Attachment 6 - MAHG201158 - Appendix E - Green Procurement Instructions.pdf

Green Procurement Determination Form (GPDF)

User’s Guide

1. PURPOSE OF FORM. The “Green Procurement Determination Form” (GPDF) is used to clearly identify items listed in the EPA’s Comprehensive Procurement Guidelines (CPG), the USDA’s Biopreferred list and EnergyStar or

FEMP Low Power Standby Devices list that are included in a procurement action. It also documents the use of applicable exemptions taken for the EPA CPG items identified.

2. OPR. Environmental Management, Civil Engineering Operations shops, and other organizations making non-Government-wide Purchase Card (GPC) procurements.

3. OCR. Contracting, Civil Engineering/Operations, Civil Engineering/Construction, Civil

Engineering/SABER, and Civil Engineering/Materiel Acquisition.

4. APPLICABILITY. The GPDF 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.

5. INTENT FOR USE.

a. GPC holders will not complete this form and will use the “GPC Exemption Form” instead.

The GPDF is included in the Keesler AFB Environmental Protection specification. The

Environmental Protection specification will be included in all service and construction contracts as well as all work orders greater than $3,000 (or the current micro purchase threshold) that will be completed in-house.

b. Contractors and CE Operations shop personnel (for in-house job and work orders regardless of project cost) will be responsible for completing a GPDF if any of the mandatory GP items are required. For GP items where exemptions are identified during project/contract performance, an amended GPDF must be completed documenting the exemption. The OCR organizations listed above will be responsible for verifying the completed GPDFs.

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

Standby Power items, complete the GP Statement instead.

6. FILING PROCEDURE. If applicable, the GPDF and any amended GPDFs will be included in the purchasing or contracting file. Contracting is responsible for ensuring that either a GP

Statement or GPDF (and any amended GPDFs) is included in contracting files.

Attachment 6

FA301024R0015

Green Procurement Determination Form

Instructions

This form is to be completed by the procurement originator when items covered by one or more of the mandatory federal purchasing lists are being procured from outside vendors. A current list (as of 2007) is listed below for your convenience. For required product specifications, or to view the most recent lists, please visit the websites listed below. The completed form becomes part of the contracting office contract file.

U.S. EPA Comprehensive Procurement Guidelines published at www.epa.gov/cpg/products.htm.

USDA Biobased product listings published at http://www.biobased.oce.usda.gov/fb4p/.

Energy Star® product listings published at www.energystar.gov/products.

FEMP Low Standby Power product listings published at http://oahu.lbl.gov/

There is also a Green Procurement Tool provided by GSA at https://sftool.gov/greenprocurement

Procurement Request / Project No._______________________________________________

The EPA-designated CPG items being procured are:

