Attachment 07 Green Procurement Form.pdf
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- Solicitation number
- FA441826R0004
About this file
Recovered Materials Determination Form Summary
This is a Recovered Materials Determination Form used for the JB CHS SABER Contract to document compliance with the EPA's Affirmative Procurement Program for Recovered Materials when procuring EPA-designated items from outside vendors. The form requires the procurement originator to identify which EPA-designated items are being purchased, specify required and actual recycled content percentages, and certify compliance with EPA standards. The form is not required for items obtained from established Federal supply sources and becomes part of the contracting office contract file upon completion.
The form identifies numerous EPA-designated product categories eligible for procurement, including construction products (building insulation, carpeting, cement and concrete with fly ash or blast furnace slag, latex paint, floor tiles, and fiberboard), landscaping products (garden hoses, lawn edging, and plastic lumber), vehicular products (engine coolants, re-refined lubricating oils, and retread tires), park and recreation products (plastic fencing, playground surfaces and equipment), nonpaper office products (binders, folders, clipboards, and toner cartridges), paper products (newsprint, printing and writing papers, and paperboard), miscellaneous products (signage, pallets, and sorbents), and transportation products (parking stops and traffic control items). The procurement originator Warren Wade certified on December 12, 2024, that the Statement of Work/Specifications for all materials listed comply with EPA standards. Part B of the certification allows for exemptions based on performance standards, availability, competitive sourcing, or unreasonable pricing, requiring both procurement originator and commander signatures.
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Recovered Materials Determination Form Instructions
This form is to be completed by the procurement originator when EPA-designated items included in the Affirmative 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 http://www.epa.gov/cpg. This form is not required for items requisitioned from established Federal supply sources.
1. The procurement originator lists which item(s) apply to the procurement request, the required recycled content, the actual recycled content, and signs and dates the appropriate Certification on the back of this form.
2. If an exemption is being claimed, the procurement originator’s unit commander also signs the
Certification on the back of this form.
3. The completed form becomes part of the contracting office contract file.
Contract: JB CHS SABER Contract
The EPA-designated items being procured are:
Construction Products Nonpaper Office Products
Building Insulation Binders (paper, solid plastic or plastic covered) Polyester Carpeting Plastic presentation folders Carpet Backing Plastic file folders Carpet Cushion Plastic clip portfolios
Cement & concrete containing: Plastic clipboards Coal fly ash, or Office recycling containers Ground granulated blast Office waste receptacles furnace slag Plastic desktop accessories Flowable fill Plastic envelopes Latex paint Plastic trash bags Floor tiles Printer ribbons Laminated paperboard Toner cartridges Patio blocks Paper and Paper Products Shower & restroom dividers Newsprint Structural fiberboard Commercial/industrial sanitary tissue products Railroad grade crossings/surfaces Printing and writing papers
Landscaping Products Paperboard and packaging Garden & soaker hoses Tray liners Lawn & garden edging Bristols (File folders, cards, tags, tickets, etc.)
Landscaping timbers & posts (plastic lumber) Miscellaneous Products Hydraulic mulch Awards and plaques Compost from yard trimmings or food waste Signage
Vehicular Products Strapping and stretch wrap Engine coolants Pallets Re-refined lubricating oils Mats Retread tires Industrial drums
Park and Recreation Products Sorbents Plastic fencing (erosion control safety barrier) Transportation Products Playground surfaces Parking stops Park and recreation furniture Traffic cones Running tracks Traffic barricades Playground equipment Channelizers
Delineators/Flexible delineators http://www.epa.gov/cpg
CERTIFICATION
Contract: JB CHS SABER Contract
Complete Part A or Part B as appropriate:
A. To the best of my knowledge the Statement of Work/Specifications for the requisition of all materials listed on this form complies with EPA standards for recycled/recovered materials content.
Warren Wade 12 Dec 2024 Procurement Originator’s Signature Date
B. The following item does not comply with EPA standards for recycled/recovered materials (please complete a separate justification for each noncompliant item purchased as part of this procurement action):
The exemption being claimed for this purchase is:
The product does not meet appropriate performance standards
The product is not available within a reasonable time frame
The product is not available competitively (from two or more sources)
The product is only available at an unreasonable price (it costs more than a comparable non-recycled-content product). The recycled-content product costs $ per and the non-recycled-content product costs $ per .
Procurement Originator Date
Commander Date
| Instructions |
| Structural fiberboard Commercial/industrial sanitary tissue products |
| Hydraulic mulch Awards and plaques |
| CERTIFICATION |
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