Fill - Free fillable Storage Lease Attachment Instructions (US House of Representatives) PDF form

Storage Lease Attachment – Instructions

The Storage Lease Attachment (“Attachment”) is a four-page document that must accompany every

storage lease that is submitted for a Member/Member-Elect’s District offices.

Three things are required:

1. The signature of the Landlord and date

2. The signature of the Member/ Member-Elect of Congress and date

3. Contact information for the person in the Member/ Member-Elect’s office whom we should

call if there are any problems or questions (the chief of staff, district director, scheduler, etc.)

A few things to keep in mind:

 The Member/ Member-Elect is required to personally sign the document.

 The Attachment may not have any provisions deleted or changed.

 Prior to either party signing a lease, the Member/ Member-Elect must submit the proposed

storage lease, accompanied by a copy of the Attachment, to the Administrative Counsel for

review and approval. If the proposed terms and conditions of the lease are determined to be in

compliance with applicable law and House Rules and Regulations, the Administrative Counsel

will notify the Member/Member-Elect that (s)he may proceed with the signing of the lease.

Please submit the proposed lease and Attachment either by e-mail in PDF form

(leases@mail.house.gov) or fax (202-225-6999).

 Once signed by both parties, the storage lease and the Attachment must be submitted to the

Administrative Counsel for final approval. They may be sent by email in PDF form or faxed to

202-225-6999. The Attachment should be submitted at the same time the storage lease is sent

to the Administrative Counsel.

 Without a properly signed and submitted Attachment, the storage lease cannot be approved and

payments will not be made.

 The parties agree that any charges for default, early termination or cancellation of the storage

lease which results from actions taken by or on behalf of the Lessee shall be the sole

responsibility of the Lessee, and are not reimbursable from the Member’s Representational

Allowance.

NO STORAGE LEASE OR ATTACHMENT CAN BE SIGNED BEFORE THEY HAVE BEEN

APPROVED BY THE ADMINISTRATIVE COUNSEL.

The term for a storage lease for the 115

Congress may not commence prior to January 3, 2017.

Members should endeavor to lease space through the last day of a congressional term rather

than the last day of a calendar year. For the 115

Congress, leases should end on January 2,

2019, not December 31, 2018.

U.S. House of Representatives

Washington, D.C. 20515

Storage Lease Attachment

(Page 1 of 4 – 115

Congress)

1. Incorporated Storage Lease Attachment. Lessor (Storage Company) and Lessee

(Member/Member-Elect of the U.S. House of Representatives) agree that this Storage Lease

Attachment (“Attachment”) is incorporated into and made part of the Storage Lease Agreement

(“Lease”) to which it is attached.

2. Performance. Lessor expressly acknowledges that neither the U.S. House of Representatives

(the “House”) nor its Officers are liable for the performance of the Lease. Lessor further

expressly acknowledges that payments made by the Chief Administrative Officer of the House

(the “CAO”) to Lessor to satisfy Lessee’s rent obligations under the Lease – which payments are

made solely on behalf of Lessee in support of his/her official and representational duties as a

Member of the House – shall create no legal obligation or liability on the part of the CAO or the

House whatsoever. Lessee shall be solely responsible for the performance of the Lease and

Lessor expressly agrees to look solely to Lessee for such performance.

3. Modifications. Any amendment to the Lease must be in writing and signed by the Lessor and

Lessee. Lessor and Lessee also understand and acknowledge that the Administrative Counsel for

the CAO (“Administrative Counsel”) must review and give approval of any amendments to the

Lease prior to its execution.

4. Compliance with House Rules and Regulations. Lessor and Lessee understand and

acknowledge that the Lease shall not be valid, and the CAO will not authorize the disbursement

of funds to the Lessor, until the Administrative Counsel has reviewed the Lease to determine that

it complies with the Rules of the House and the Regulations of the Committee on House

Administration, and approved the Lease by signing the last page of this Attachment.

5. Payments. The Lease is a fixed term lease with monthly installments for which payment is due

in arrears on or before the end of each calendar month. In the event of a payment dispute, Lessor

agrees to contact the Office of Finance of the House at 202-225-7474 to attempt to resolve the

dispute before contacting Lessee.

