210364_Attach5_RMDF-Signed.pdf

RMDF_v0_05/23/19

Recovered Materials Determination Form (RMDF) User’s Guide

1. PURPOSE OF FORM. The “Recovered Materials Determination Form” (RMDF) is used to clearly identify items listed in the Comprehensive Procurement Guidelines (CPG) that are included in a procurement action, require the consideration of energy efficiency and environmentally preferable purchasing (EPP) for the procurement action, and document the use of applicable exemptions taken for the CPG items identified.

2. APPLICABILITY. The RMDF applies to all procurement actions (other than GPC purchases) that include items that are listed in the CPG, biobased, Energy Star®, or FEMP Low Standby Power programs.

3. INTENT FOR USE.

a. Contractors and CE Operations shop personnel (for in-house job and work orders regardless of project cost) will be responsible for completing an RMDF if any of the mandatory EPP items are required. For CPG items where exemptions are identified during project/contract performance, an amended RMDF must be completed documenting the exemption.

b. If the procurement action does not include any CPG, biobased, Energy Star®, or FEMP

Low Standby Power items, complete the GPP Statement instead.

4. FILING PROCEDURE. If applicable, the RMDF and any amended RMDFs will be included in the purchasing or contracting file. Contracting is responsible for ensuring that either a Green Procurement Statement or RMDF (and any amended RMDFs) is included in contracting files.

5. SIGNER. The Recovered Materials Determination Form can be signed by any person who has technical knowledge of the products or services being purchased. For service and construction contracts, the signer should have general knowledge of the products that will be purchased by the contractor to complete the job. It is the signer’s responsibility to check the mandatory purchase lists and determine if any of those products will be purchased.

6. INSTRUCTIONS. This form is to be completed when EPA-designated items included in the Green Procurement Program for Recovered Materials are being procured from outside vendors.

For questions on whether the product counts as “EPA-designated” or what the required recycled content is, refer to product descriptions on EPA’s website at www.epa.gov/cpg/products. For USDA designated items, refer to the website at http://www.biopreferred.gov/?SMSESSION=NO. For Energy Star items, refer to the website at www.energystar.gov/products . For FEMP items, refer to the website at http://oahu.lbl.gov. The completed form becomes part of the contracting office contract file.

http://www.epa.gov/cpg/products http://www.biopreferred.gov/?SMSESSION=NO http://www.biopreferred.gov/?SMSESSION=NO http://www.energystar.gov/products http://oahu.lbl.gov/

Recovered Materials Determination Form

Project # / Title: WWYK210364/Construct Loading Dock & Dock Leveler, B3113

The EPA-designated items being procured are:

Construction Products Paper and Paper Products Building insulation products Commercial/industrial sanitary tissue products Polyester carpet Miscellaneous papers Carpet cushion Newsprint

Cement and concrete containing: Paperboard and packaging products

X Coal fly ash Printing and writing papers

X Ground granulated blast furnace slag Cenospheres Park and Recreation Products

Silica fume Park benches and picnic tables Consolidated and reprocessed latex paint Plastic fencing Floor tiles Playground equipment Flowable fill Playground surfaces Laminated paperboard Running tracks Modular threshold ramps Nonpressure pipe Transportation Products Patio blocks Channelizers Railroad grade crossing surfaces Delineators Roofing materials Flexible delineators Shower and restroom dividers/partitions Parking stops Structural fiberboard Traffic barricades

Traffic cones Landscaping Products Compost and fertilizer made from recovered organic materials Vehicular Products

Engine coolants Garden and soaker hoses Rebuilt vehicular parts Hydraulic mulch Re-refined lubricating oils Lawn and garden edging Retread tires Plastic lumber landscaping timbers and posts Miscellaneous Products Nonpaper Office Products Awards and plaques Binders, clipboards, file folders, clip portfolios, and presentation folders Bike racks

Blasting grit Office furniture Industrial drums Office recycling containers Manual-grade strapping Office waste receptacles Mats Plastic desktop accessories Pallets Plastic envelopes Signage Plastic trash bags Sorbents Printer ribbons Toner cartridges

