Attch_9_GPP_Certification.pdf

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UNCLASSIFIED

Recovered Materials Determination Form (RMDF) User’s Guide

1. PURPOSE OF THE 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. 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/Material Acquisition.

4. 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.

5. INTENT FOR USE.

a. GPC holders will not complete this form and will use the “GPC Purchasing Considerations and Guidelines Log” instead. The RMDF is included in the Patrick Air Force Base Environmental Protection specification. The Environmental Protection Specification will be included in all service and construction contracts as well as all work orders greater than $2,500 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 an RMDF if any of the mandatory EPP items are required. For CPG items where exemptions are identified during project/contract performance, and amended RMDF must be completed documenting the exemption. The OCR organizations listed above will be responsible for verifying the completed RMDFs.

c. If the procurement action does not include any CPG, Energy Star®, or FEMP Low Standby Power items, complete the AP statement instead.

6. 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 GPP Statement or RMDF (and any amended RMDFs) is included in contracting files.

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DIRECTIONS FOR USE OF THE RECOVERED

MATERIALS DETERMINATION FORM

Complete top of the Recovered Materials Determination Form (RMDF) Form and check mark all EPA-designated items applicable to this acquisition.

Complete page 2 of the RMDF Form

Check mark Box A on Part 1 of the RMDF

Form. Provide signatures/dates.

Were any EPA-designated items checked on page 1of the RMDF Form?

Yes

No

Yes

No Were all possible

EPA-designated items specified in the procurement action?

Check mark Box C on Part 1 of the RMDF

Form and complete the justification section.

Provide signatures/dates.

Check mark Box B on Part 1 of the RMDF Form.

Provide signatures/ dates.

Complete Part 2 of the RMDF Form

Were all EPA-designated items specified in the procurement action purchased?

No

Yes

Check mark Box A on Part 2 of the RMDF

Form. Provide signatures/dates.

Check mark Box B on Part 2 of the RMDF Form and complete the justification section. Provide signatures/dates.

Complete page 2 of Part 2 for each EPA-designated item for which an exemption has been claimed on Part 1 or 2 of the RMDF Form.

Place all forms in the Contracting Office contract/project file.

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RECOVERED MATERIALS DETERMINATION FORM

(Part 1) Design/Procurement

INSTRUCTIONS

This form is to be completed by the requiring activity when EPA-designated items are applicable to the requirement. 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.htm.

This form is not required for construction item purchases less than $2,000, or for other purchases less than $3,000. The completed form becomes part of the contracting office contract file.

PROCUREMENT TITLE: DBEH 08-1616, DBEH 08-1618, DBEH 08-1619, DBEH 08-1626,

DBEH 08-1630, and DBEH 13-1500

PROCUREMENT REQUEST NO.

PART 1: RECOVERED MATERIALS DETERMINATION

Part 1 shall be completed by the specifying authority when requesting a procurement action.

EPA-DESIGNATED ITEMS

(Place a check mark next to each product that applies to this procurement)

Construction Products:

Building insulation Polyester carpet Carpet Cushion Cement & concrete containing:

Coal fly ash Ground granulated blast furnace slag

Cenospheres or Silica fume

Floor tiles (rubber & plastic) Flowable fill Latex paint Laminated paperboard Modular threshold ramps Nonpressure pipe Patio blocks Railroad grade crossings/surfaces Roofing materials Shower & restroom dividers/partitions

Structural fiberboard

Landscaping Products:

Compost from yard trimmings or food waste

Garden and soaker hoses Hydraulic mulch Lawn and garden edging Plastic lumber landscaping timbers and posts

Park & Recreation Products:

Park and recreational furniture Playground equipment Playground surfaces Running tracks Plastic fencing (snow or erosion control, safety barriers)

Non-paper Office Products:

Binders (paper, solid plastic or plastic covered)

Plastic clipboards Plastic file folders Plastic clip portfolios Plastic presentation folders Office furniture Office recycling containers Office waste receptacles Plastic desktop accessories Plastic envelopes Plastic trash bags Printer ribbons Toner cartridges

Paper & Paper Products:

Commercial/industrial sanitary tissue products

Miscellaneous papers Newsprint Paperboard and packaging Printing and writing papers Tray liners

Vehicular Products:

Engine coolants Rebuilt vehicular parts Re-refined lubricating oils Retread tires

Transportation Products

Channelizers Delineators Flexible delineators Parking stops Traffic barricades Traffic cones

Miscellaneous Products:

Awards and plaques Bike racks Blasting grit Industrial drums Mats Pallets Signage Sorbents Strapping http://www.epa.gov/cpg/products.htm