion of the gross area which is available for use by 

an occupant's personnel or furnishings, including space which is available jointly to the 

various occupants of the buildings, such as auditoriums, health units, and snack bars. 

Occupiable area does not include that space in the building which is devoted to its 

operations and maintenance, including craft shops, gear rooms, and building supply storage 

and issue rooms. 

h. Parking. A GSA classification of space which is measured by parking space rather than 

square footage and is denoted as surface or structured. 

i. Pricing Structure (GSA's). Effective in FY 2000, GSA will convert all existing 

assignments, government-owned or leased, to a new pricing structure. The new pricing 

structure is as follows: 

1. Leased space: All rent bills are based on the cost of the lease to GSA. In 

addition to the lease's cost, an agency's rent includes the costs of services not 

included in the lease, security, and a GSA fee for the services provided. 

2. Government-owned space: The rent rates are based on a 5-year fixed rate for 

base rent and annual escalation of operating costs and taxes. 

3. All buildings: New pricing for security applies. There will be three line items 

for security: the basic charge ($0.16 per square feet applies to all buildings with 

Federal Protective Services responsibility); building specific operating cost, and 

building specific amortization of capital. Other features or benefits may also be 

included. 

J. Reimbursable Work Authorization Form (Standard Form -2957). Form used to request 

services to be rendered by GSA. 

k. Shell Rent. For leased space, shell rent is the portion of the overall rent that GSA pays 

to the lessor for the unfinished shell of the space before it is tailored to meet the tenant's 

specific workplace needs. The shell rent is derived by deducting the tenant's improvement 

amortization, services, and taxes from GSA's overall cost for the space. For Governmentowned space, shell rent is based on independent appraisals conducted by professional 

appraisers. 

2 
I. Short-term Use Space. Refers to an agency's need for facilities for short-term use, such 

as conferences, meetings, and storage, judicial proceedings or emergency situations. 

Payment of the short-term use space is the responsibility of the office making the request. 

m. Space Utilization. The manner and the degree of efficiency in which Governmentowned and -leased facilities are occupied. (See Standard Utilization Rate below.) 

n. Standard Form SF- 81. Form which may be used to request space. Its use is optional. 

o .. Standard Form SF- 81A. Form which may be used to identify space requirements. Its 

use is optional. 

p. Standard Level User Charges. Refers to the rate charged for assigned space in 

Government-owned or -leased property for which GSA has assignment responsibility. The 

user charge approximates commercial charges for comparable space and services. 

q. Standard Utilization Rate. Refers to the average amount of space used per person. A 

current average utilization rate used per person is 125 occupiable square feet, in addition to 

22 percent for support space. (See Space Utilization above.) 

r. Storage Space. Refers to space consisting of concrete, wood block or unfinished floors, 

bare block or brick interior. General storage area may include, basements, attics, closets, 

supply rooms, storerooms, inside parking and others. 

s. Reimbursable Work Authorization Form (Standard Form- 2957). Form used to request 

services to be rendered by GSA. 

t. Warehouse. A GSA classification of space which applies to properties for which storage 

is the predominant use (70% or more). 

4. Policy/Procedures. 

a. Concept. The goals of the Management of Leased Space are to provide suitable office 

space for all OSM employees and provide for a professional workplace environment, 

while achieving cost-effective space utilization in compliance with the current FPMR. 

The standard utilization rate is used as a basis for acquiring space. 

b. Policy. The OSM policy for managing leased space is derived from the following 

authorities and sources: 

(I) 41 CFR 101-17.101 Public Contracts and Property Management, July I, 1999; 

(2) 425 DM 1-1, Real Property and Space Management dated August I 0, 1994; 

and 

3 
(3) Administrative memoranda, directives, and documents of a permanent or 

temporary nature pursuant to the above authorities. 

c. Scope. The Management of Leased Space directive applies to all short-term use 

space, permanent and temporary leased space acquired for official purposes by GSA, 

the Department of the Interior (DOl) or OSM through interagency agreements. 

d. Organization. The Management of Leased Space Program is established in the Office 

of the Assistant Director, Finance and Administration, under the Chief, Office of 

Administration. The purpose of the Management of Leased Space Program is to 

ensure adherence with the guidelines set forth by GSA and any other policy direction 

provided for by DOL 

e. Use of this document. 