6. Void Provisions. Any provision in the Lease purporting to require the payment of a security

deposit shall have no force or effect. Furthermore, any provision in the Lease purporting to vary

the dollar amount of the rent specified in the Lease by any cost of living clause, operating

expense clause, pro rata expense clause, escalation clause, or any other adjustment or measure

during the term of the Lease shall have no force or effect.

7. Certain Charges. The parties agree that any charge for default, early termination or cancellation

of the Lease which results from actions taken by or on behalf of the Lessee shall be the sole

responsibility of the Lessee, and shall not be paid by the CAO on behalf of the Lessee.

8. Death, Resignation or Removal. In the event Lessee dies, resigns or is removed from office

during the term of the Lease, the Clerk of the House may, at his or her sole option, either: (a)

terminate the Lease by giving thirty (30) days’ prior written notice to Lessor; or (b) assume the

obligation of the Lease and continue to occupy the premises for a period not to exceed sixty (60)

days following the certification of the election of the Lessee’s successor. In the event the Clerk

elects to terminate the Lease, the commencement date of such thirty (30) day termination notice

U.S. House of Representatives

Washington, D.C. 20515

Storage Lease Attachment

(Page 2 of 4 – 115

Congress)

shall be the date such notice is delivered to the Lessor or, if mailed, the date on which such notice

is postmarked.

9. Term. The term of the Lease may not exceed the constitutional term of the Congress to which

the Lessee has been elected. The Lease may be signed by the Member-Elect before taking office.

Should the Member-Elect not take office to serve as a Member of the 115th Congress, the Lease

will be considered null and void.

10. Early Termination. If either Lessor or Lessee terminates the Lease under the terms of the Lease,

the terminating party agrees to promptly file a copy of any termination notice with the Office of

Finance, U.S. House of Representatives, O’Neill Federal Building, Suite 3220, Attn: Levi

Matthews, Washington, D.C. 20515, and with the Administrative Counsel, Office of the Chief

Administrative Officer, U.S. House of Representatives, 217 Ford House Office Building,

Washington, D.C. 20515.

11. Notification upon Occurrence of Certain Events. Lessor agrees to promptly notify Lessee in

writing in the event Lessor sells, transfers, or otherwise disposes of the leased premises; in the

event Lessor is placed in bankruptcy proceedings (whether voluntarily or involuntarily); in the

event the leased premises is foreclosed upon; or in the event of any similar occurrence. Lessee

shall promptly file a copy of any such notice with the Office of Finance, U.S. House of

Representatives, O’Neill Federal Building, Suite 3220, Attn: Levi Matthews, Washington, D.C.

20515.

12. Maintenance of Common Areas. Lessor agrees to maintain in good order, at its sole expense,

all public and common areas of the building including, but not limited to, all sidewalks, parking

areas, elevators, escalators, entryways, exits, alleys and other like areas.

13. Maintenance of Structural Components. Lessor also agrees to maintain in good order, repair

or replace as needed, at its sole expense and when applicable, all structural and other components

of the premises including, but not limited to, roofs, ceilings, walls (interior and exterior), floors,

windows, doors, foundations, fixtures, and all mechanical, plumbing, electrical and air

conditioning/heating systems or equipment (including window air conditioning units provided by

the Lessor) serving the premises.

14. Lessor Liability for Failure to Maintain. Lessor shall be liable for any damage, either to

persons or property, sustained by Lessee or any of his or her employees or guests, caused by

Lessor’s failure to fulfill its obligations under Sections 12 and 13 of this Attachment.

15. Federal Tort Claims Act. Lessor agrees that the Federal Tort Claims Act, 28 U.S.C. §§ 2671-

80, satisfies any and all obligations on the part of the Lessee to purchase private liability

insurance. Lessee shall not be required to provide any certificates of insurance to Lessor.

16. Limitation of Liability. Lessor agrees that neither Lessee nor the House nor any of the House’s

officers or employees will indemnify or hold harmless Lessor against any liability of Lessor to

any third party that may arise during or as a result of the Lease or Lessee’s tenancy.

17. Compliance with Laws. Lessor shall be solely responsible for complying with all applicable

permitting and zoning ordinances or requirements, and with all local and state building codes,

U.S. House of Representatives

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Storage Lease Attachment

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Congress)

safety codes and handicap accessibility codes (including the Americans with Disabilities Act),

both in the common areas of the building and the leased space of the Lessee.