The USDA-designated biobased items being procured are:

Construction and Industrial Facility Operations and Maintenance Carpets 2-Cycle engine oils Chain and cable lubricants Corrosion preventatives Composite panels: Diesel fuel additives

Acoustical Dust suppressants

Interior panels Fertilizers

Plastic lumber Gear lubricants

Structural interior panels General purpose de-icers

Structural wall panels Greases:

Concrete and asphalt release fluids Food grade Expanded polystyrene foam recycling products Multipurpose

Forming lubricants Other Fluid-Filled transformers: Rail truck Synthetic ester-based Track

Vegetable oil-based Heat transfer fluids

Hydraulic fluids: Ink removers and cleaners Mobile equipment Mulch and compost materials

Stationary equipment Multipurpose lubricants

Industrial cleaners Penetrating lubricants Metalworking fluids: Sorbents

General purpose soluble, semi-synthetic, and synthetic oils Turbine drip oils

High performance soluble, semi-synthetic, and synthetic oils

Janitorial

Adhesive and mastic removers

Straight oils Bathroom and spa cleaners

Parts wash solution Carpet and upholstery cleaners:

Plastic insulating foam for residential and commercial construction

General purpose

Spot removers Roof coatings Floor strippers Water tank coatings General purpose household cleaners Wood and concrete sealers: Glass cleaners

Membrane concrete sealers Graffiti and grease removers

Penetrating liquids Laundry products:

General purpose Miscellaneous Pretreatment/spot removers

Bedding, bed linens, and towels Multipurpose cleaners

Firearm lubricants Trash bags/can liners (films):

Hand cleaners Non-durable

Hand sanitizers Semi-durable

Lip care products Topical pain relief products Food Service Disposable containers Disposable cutlery

Disposable tableware Food Cleaners

The Energy Star products being procured are:

Building Products Heating and Cooling Seal and insulate Air conditioning, central Roof products Boilers Windows, doors, and skylights Fans, ventilating

Heat pumps, geothermal Commercial Appliances Light commercial heating and cooling Commercial clothes washers

Vending machines Lighting Water coolers Commercial LED lighting

Light bulbs (CFLs) Commercial Food Service Equipment Light Fixtures Commercial kitchen package LED light bulbs Commercial dishwashers Commercial fryers Plumbing Commercial griddles Water heater, gas condensing Commercial hot food holding cabinets Water heater, heat pump Commercial ice machines Water heater, high efficiency gas storage Commercial ovens Water heater, solar Commercial refrigerators and freezers Water heater, whole home gas tankless Commercial steam cookers

Computers and Electronics

Audio/Video Battery chargers Computers Displays Enterprise servers External power adapters Imaging equipment Televisions

The Federal Energy Management Program Low Standby Power products being procured are:

Audio products Microwave

Cell phone Multifunction device Computer monitor Multimedia projectors Copier FPDA holder and charger Cordless phone Printer

Desktop computer Room air conditioner Docking station Scanner DVD player Telephone answering machine External disk drive TV

Fax TV/VCR/DVD combinations Laptop computer

Recovered Materials Procurement Determination

X EPA recycled-content requirements have been met for this procurement action.

**** OR *****

The following EPA designated guideline item is included in the specifications for project number , however, compliance with EPA standards is not attainable.

Item(s):

I have determined that the EPA guidelines were considered and determined inapplicable, based on the following:

Item is not available within a reasonable period of time.

Need date: Date available:

Item fails to meet a performance standard in the specifications.

Describe the standard and why it is needed:

Describe how the guideline item fails to meet the standard:

Item is not available from 2 or more sources.

Market research was performed by calling (insert number) vendors, but only (enter name) was able to supply the item.

Item was only available at an unreasonable price (i.e., recycled item is more expensive).

Price of recycled item:

Price of non-recycled item:

This determination is made in accordance with FAR 23.405(c).

Signature and Office Symbol Date

Signature of Contracting Officer Date

Recovered Materials Procurement Determination