!. Two matrices. Two distinct matrices are listed below: one is, GSA Controlled 

Space, and the other is Agency (DOl) Controlled Space, as the acquisition and 

management of leased space for each differs slightly. For GSA controlled 

space, which is the space used by the field installations, OSM deals directly with 

GSA; for Headquarters space, which is an agency controlled space and is part of 

the "Interior Department Complex", OSM deals with the DOL 

2.. Identification of management responsibility. To identifY the management level 

responsible for the topics related to requests for extension of a lease, new office 

space, alterations, short-term use space, or review of rental charges, first locate 

the subject on the matrix. The box marked with an "X" and/or an acronym 

shows who has the responsibility within the organization. Acronyms used are: 

AD 

COA 

DC 

FOD 

HOA 

AOU 

RD 

MLS 

= 

= 

= 

= 

= 

Assistant Director 

Chief, Office of Administration 

Division Chief 

Field Office Director. Delegation has been extended to the 

Administrative Officer or Office Manager. 

Headquarters Office of Administration 

Chief, Administrative Operations Unit, Office of 

Administration 

Regional Director 

Headquarters Manager of Leased Space 

f. Responsibilities/Procedures. For easy reference, the areas of responsibilities and 

procedures for users of GSA and DOl leased space are listed separately in the 

following matrices. 

4 
(I) For GSA Controlled Space- OSM Field Installations 

AREAS OF RESPONSIBILITIES/Procedures RD/ HOA 

FOD/ 

DC 

I. Extension of Lease. 

The Request for Space Form (SF- 81) and the Space Requirements 

Worksheet (SF- 81A) may be used The use of these forms is 

determined by the local GSA office. When the SF-81 and 81A are 

not required, a memorandum may be used to reflect the field 

installation's plans concerning the extension of the lease. 

The respective Regional/Assistant Director will be kept abreast of 

the field installation's plans concerning the extension of the lease. 

a. Usually 18 months prior to termination of a lease, GSA will X 

contact OSM, (either the field installation or the Headquarters 

Manager of Leased Space) to determine whether OSM will 

remain at the site. 

The OSM field installation will notify their intent to renew the 

lease, or to relocate at a different site. Within 10 calendar 

days, the field installation will forward to the Office of 

Administration a justification to support their intent, including 

applicable information regarding their space needs. 

b. Discussion with GSA is initiated within 5 calendar days of MLS 

receipt of notice from the field installation. A written response COA 

to GSA will be completed within 10 calendar days of receipt 

of notice from the field installation. 

5 
(1) For GSA Controlled Space - OSM Field Installations 

AREAS OF RESPONSIBILITIES/Procedures RD/ HOA 

FOD/ 

DC 

2. Reguests for Space. 

The need for space is identified by the field installation requesting 

the space. A request for space will include a justification for space 

utilization, including the type of space, amount of space needed, 

and purpose for use of space. The Standard Utilization Rate is 

used as a reference when requesting space. 

The Request for Space Form (SF- 81) and the Space Requirements 

Worksheet (SF- 81A) may be used The use of these forms is 

determined by the local GSA office. When the SF-81 and 81A are 

not required, a memorandum may be used to reflect the field 

installation's plans concerning the extension of the lease. 

The respective Regional/Assistant Director will be kept abreast of 

the field installation's request for space. 

a. Originates. X 

The field installation will forward to the Office of 

Administration a justification to support the request for space. 

b. Concurs within 10 calendar days of receipt of request. The COA 

request for space is reviewed to determine whether the need 

for space is justifiable and that funds are available to procure 

space. 

c. Negotiates with GSA for the acquisition of space. MLS 

d. Delegates authority to a field installation to enter into direct COA 

negotiations with GSA, on a case by case basis, where direct 

negotiations between a field installation and GSA may be 

advantageous to the agency. 

6 
(I) For GSA Controlled Space - OSM Field Installations 

AREAS OF RESPONSIBILITIES/Procedures RD/ HOA 

FOD/ 

DC 

3. Repairs or Alterations. Requests for repairs or alterations to 

occupied space and/or above standard alterations for occupied space 

or a new space acquisition. As deemed necessary, the respective 

Regional/ Assistant Director will be kept abreast of the field 

installation's plans related to space alterations. 

Field Installations CGSA leased SQace/: Use the Reimbursable Work 

Authorization (RWA) form. Appendix C provides instructions on 

use of this form. 

a. Originates with the unit within the field installation X 

responsible for space and the facility management. 

b. Approves (References below concerning the levels of 

authorities are consistent with OPM-5, OSM Directive on 

Delegation of Authority.) 

I. When the estimated cost of the work does not exceed the X 

dollar amount the RD, FODor Division Chief is 

authorized to approve. 

Once approved, it is forwarded to GSA by the requesting 

office. Also, a copy of the RWA is sent to the OSM's 

Manager of Leased Space for inclusion in the specific 

site folder. 

2. When the estimated cost of the work exceeds the dollar COA 

amount the RD, FOD or Division Chief is authorized to 

approve, the R W A is forwarded to the Office of 

Administration for approval. This approval serves to 

concur that the commitment of funds is a reasonable 

investment. 

Once the R W A is approved by the COA, it is sent to 

GSA. A copy of the RWA is retained by the OSM 

Manager of Leased Space and a copy is sent to the 

respective field installation for inclusion in the specific 

site folder. 