18. Electronic Funds Transfer. Lessor agrees to accept monthly rent payments by Electronic Funds

Transfer and agrees to provide the Office of Finance, U.S. House of Representatives, with all

banking information necessary to facilitate such payments.

19. Refunds. Lessor shall promptly refund to the CAO, without formal demand, any payment made

to the Lessor by the CAO for any period for which rent is not owed because the Lease has ended

or been terminated.

20. Conflict. Should any provision of this Attachment be inconsistent with any provision of the

attached Lease (or with any subsequent or additional amendments thereto), the provisions of this

Attachment shall control, and those inconsistent provisions of the Lease (or any subsequent or

additional amendments thereto) shall have no force and effect to the extent of such inconsistency.

21. Construction. Unless the clear meaning requires otherwise, words of feminine, masculine or

neuter gender include all other genders and, wherever appropriate, words in the singular include

the plural and vice versa.

22. Fair Market Value. The Lease is entered into at fair market value as the result of a bona fide,

arms-length, marketplace transaction. The Lessor and Lessee certify that the parties are not

relatives nor have had, or continue to have, a professional or legal relationship (except as a

landlord and tenant).

23. Counterparts. This Attachment may be executed in any number of counterparts and by

facsimile copy, each of which shall be deemed to be an original but all of which together shall be

deemed to be one and the same instrument.

24. Section Headings. The section headings of this Attachment are for convenience of reference

only and shall not be deemed to limit or affect any of the provisions hereof.

[Signature page follows.]

U.S. House of Representatives

Washington, D.C. 20515

Storage Lease Attachment

(Page 4 of 4 – 115

Congress)

IN WITNESS WHEREOF, the parties have duly executed this Storage Lease Attachment as of the later

date written below by the Lessor or the Lessee.

Print Name (Lessor) Print Name (Lessee)

Lessor Signature Lessee Signature

Date Date

This Storage Lease Attachment has been reviewed and is approved, pursuant to Regulations of the

Committee on House Administration.

Signed Date , 20 .

(Administrative Counsel)

From the Member’s Office, who should be contacted with questions?

Name Phone ( ) E-mail @mail.house.gov

Send completed forms to: Administrative Counsel, 217 Ford House Office Building, Washington, D.C. 20515.

Copies may also be faxed to 202-225-6999

U.S. House of Representatives

Substitute W-9 and ACH Vendor/Miscellaneous Payment Enrollment Form

INSTRUCTIONS

FAX NUMBER:

(202) 225-6914

SECTION I UNITED STATES HOUSE OF REPRESENTATIVES INFORMATION

ADDRESS US HOUSE OF REPRESENTATIVES - ACCOUNTING, 3110 O'NEILL FEDERAL BUILDING, WASHINGTON DC 20515

AGENCY IDENTIFIER

53-6002523

AGENCY LOCATION CODE 4832 TELEPHONE NUMBER (202) 226-2277

SECTION II PAYEE/COMPANY INFORMATION

BUSINESS NAME/DISREGARDED ENTITY NAME OR DBA, IF DIFFERENT THAN NAME

ON YOUR INCOME TAX RETURN

ADDRESS/CITY/STATE/ZIP Enter the correct Tax Identification Number type

SOCIAL SECURITY NUMBER (SSN) EMPLOYER TAX ID NUMBER (EIN)

CONTACT PERSON NAME PURCHASE ORDER ADDRESS/CITY/STATE/ZIP

PO EMAIL

TELEPHONE NUMBER FAX NUMBER TELEPHONE NUMBER FAX NUMBER

REMIT TO ADDRESS

CHECK APPROPRIATE BOX FOR FEDERAL TAX CLASSIFICATION (required)

Partnership

Trust/Estate

C Corporation

SECTION III FINANCIAL INSTITUTION INFORMATION

BANK NAME TELEPHONE NUMBER

NINE-DIGIT ROUTING TRANSIT NUMBER

___ ___ ___ ___ ___ ___ ___ ___ ___

DEPOSITOR ACCOUNT TITLE

DEPOSITOR ACCOUNT NUMBER

LOCKBOX NUMBER

TYPE OF ACCOUNT CHECKING SAVINGS LOCKBOX

SECTION IV

SOCIO-ECONOMIC INFORMATION

Type of Business Large Business-No Socio-Economic Designations Minority SmBusiness Sm-Disadv/Minority Sm-Disadv Only SmMin Only