Construction Products

__Carpet

__Carpet Cushion

__Cement and Concrete

__Floor Tile/Patio Blocks

__Flowable Fill

__Insulation

__Latex Paint

__Laminated Paperboard

__Modular Threshold Ramps

__Non-Pressure Pipe

__Railroad Grade Crossing Surfaces

__Roofing Materials

__Shower/Restroom Dividers

__Structural Fiberboard

Landscaping Products

__Compost from Yard/Food Waste

__Compost from Manure/Biosolids

__Garden/Soaker Hoses

__Fertilizers

__Lawn and Garden Edging

__Plastic Timbers and Posts

Non-Paper Office Products

__Binders

__Clipboards (Plastic)

__Plastic File Folders

__Plastic Clip Portfolios

__Plastic Presentation Folders

__Office Furniture

__Office Recycling Containers

__Office Waste Containers

__Plastic Desktop Accessories

__Plastic Envelopes

__Plastic Trash Bags

__Remanufactured Printer Ribbons

__Remanufactured Toner Cartridges

Paper and Paper Products

__Printing and Writing Paper

__Newsprint

__Bathroom Tissue

__Paper Towels

__Paper Napkins

__Facial Tissue

__General Purpose Industrial Wipers

__Corrugated Containers

__Solid Fiber Boxes

__Folding Cartons

__Industrial Paperboard (tubes, cores, drums)

__Misc. (book covers, mailing tubes, pad backs)

__Padded Mailers

__Carrierboard

__Brown Papers (Wrapping Paper and Bags)

__Tray Liners (Place Mats)

Park and Recreation Products

__Benches and Picnic Tables

__Plastic Fencing

__Playground Equipment

__Rubber/Plastic Running Tracks

__Rubber/Plastic Playground Surfaces

Transportation Products __Channelizers

__Concrete

__Delineators

__Flexible Delineators

__Parking Stop

__Traffic Barricades

__Traffic Cones http://www.epa.gov/cpg/products.htm http://www.biobased.oce.usda.gov/fb4p/ http://www.energystar.gov/products http://oahu.lbl.gov/ https://sftool.gov/greenprocurement

Vehicular Products

__Engine Coolants

__Rebuilt Vehicular Parts

__Re-refined Lubricating Oils __Retread Tires

Miscellaneous Products

__Awards/Plaques

__Bike Racks

__Blasting Grit

__Industrial Drums

__Manual-Grade Strapping

__Mats

__Pallets

__Signs and Posts

__Sorbents

The USDA-designated biobased items being procured are:

___ Mobile Equipment Hydraulic

Fluid

___ Roof Coatings

___ Water Tank Coatings

___ Diesel Fuel Additives

___ Penetrating Lubricants

___ Bedding, Bed Linens and

Towels

___ Adhesive and Mastic Removers

___ Insulating Foam for Wall

Construction

___ Hand Cleaners and Sanitizers

___ Composite Panels

___ Fluid-filled Transformers

___ Biodegradable Containers

___ Fertilizers

___ Metalworking Fluids

___ Sorbents

___ Graffiti and Grease Removers

___ 2-Cycle Engine Oils

___ Lip Care Products

___ Biodegradable Films

___ Stationary Equipment Hydraulic

Fluids

___ Biodegradable Cutlery

___ Glass Cleaners

___ Greases

___ Dust Supressants

___ Carpets

___ Carpet and Upholstery Cleaners

___ Bath and Tile Cleaners

___ Clothing Products

___ Concrete and Asphalt Release

Fluids

___ Cutting, Drilling and Tapping

Oils

___ De-icers

___ Durable and Plastic Films

___ Firearm Lubricants

___ Floor Strippers

___ Laundry Products

___ Wood and Concrete Sealers

The EnergyStar and/or FEMP Low-Power Standby Devices being procured are:

___ Battery Chargers

___ Clothes Washers

___ Dehumidifiers

___ Dishwashers

___ Refrigerators & Freezers

___ Room AC

___ Room Air Cleaners

___ Water Coolers

___ Computers

___ Copiers

___ Fax Machines

___ Laptops

___ Mailing Machines

___ Monitors

___ Multifunction Devices

___ Printers

___ Scanners

___ Water Coolers

___ Air-source Heat Pumps

___ Boilers

___ Central AC

___ Ceiling Fans

___ Furnaces

___ Geothermal Heat Pumps

___ Home Sealing (Insulation)

___ Light Commercial

___ Programmable Thermostats

___ Ventilating Fans

___ Compact Fluorescent Light

Bulbs (CFLs)

___ Residential Light Fixtures

___ Ceiling Fans

___ Exit Signs

___ Traffic Signals

___ Transformers

___ Vending Machines

___ Home Sealing (Insulation and

Air Sealing)

___ Roof Products

___ Windows, Doors & Skylights

___ Cordless Phones

___ Combination Units (TVs)

___ DVD Products

___ External Power Adapters

___ Home Audio

___ Televisions

___ VCRs

___ Commercial Fryers

___ Commercial Hot Food Holding

Cabinets

___ Commercial Solid Door

Refrigerators and Freezers

___ Commercial Steam Cookers

Green Procurement Determination

_____Green Procurement requirements have been met for this procurement action.

*****OR *****

_____The following item is included in the specifications for project number_______________, however, compliance with Green Procurement standards is not attainable.

Item:

I have determined that the GP 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 GP-compliant item: ___________________

Price of GP-noncompliant item: ________________

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

Technical OPR - Signature and Office Symbol Date

Concurrence - Contracting Officer Date