7 
(1) For GSA Controlled Space- OSM Field Installations 

AREAS OF RESPONSIBILITIES/Procedures RD/ HOA 

FOD/ 

DC 

4. Relinquishing space. The Management of Leased Space program 

promotes efficient space utilization. Space for which there is no 

current foreseeable need will be relinquished. 

The respective Regional/Assistant Director will be kept abreast of 

the field installation's plans concerning relinquishing space. 

a. Originates. The field installation projecting excess space will 

inform the Office of Administration of the intent to release the 

space. Notice must be in writing. 

I. Inform OSM Manager of Leased Space within 10 X 

calendar days prior to the 120 calendar day notice 

required by GSA for relinquishing space. 

2. Provide GSA within 10 calendar days a notice for MLS 

relinquishing space. Notice must be in writing. 

b. Monitors assignment of relinquished space for accurate rental MLS 

charges on a monthly basis. 

5. Rental charges. 

a. Distributes rent bills to field installations upon receipt from MLS 

GSA. 

b. Certifies accuracy of the bill, square footage, classification of X 

space, and rent charges within 14 calendar days. 

c. Reports to the OSM Manager of Leased Space inaccuracies on X 

the bill and corresponding support documentation within 14 

calendar days. . 

d. Reports to GSA and HOA inaccuracies on the bill, provides X 

supporting documentation, and monitors assignment until 

corrections are made within 14 calendar days. 

e. Certifies payment of GSA bill to OSM's finance office MLS 

(Division of Debt Management) within 21 calendar days. 

8 
(1) For GSA Controlled Space- OSM Field Installations 

AREAS OF RESPONSIBILITIES/Procedures RD/ HOA 

FOD/ 

DC 

6. Short-term use space. When needed, the Manager of Leased Space 

will assist the requesting office in locating and acquiring privately 

owned space. 

a. Requests for conference, meeting, hearing, and/or training X 

room. 

b. Requests for storage room. 

1. Prepares written justification detailing the need and X 

period of time the requested space will be occupied. 

2. Concurs with request for storage space. COA 

3. Forwards request to GSA. If GSA is unable to locate MLS 

Government-controlled facilities, OSM may arrange for 

the use of privately owned facilities for a period not to 

exceed 180 days. 

4. Obtains extension beyond 180 days from GSA, if MLS 

needed. 

9 
(2) For Agency (DOl) Controlled Space - Headquarters 

AREAS OF RESPONSIBILITIES/Procedures AD/ HOA 

DC 

1. Extension of Lease. 

a. Usually 18 months prior to termination of a lease, the AOU 

Department will contact OSM to determine whether OSM will 

remain at the site. OSM notifies the Department of the intent to 

renew the lease, or to relocate at a different site. 

b. Discussion with the Department is initiated within 5 calendar AOU 

days of receipt of notice. A written response to the Department 

is completed within I 0 calendar days of receipt of notice. 

2. Requests for Space. 

The need for space is identified by the Directorate needing the space. 

The request will be submitted to the Chief, Administrative Operations 

Unit, Office of Administration. A request for space will include a 

justification for space utilization, including the type of space, amount 

of space needed, and purpose for use of space. The Standard 

Utilization Rate is used as a reference when requesting space. 

a. Originates. Request to be submitted to the Chief, Administrative X 

Operations Unit, Office of Administration. 

b. Concurs within I 0 days of receipt of request. The request for COA 

space is reviewed to determine whether the need for space is 

justifiable and that funds are available to procure space. 

c. Negotiates with the Department for the acquisition of space. AOU 

3. Regairs or Alterations. Requests for repairs or alterations to occupied 

space and/or above standard alterations for occupied space or a new 

space acquisition. 

Headquarters: Use the Department of Interior Requisition form 

(FormDI-1) 

a. Originates with the unit responsible for space and facility AOU 

management. 

b. Approves (Reference is consistent with OPM-5, OSM Directive 

on Delegation of Authority.) 

10 
(2) For Agency (DOl) Controlled Space - Headquarters 

AREAS OF RESPONSIBILITIES/Procedures AD/ HOA 

DC 

1. When the estimated cost of the work does not exceed the AOU 

dollar amount the AOU is authorized to approve. 

2. Once the AOU approves the request, it is sent directly to AOU 

the Department by the AOU. 

3. When the estimated cost of the work exceeds the dollar COA 

amount the AOU is authorized to approve. 

4. Once the DI-1 is approved by the COA, it is sent to the AOU 

Department's Facility Manager. 

4. Relinquishing space. The Management of Leased Space program 

promotes efficient space utilization. Space for which there is no 

current foreseeable need will be relinquished. 

a. Originates. The program office projecting excess space will 

inform the Chief, Administrative Operations Unit, Office of 

Administration, of the intent to release the space. 

