eppform~8.docx

[NOTE TO RFR OR RFQ DEVELOPERS: The following form requires editing prior to including in an RFR or RFQ. This form is to be used for evaluation purposes only. Depending on the products/service bid, some of the entries below may not be applicable. Bid developers should keep those entries that make sense for the product/service bid (e.g., packaging may not apply to some bids). In addition, bid developers may add entries that are applicable (e.g., if there is a specific certification for the industry or a particular environmental practice to add)]

BIDDER CURRENT ENVIRONMENTALLY PREFERABLE PRODUCTS / PRACTICES FORM

Bidder Company Name: _________________________________________ Date: _______________

This form is a standard evaluation tool. Questions 1- 6 apply to the operations of the Bidder (not the operations of a manufacturer or other company the bidder works with). Question 7 requests additional information about environmentally preferable product offerings.

The primary purpose of this form is to encourage potential Bidders to communicate existing business practices that foster a sustainable approach to conducting their operations. This may include one that has a reduced impact on the environment or public health, such as, but not limited to, creating less waste by using less packaging; eliminating the use substances and/or materials that are considered toxic; or using alternative fuel vehicles in the delivery fleet for the purpose of reducing air pollution and greenhouse gas emissions.

The Commonwealth considers such initiatives part of the “best value” of procurement. Bidders have an opportunity to receive additional points in the evaluation phase of the RFR for the environmental initiatives they have identified. However, bidders must substantiate all answers in the space provided below or in an attachment in order to receive any additional points. If reference is made to an attached document, or a website, list the specific page and line to which information is referenced.

1. Sustainability Program/Environmental Business Practices

a) Does your firm have a corporate-wide sustainability policy? If yes, attach or provide a link to your sustainability policy AND summarize what your corporate sustainability policy directs your company to do: Click here to enter text.

b) Indicate any other types of corporate sustainability policies AND attach policy in order to receive credit.

☐Climate Action Plan ☐Zero Waste Policy ☐Toxics Reduction Strategy ☐Green Fleet Policy ☐Sustainable Procurement Policy or Environmentally Preferable Purchasing Policy ☐Waste Prevention and/or recycling policy/program (describe and list types of materials you recycle)

Briefly describe and list sustainable procurement practices and achievements as a result of the policies checked above: Click here to enter text.

c) Does your company publish an annual Sustainability Report listing accomplishments and future goals? If yes, please attach (or provide a link to) your latest Sustainability Report. Please describe key elements and accomplishments (such as receiving sustainability awards). Click here to enter text.

d) Please list individual steps not indicated above that your firm has taken to improve the sustainability at your own operations:

☐ Uses at least 50% remanufactured toner cartridges in printers (attach total annual spend on remanufactured and Original Equipment Manufacturer cartridges) Click here to enter text.

☐ Uses Green Cleaning products (certified by UL Ecologo, GreenSeal or SaferChoice) in all cleaning or janitorial services (attach copy of scope of work with cleaning services provider and types of green products used) Click here to enter text.

☐ Purchase appliances and equipment (printers, copiers, microwaves, etc.), that are Energy Star or EPEAT certified models. (list certified products) Click here to enter text.

☐ Incorporates green building design elements into all construction and renovation projects (list green design elements and provide documentation). Click here to enter text.

☐ Owns or leases buildings certified to LEED or another green building standard? (describe) Click here to enter text.

☐ Purchases or creates renewable electricity onsite (through solar or wind systems, for example)? Describe and indicate the % of energy that is derived from renewable sources: Click here to enter text.

☐ Has received a third party energy audit (usually through the utility) and implemented recommendations (attach audit recommendations and identify what has been completed). Click here to enter text.

☐ Has received a third party waste audit and implemented recommendations (attach audit recommendations and identify what has been completed). Click here to enter text.

☐ Please list other sustainable initiatives (e.g., waste reduction programs, green building management programs, other energy efficiency programs, etc.) and provide any measurable data: Click here to enter text.

2. Packaging:

Has your company implemented any of the following environmental packaging initiatives?

☐ Packaging materials do not contain chemicals or materials of concern such as PVC (vinyl), BPA, etc.). Please describe: Click here to enter text.

3. Shipping/Transportation:

Describe in detail how your company has implemented environmentally sound shipping and transportation practices.

☐ Your firm uses electric, hybrid-electric, bicycles or other alternative fuel vehicles to transport products to your retail stores or other locations. (Describe program) Click here to enter text.

☐ Your firm is a US EPA SmartWay Partner. Attach partnership agreement. Click here to enter text.

☐ Has an anti-idling policy. Attach policy.

☐ Diesel vehicles are equipped with emission control devices. List device(s) here: Click here to enter text.

☐ Uses biodiesel in your vehicles. List estimated amount used in the last year: Click here to enter text.

☐ Use environmentally preferable products in its fleet program (e.g., retread tires, re-refined motor oil, low-VOC solvents, etc.). List products here: Click here to enter text.

☐ Encourages the use of public/green transit. Provide name and description of program(s): Click here to enter text.

☐ Minimizes shipping energy and environmental impacts in other ways? Please describe: Click here to enter text.

4. Training and Education Describe how your company trains staff and educates customers on the products or service that involves an environmentally preferable component. Click here to enter text.

5. Certifications Bidders should familiarize themselves with the various certifications for products and processes that are available within the industry in which they operate, with particular attention to those concerning environmental issues. Has your company or any of its manufacturers and/or subcontractors obtained any of the following product / industry certifications? In order to receive credit, please attach a copy certifications listed below:

6. Other Environmental Criteria Bidders may provide additional information about environmentally preferable practices that are not indicated and explained above (attach any appropriate documentation to substantiate claim) Click here to enter text.

7. Environmental Product Offering:

Bidders providing environmentally preferable options in the price sheet should also provide additional information about those options here. Please include a description of the product, how the product is environmentally preferable, how pricing compares to the conventional product counterpart, links to additional information, or if attaching product information, please reference names of files, and any additional information that would be helpful for reviewer:

Click here to enter text.

Bidder Current Environmentally Preferable Products and Practices Form