Sm-Disadvantaged Business Prog 8 (a) Firm HUBZone Program HUBZone Eligible

Emerging Small Business

Women-Owned Business

Other Preference Programs Buy Indian Directed to JWOD Non-Profit No Preference/Not Listed Small Business Set-Aside Very Small Business Set-Aside

Veteran Owned Status Non-Vet Owned SmBus Other Vet Owned SmBus Serv-Disabled Vet Other Bus Serv-Disabled Vet Owned SB Vet-Owned Other Bus

Size of Business: (A) 50 or less (B) 51-100 (C) 101-250 (D) 251-500 (E) 501-750 (F) 751-1,000 (G) Over 1,000 (M) 1 million or less

(N) 1.1-2 million (P) 2.1-3.5 million (R) 3.1-5 million (S) 5.1-10 million (T)10.1-17 million (Z)Over 17 million

SECTION V

CERTIFICATION OF DATA BY PAYEE/COMPANY

NAME TITLE/POSITION

SIGNATURE

DATE

TELE

Internal Revenue Code 6109, 31 U.S.C. 3322, 31 CFR 210 and the 1996 Debt Collection Improvement Act require all entities that do business with the United

States Government to provide a Tax Identification Number (TIN) and Electronic Funds Transfer (EFT) information for payment. PL 93-579 protects your privacy

and mandates that the information never be published or used for any other purpose than to pay you. Please complete all sections below, sign and return via the

email or fax number listed.

NAME AS SHOWN ON YOUR INCOME TAX RETURN

RETURN FORM TO:

Exemptions (codes apply only to certain

entities, not individuals):

Exempt payee code

(if any)

Exemption from FATCA reporting code

(if any)

(Applies to accounts maintained outside

the U.S.)

U.S.)

S Corporation

Individual/Sole Proprietor or

Single Member LLC

Limited Liability Company. Check the tax classification: C corporation S corporation Partnership

Note. For a

single-member LLC

that is disregarded, check the appropriate box for the tax classi fication of the single-member owner.

Government Entity. Check the tax classification:

Federal State Local

Other

This form must be completed using Adobe Reader.

vendorEFT@mail.house.gov

USHR v. 2015.3b ms

Instructions for Completing

U.S. House of Representatives

Substitute W-9 and ACH Vendor/Miscellaneous Payment Enrollment Form

Section I - Agency Information – Includes the name and address, agency identifier, agency location code and

telephone number for the House of Representatives.

Section II - Payee/Company Information – Print or type the name of the payee/company and address that will

receive payment, social security or taxpayer ID number, contact person name, telephone number and email of the

payee/company. Print or type the purchase order and remit to addresses if different from the payee/company

address. Check the appropriate boxes for federal tax classification.

Section III - Financial Institution Information – Print or type the name and address of the payee/company’s

financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit

routing transit number, depositor (payee/company) account title and account number. Check the appropriate box

for type of account. Payee/Company may include a voided check with this form.

ACH Account Information Located on a Check or Deposit Ticket

FINANCIAL INSTITUTION NAME name of the financial institution to which the payments are to be directed

ROUTING TRANSIT NUMBER (RTN) financial institution's 9 digit routing transit number;

found on the bottom of a check or deposit ticket or from your Financial Institution

ACCOUNT TITLE employee's or vendor's name on the account

ACCOUNT NUMBER account number at the financial institution

Section IV - Socio-Economic Information – Check the boxes for each category, if applicable: type of business,

small disadvantaged business program, HUBZone program, emerging small business, women-owned business,

other preference programs, Veteran owned status and size of business. Detailed information related to Small

Business programs can be found at http://www.sba.gov/.

Section V - Certification of Data By Payee/Company – Print or type the name, title/position and phone number of

the Authorized official. The Authorized official must sign and date the form.

1. Routing Transit Number (RTN)

– nine digits located between

two symbols. This number

identifies the bank holding your

account and check processing

center.

2. Account number – this is your

complete account number.

Your account number can be

up to 17 digits. Please include

leading zeros.

3. ACH Routing Transit Number –

Automated Clearing House

routing number, use this

number for your Routing

Transit Number (RTN) if you

bank with SunTrust Bank.

4. Check number – This

information is not necessary -

do not provide

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