I. Inform Chief, Office of Administration within 10 calendar AOU 

days prior to the 120 calendar day notice required by the 

Department for relinquishing space. 

2. Provide the Department a 120-calendar day notice for AOU 

relinquishing space. Notice must be in writing. 

b. Monitors assignment of relinquished space for accurate rental MLS 

charges. 

5. Rental charges. 

a. Distributes a rent bill to Chief, Administrative Operations Unit, MLS 

Office of Administration upon receipt from DO I. 

b. Certifies accuracy of the bill, square footage, classification of AOU 

space, and rent charges within 14 calendar days. 

11 
AREAS OF RESPONSIBILITIES/Procedures AD/ 

DC 

c. Reports to the OSM Manager of Leased Space inaccuracies on 

the bill and corresponding support documentation within 14 

calendar days. 

d. Reports to the Department and MLS inaccuracies on the bill, 

provide supporting documentation, and monitor assignment until 

corrections are made within 14 calendar days. 

e. Certifies payment of Department's bill to OSM's finance office 

(Division of Debt Management) within 21 calendar days. 

6. Short-term use space. The Chief, Administrative Operations Unit, 

Office of Administration will assist the requesting office in locating 

and acquiring privately owned space. 

a. Obtain conference, meeting, hearing, and/or training room. 

b. Requests for storage room. 

I. Prepares written justification detailing the need and period 

of time the requested space will be occupied 

2. Concurs with request for storage space. 

3. Forwards request to the Department or to GSA. If the 

Department or GSA is unable to locate Governmentcontrolled facilities, OSM may arrange for the use of 

privately owned facilities for a period not to exceed 180 

days. 

4. Obtains extension beyond 180 days from GSA, if needed. 

5. Reporting Requirements. As required. 

6. Effect On Other Documents. Supersedes OSM Directive ADS-13, Office Space 

Management, dated December 2, 1993. 

7. References. 

41 CFR 101-17.101 Public Contracts and Property Management, July 1, 1999. 

425 DM 1-1 Real Property and Space Management dated August I 0, 1994. 

OSM Directive OPM-5, Delegations of Authority dated May 29, !997. 

8. Effective Date. Upon issuance. 

12 

HOA 

AOU 

AOU 

MLS 

AOU 

AOU 

COA 

AOU 

AOU 
9. Contact. Manager of Leased Space, Office of Administration, 202-208-2961 

10. Keywords. Office Space, Special Space, and Space Utilization 

11. Appendices. 

APPENDIXAAPPENDIXBAPPENDIXCStandard Form 81 

Standard Forms 81 - A 

Reimbursable Work Authorization (RWA) Form 2957 and 

instructions for completing R W A 

APPENDIX D- Department oflnterior (DO I) Requisition Form DI-1 (Instructions for 

completing the DI-1 appear on the form.) 

13 
REQUEST FOR SPACE 

(See instructions on reverse) 

TO: 

CONTINUING REQUIREMENTS 

14. AGENCY CERTIFICATION 

certify that this request is accurate and complete; is for the minimum amount 

required; is in compliance with FPMR 101-17, including all laws and executi• 

governing the location of space; and that funds are available for payment . 

moving expenses, telecommunication expenses, and any related reimbursab 

15. FOR GSA USE ONLY 

(Action by Authorized GSA Official) 

GOV'T CONTROLLED SPACE TO BE ASSIGNED 

NO GOV'T SPACE AVAILABLE LEASING ACTION PLANNED 

UNIQUE AGENCY SPACE DETERMINED- SEE A IT ACHED 

AGENCY AUTHORIZED TO ACQUIRE SPACE UNDER ITS OWN AUTHORITY 1;; 

"' "' 13 

H 

:>< 

> 
INSTRUCTIONS 

Subm~tlnq the SF-81 

Submll the SF -81 in triplicate, accompanied by a completed SF -81 A, Space Requirements Worksheet, Space Requirements 

Questionnaire and any additional documentation to fully support the agency's space needs. Failure to provide complete and accurate 

information will delay processing and may result in return of the SF-81 for correction, update, and resubmission. 

The SF-81 must be submilted by the office which has authorlly to obligate funds to reimburse GSA for all applicable costs associated 

with the delivery of space. Agency field components which do not have delegated authority to obligate funds must coordinate 

submission and approval of the SF-81 with offices which have this authority. A GSA Form 2957, Reimbursable Work: Authorizalion, 

should be submitted when applicable. 

ttem 1. Date form is prepared. 

ttem 2. Agency established request number. 

ttem 3. Name and phone number of the local agency official who is k:noy.-ledgeable of the request and will serve as the agency's 

point of contact for this project. 

rtem 4. Name and phone number of agency representative who will work: with GSA if a market survey is conducted. This individual 

must h,we the authority to determine acceptability of the building and/or sites and their location. 

ttem 5. GSA regional office which has jurisdiclion for geographical area where space is required. 

