GSA Form 12002 "High Risk Operation"

What Is GSA Form 12002?

This is a legal form that was released by the U.S. General Services Administration on August 1, 2019 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest available edition released by the U.S. General Services Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of GSA Form 12002 by clicking the link below or browse more documents and templates provided by the U.S. General Services Administration.

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CUI when filled in
HIGH RISK OPERATION
(Parts A and B are to be completed during the Project Planning stages of a new customer agency project.)
PART A
Current Occupancy Information
The Regional Planning Manager (Office of Portfolio Management and Customer Engagement) must complete Part A and B
below for any new project that involves a High Risk Operation for the customer agency.
Customer Agency Name
Agency Bureau (AB) Code
Building Number
Occupancy Agreement (OA) Number
OA Expiration Date
Building Name
Building is:
GSA-Owned
Building Address
GSA-Leased
Date
City
State
Regional Planning Manager (RPLM)
PART B
High Risk Operation Information
Estimated size of occupancy, if known
Types of High Risk Operations
(usable, American National Standards Institute (ANSI)/Building Owners and Managers
(check all that apply)
Association (BOMA) Office Area (ABOA), rentable, etc.)
High Risk Laboratory
Explosive Materials Storage
Firing Range or Shoot House
PART C
High Risk Operation Technical Requirements
(
to be completed during the Project Management stages of a new customer agency project)
The Project Management Team must complete the following sections.
Have high risk technical requirements been received from the customer agency?
Yes
No
If yes, are the agency requirements sufficient and acceptable to the project team?
Yes
No
If no to either above, has the project team provided high risk technical requirements to
Yes
No
the agency for review?
Has the customer agency accepted the technical requirements provided by the project
Yes
No
team?
Sign below once the high risk technical requirements have been found sufficient and acceptable to both the
Project Management Team and the customer agency.
Name of Project Manager:
Signature:
Date:
Regional Environmental, Health, Safety, Fire (EHSF)
Project Management Team Representative:
Signature:
Date:
GENERAL SERVICES ADMINISTRATION
GSA 12002 (REV. 10/2021)
CUI when filled in
HIGH RISK OPERATION
(Parts A and B are to be completed during the Project Planning stages of a new customer agency project.)
PART A
Current Occupancy Information
The Regional Planning Manager (Office of Portfolio Management and Customer Engagement) must complete Part A and B
below for any new project that involves a High Risk Operation for the customer agency.
Customer Agency Name
Agency Bureau (AB) Code
Building Number
Occupancy Agreement (OA) Number
OA Expiration Date
Building Name
Building is:
GSA-Owned
Building Address
GSA-Leased
Date
City
State
Regional Planning Manager (RPLM)
PART B
High Risk Operation Information
Estimated size of occupancy, if known
Types of High Risk Operations
(usable, American National Standards Institute (ANSI)/Building Owners and Managers
(check all that apply)
Association (BOMA) Office Area (ABOA), rentable, etc.)
High Risk Laboratory
Explosive Materials Storage
Firing Range or Shoot House
PART C
High Risk Operation Technical Requirements
(
to be completed during the Project Management stages of a new customer agency project)
The Project Management Team must complete the following sections.
Have high risk technical requirements been received from the customer agency?
Yes
No
If yes, are the agency requirements sufficient and acceptable to the project team?
Yes
No
If no to either above, has the project team provided high risk technical requirements to
Yes
No
the agency for review?
Has the customer agency accepted the technical requirements provided by the project
Yes
No
team?
Sign below once the high risk technical requirements have been found sufficient and acceptable to both the
Project Management Team and the customer agency.
Name of Project Manager:
Signature:
Date:
Regional Environmental, Health, Safety, Fire (EHSF)
Project Management Team Representative:
Signature:
Date:
GENERAL SERVICES ADMINISTRATION
GSA 12002 (REV. 10/2021)