Item 6. Name and address of organization making the request. 

ttem 7. Name of agency, and bureau code of the organization which will occupy the space (e.g. regional office, district office, field 

office) if different than information provided in block: 6. City and state where the space is requested. 

ttem 8. Type of request. ~ A request for new space that is not associated with an existing assignment. Expansion: A request for 

additional space associated with an existing assignment. Continuing requirements: A space action requ1red tor a lease renewal, 

succeeding lease, lease extension or move. Reduction: A space act1on that requires regional Real Estate Division effort to 

effect the parlial or !olaf termination of an assignment. 

ttems 9a. and b. Geographic/Delineated area that the agency Will s~rvice. The geographic area (State, city, county, ZiP code, etc.) for 

wh1cl'l an agency/bureau has operatiOnal responSibility as wen as the spec1f1c delineated area as 1den11f1ed and justified by the 

requesting agency. GSA re\·iew of the delineated area shafl be limited to ensuring that the delineated area will provide 

adequate competition and the maximum use of existing Government controlled space (see Item 14 Agency Cenifica!ionl. 

ttem 10. Period of time the organization will use the space and the suggested number of years for a firm term period. This time 

period mu:t be representative of the longest period for which the agency can commit. "Indefinite" and "ASAP" are not 

accepta'Jfe responses. 

ttem 11. Total number of personnel to occupy the requested space. ("Personnel" means the peak number of persons to be housed, 

regardless of how many worksta1ions are provided for them. In addition to permanent employees of the agency, personnel 

incf,Jdes temporar\es, part-time, seasonal, contractual employees and budgeted vacancies.) 

ttem 12. This pcrlion of the SF-81 is used to identify agency's square footage requirements by type of space. Art information should 

be supported by a detailed exptana!ion on the Space Requirements Questionnaire and SF -81 A. 

~lt'-'e"-m"--'1-'2"--',ll";nc;•'r;;•C'-· This. fine identifies the Office Space Subtotal. The - space reqv1red for the primary office i!rea and adding 

"Prim~ry Office Area" is the primary people occupied area in 

Office Space Subtotal is determined 

this to the amount required for 

which an ac!ivl!y's normal operational 

by entering the amount of 

tl'le office support area. 

functions are performed. 

'"Office Support Area" refers to the areas consrructed as office space and used to meet needs outside the agency's primary 

work area requirements ( e.g. recept'lon, conference, fife, libraries, hearing, interview, and secondary work areas). Office 

support ~reas should be clearly identified on the attached SF-81A and Space Requirements Questionnaire. 

l!ne: b c. Amount of general and warehouse storage space required. (See Hem 12, line o for ST 2 inside parking). 

==--'=-l"ln"'•=--"-'d. Total amount of storage space required (add lines b and c). 

Item 12 

Item 12 

Item 12 lines e-!c. Amount of special space required. 

'-'-'"'-'--'-"'--l"b"o"--"1. ttem 12 Total amount of special space required (add fines e through k). 

"-'"'-'--'""-'-"lln'-"'o--"m"'-. Total amount of Office, Storage and Special space required. (add lines a, d, and 1). 

"-'"'-'--'-"-'--1'-'i!.!n::•--'-'.n. Total acres needed. For amounts less than 1 acre, 1 acre equals 43,560 square feet. 

Item 12 

~em 12 

"-'"'-'-'-"-'-'l"ln"'•e,..,_,.o';,,-!P~· Agency's inside and outside parking requirement. Certification that the parking is necessary for the efficient 

operat1on of the agency mission is required. One parking space equals 300 square feet. Please indicate the number of 

~em 12, 

spaces. 

ttem 12, line g. Total parking spaces required. (Add lines o and p). 

ttem 13. This Hem refers lo the specific architectural, mechanical, electrical, structural, and other special requirements related 10 each 

of the types of space requested in Item 12. These include security; electrical; HVAC; floor loading; sound conditioning; fire 

and safety; and the need for after hours building access, ulilities, and cleaning services. Such requirements must be fully 

defined by area, including computer rooms, laboratories, conference rooms, etc., These requirements must be specified in 

detail on the Space Requirements Questionnaire and SF-81A. Check: box in !lam 13 to indicare if this information is 

attached. 

Agency Certification 

ttem 14. The certifiCation must be signed by an authorized agency official. 

Item 15. GSA will evaluate the reQuest in terms of the space available in rts inventory and determine the appropriate action. If GSA 

determines that space requested is unique agency space, GSA will take no action until the agency has concurred with that 

designation. GSA will assign a space request number which will be used to track the request until it is satisfied. 

Name and phone number of the GSA regional official who is knowledgeable of the request and will serve as GSA's point of 

contact. 

• ~ S. :: ·'-· - -.:,·· ::. ~: r.; (H,ca: 1932- 312-071150049 STANDARD FORM 81 BACK r::>::~r -,-~~, 
SPACE REQUIREMENTS WORKSHEET .... This form must accompany SF-81, Request for Space, ... PAGE OF 

1EPT./8UREAU PREPARED BY CITY AND STATE 

.GENCY/OFFICE TITLE ORGANIZATIONAL UNIT DESCRIBED ON THIS PAGE; 

'I VISION DATE 

UJ (SEE INSTRUCTIONS, STANDARDS, AND SYMBOLS ON REVERSE.) 0 EMPLOYEE NAME COS· MISC. a: 0 OR DESKS TABLES STORAGE UNITS 0"' u 1- TUMER EQUIPMENT SUPPORT SPACE UJ w UJ 

a. UJ 

a: wo u."' 

u 0 ,. =>w 

Ww 

00 

TConf. TR·36 Dl DB·S Wa: 

<1: <1: 1- U.a: 

D CD~ @ @] 1-<1: a. a: Ula. UJ- TDL UDL 8 8 8 ~ ~ SF DB-6 0::; "' UJ o,. a:=> G 0 lcM-el zw "' "' u (}I- <>:0 TOR UDR b"' a: FUNCTIONAL TITLE <1: :::.w [ill TH MC 

0 a. z o"' ~ 0 "' UJ 0 3: CM·I2 TE u. "' TS TM TR·54 

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... PERSONS- TOTALS- SPACE .... REMARKS: 

> 

~ 

~ STANDARD FORM 81·A (10.83) 0 

Prescribed by GSA 

FPMR (41 CFRJ 101·17.101 

7"itln.n1-14n-<><;<7 
I SECTION 1 

0 

0 

Standard Desk 

60x30 

Typist Desk 

60x34 

wiLeft or Right 

Typing Bed 

~ ----- ~r-~====~-+~~~~~--1 

INSTRUCTIONS, STANDARDS AND SYMBOLS 

Table, Conlerence 

72x36 

Standard Table 

60x34 

Table, Medium 

45x34 

Table, Small 

36x24 ® 

Ul 

:::> 

Storage Cabinet 

2-Door 

36x18 (12 

·Steel Shelving 

36x18 (10: 

Library Shelving 

36x15 

Drawing Boards 

DB-5 60x40 

DB-6 72x45 

S' Stool 

a ~L l Unitized Desk 

UDR 60x30 

I MTU I Modular Table Unit 

66x18 

!::::'\ Table, Round 

@~~~~~~-+--------------

0 zc:J ~ wiLeft or Right 

L-unit Return 

36x18 ~~-~~~=~~--4-----~--"-----1 s I MIC : 

Map Cabinet 

~x42 

I I L ___ .J 

Conference 

Desk 

72x36 

@8 Table, Round 

42" Costumer 12-Hanger 

51x20 (14) 

8 Table, Round 

36" I~~~ I Costumer 6-Hanger 

l---;:::;::=:=;;::;---t-"""'1':,;30;;;x;7;20 (8) 

fTT;T T: File, Letter I TH L Table, Host I I i CR i I c~::1n:a '--'-y.LJ 15x28 · I 42x18 SPACE TYPE SYMBOLS: 

~ f--::..=:..=.;::..=-~-:.:-:..:-:;-;_+-------_;("-7):-J GEJ . Table, End t-:0=-t-.;:Ope::;_:n;;.:,;A::.;re::•:.._ __________ 

Z r--.,. -EI- T-, l--lc---=~==---4--_:1:::8~x::;24::.._ __ -l P Private Area 

=> 1 ,. LF I I 

w 1 I 1 1 File, Legal z 1::] D S f SF Semi-Private Area 

CJ L. ... ...1..... ..... ...... ..J < ivan or o a s,:;;..L....:.:::.;;..,:..:.:.;:.:.:.;~.::..---------

~ 1 18x2B ~ or 72x40 ENCLOSURE TYPE SYMBOLS: 

f:? ---- - - ~._ (8) lcH Ceiling~High Panition 

(J) r;:::=-;::-=::-::;-i--;-::;=;7,;;:-...:.:i a: 1 LAT 1 __ ,J1 Lateral File < 

36x18 {9) 1'5 

Bookcase 

34x14 (6) f SECTION 2 

Guest Chair 

Lounge Chair 

PS Privacy Screen 

0 Open 

PROGRAMMING INSTRUCTIONS 

(1) Organize the data supporting your request by functional work groups. When one work group has been described begin 

the next work group on·a new page. · 

(2) The requesting agency is responsible for describing the following workspace elements of the Spice Requirements 

Program. . 

• Workstations are indic.Ued by employee name, functional title.and grade for each authorizet} .and· 

budgeted position. If the authorized position· is vacant, so indicate. Square feet required are determined by 

layout design on SF-81A, Part 2. 

• ComrDon Function spaces are indicated by 1he appropriate name of the workspace (conference, reception, etc.) 

and the symbol CIF in the grade column. Square feef required are determine by layout design on SF-B1A, Part 2. 

• Admlnlstratlve Support spaces are either centralized files or miscellaneous equipment (i.e., costumers, an extra 

bookcase) not app<opriately contained within other workspaces. Indicate NS in the grade column. Square feet 

required may be determined by multiples of the allowance indicated in ( ) in Section 1 above_ 

(3) Develop ttie space requirements program in the following manner. 

Step 1: List all. workspace elements described in (2) abcve in an order determined by adjacency relationships. 

Step 2: As necessary, prepare a standard workspace design on SF-81A, Part 2 for each workstation or 

common function workspace element. Indicate the dimensions of the workspace and calculate the 

square feet requireci 

Step 3: Use the symbols shown within the illustrations above in Section 1 to itemize furnishings and equipment on 

SF-81A. DO NOT LIST EXCESS. Itemized, list;ngs need not be shown for lioo items previously standardized. Simply 

cod"' the line entry appropriately. 

Step 4: Complete the line item entry by indicating space and enclosure type, square feet required arod 

workspace code No. 

{4) Describe, in Remarks, all special needs such as: weight of heavy items, special utilities, se~ice 

access requirements, suppbmental HVAC, etc. Develop a separate specification sheet if necessary. 

(5) The information provided on these worksheets is to be summarized on SF-81, Request lor Space, and submitted 

attach'ed thereto. 
APPENDIX C 

REIMBURSABLE WORK AUTHORIZATION r. DATE OF REQUEST I"~ HWA \ tu,:,A use umyJ 

3. NAME OF AGENCY 4. WORK SITE 

5A. CONTACT'S NAME 

58. CONTACT"S AREA CODE PHONE NUMBER ~EXT. 

TELEPHONE NO. 50. CONTACT'S ADDRESS 

5C. CONT ACT"S AREA CODE PHONE NUMBER 

FAX NUMBER 

SE.CONTACT'S E-MAIL 

6. OET AILED OESCAJPTJ•)N OF REQUESTED WORK 

CHECK AS APPROPRIATE 10. REQUESTED WORK DATES 13A. FED CODE 1138. BUREAU CODE 

I 7. PLANS ATTACHED A. START: 

I•· MOD B. COMPLETION: 14A. AGENCY FINANCE BILLING OFFICE 

.SA. BILLING TYPE l9B. BILLING TERMS 1 1 • AMOUNT CERTIFIED BY AGENCY 

148. STREET ADDRESS 

12A. AGENCY LOCATION CODE 128. AGENCY 10 NO. 12C. FUND CODE 

14C. CITY 140. STATE- r4E. ZIP CODE 

120. AGENCY ACCOUNTING DATA (Limited to 60 characters) 1 6A. CREDIT CARD NUMBER 168. EXPIRATION DATE 

16C. TYPE OF CARD (i.e., VISA) 16D. NAME OF CARD HOLDER 

15A. CERTIFICATION SIGNATURE 158. DATE 

17. TELEPHONE NUMBER OF CERTIFYING OFFICIAL 

15C. NAME OF SIGNER AREA CODE I PHONE NUMBER \EXT. 

NOTE: GSA will b1ll1n accordance With FPMR Part 101 ·21 .604(e) 

FoR GENERAL sERvices ADMINISTRATioN usE oNL v 

18. PAOJEc I No. 

1

1 §A. 6AGXNI2X IIBN cbDE 1198. 8/X cooE 

1

19c. BbXc cObE 1196 coRA€§. s9MB6L 

20. 'BRIEF PROJECT DESCRIPTION (Limited to 25 characters) 

21. ACTION (Check one) 22. PLEASE CHECK IF APPROPRIATE 

DNEW OcHANGE D DELETE D COMPLETE D COST BREAKDOWN ATTACHED D MULTIPLE BLDG./FUNCTION (See reverse) 

25. AGREED UPON COMPLETION DATE D 23. FIXED PRICE DOES NOT APPLY D 24. GUARANTEE DOES NOT APPLY 

26A.ORGANIZATIO 26B. BUILDING 26C. LEASE 

CODE NUMBER NUMBER 

27A. GSA APPROVING OFFICIAL'S SIGNATURE 278. DATE 

270. NAME 

29A. CERTIFICATE OF COMPLETION SIGNATURE 

GENERALSERVICESADMINISTRA TION 

26D. FUNCTION 26E.O/C 26F.TOTAL CODE 

26G.GRANDfO"IAL 

27C. TELEPHONE 

AREA CODE NUMBER I EXT. 

28. POINT OF SALE TERMINAL (For credit card purchases only} 

rJ A. FINANCE Os 

298. SIGNER'S NAME (Type or Print/ 

PBS 

29C. COMPLETION 

DATE 

GSA FORM 2957 !REV. 10·971 

Prescribed by PBS P 7000.2A 
INSTRUCTIONS 

GENERAL: Keep a copy for your record and forward one copy to your obligating/payingoffice. 

ITEM 

NO. 

1. 

2. 

3. 

4. 

5A-E. 

6. 

7. 

Enter date of work request. 

For GSA Use Only. 

Enter name of agency requesting the work. 

SPECIFIC ITEM 

Enter location where work is to be performed. If multiple locations, use attachment (below). 

Enter information regarding the individual with the authority to make decisions regarding the project. 

Enter a concise statment of work to be done, including location where work is to be performed. 

Check if agency plans are attached. 

Check if submittal is a modification to an existing RWA. 

Enter billing type: 1 = lnterfund, C = CreditCard, P = Prepaid 

8. 

9A. 

98. Enter billing terms: A = Advance, C = At completion, M = Monthly, Q = Quarterly, T = At termination, Y = Annually 

(in arrears), non-recurring RWA's under $25,000will be billed at project completion. Default for billing is monthly for 

projects aver $25,000. 

1 OA-8. Enter requested project start and completion dates. 

11. Enter the total dollar amount approved for funding. Must match GSA'scost quote. 

12A. Enter the eight {8) character Agency location Code. {Treasury Pay-Station Designator) 

1 28. Enter the appropriate agency identificationnumber. 

12C. Enter the appropriate agency fund code. 

12D. Enter agency accounting information (limited to 60 characters). THIS WILL APPEAR ON YOUR BILL. 

1 3A. Enter the agency Fed Code. 

13B. Enter the agency Bureau Code. 

14A-E. Enter the appropriate billing addressinformation. 

15A-C. Enter the date, signature, and name of agency's authorized representative, certifying the validity of order and the 

availabilityof funds. 

16A-D. Enter the credit card number, type of card, card holder's name, and expiration date. (You may contact your GSA 

Representative and provide the information confidentially.) 

17. Enter the certifyingofficial' s phone number. 

18. Enter proJect number, If applicable. 

19A-D. Enter: a. GSA Organization Code, b. B/A code, c. BOAC code, and d. the Organization Correspondence Symbol. 

20. Enter a brief project description,limited to 25 characters. 

21. Check the appropriate action block. 

22. Check box(es) if appropriate. 

23. Check if the project is_NOT fixed price. If the project is to be actual cost instead of fixed price, the requesting agency 

contact should be advised that his/her agency is responsible for all actual costs, including overhead. 

24. Check if the guarantee DOES NOT apply. 

25. Enter the mutually agreed upon completion date. 

26A-G. Enter the Organization Code, Building Number, Lease Number, Function Code, Object Class, Total Dollar Amount, and 

Grand Total. 

27 A-D. Enter the signature, name, date, and telephone number of the GSA Approving Official. 

28. Enter the Point of Sale Ter111inal {for Credit Card PurchasesOnly). 

29A-C. Enter the certificate of completion signature, name, and date when the project was physicallycompleted. 

ATTACHMENT- MD[flp[E BdiLDJNGS/MOLTJPLE FUNCTION 

ORGANIZATION BUILDING LEASE FUNCTION 0/C TOTAL CODE NUMBER NUMBER CODE 

GSA FORM 2957 !REV. 10-97} BACK 
Form DI-1 

(Rev.Ju1y 1994) 

UNITED STATES 

DEPARTMENT OF THE INTERIOR 

-REQUISITION 

APPENDIX D 

Page of 

Requisition No. 

Date 

INSTRUCTIONS - Prepare in single space typing. Use double space between items. Fill out top of requisition completely, showing 

complete shipping instructions and appropriation if different from that to which requisition is chargeable. 

To Bureau/Office 

FfS Phone No. (include area code) I FfS Fax No. (include area code) 

Appropriation/Allotment No. Charge shipping costs to 

Vendor Deliver to 

ITEM OR DESCRIPTION QUANTITY UNIT UNIT AMOUNT FORM NO. PRICE 

. TO BE COMPLETED B\ 'FISCAL AUTHORITY ONLY . 

FUND CERTTFICATT?N: r_~:~.nJs in the amounts shown are available and chargeable to the cost authorities shown above.-~----

Signature !Title lli~ 

Requisitioned by (SigNature) l Title Date 

Approved by (Sigr'ururc) Title Date 

Bureau Officer (Signatllre) !Titl(· n