Att_4_RMDF.pdf

Recovered Materials Determination Form (RMDF) – Instructions

The procurement originator shall complete this checklist when EPA-designated recycled-content products are being procured (except for procurements below the micro purchase threshold). This checklist will help the contractor/vendor with identification of the products to be procured. Information about the products listed below can be found at the EPA website, http://www.epa.gov/cpg/products.htm. This completed checklist shall become part of the contract file.

Procurement Request / Project No.:

The EPA-designated items being procured are:

Construction Products Building insulation products Carpet (polyester) Carpet cushion Cement and concrete containing:

Coal fly ash Ground granulated blast furnace slag Cenospheres or Silica fume

Consolidated and reprocessed latex paint Floor tiles Flowable fill Laminated paperboard Modular threshold ramps Nonpressure pipe Patio blocks Railroad grade crossing surfaces Roofing materials Shower and restroom dividers/partitions Structural fiberboard

Landscaping Products Compost made from yard trimmings or food waste Garden and soaker hoses Hydraulic mulch Lawn and garden edging Plastic lumber landscaping timbers and posts

Non-Paper Office Products Binders, clipboards, file folders, clip portfolios, and presentation folders Office furniture Office recycling containers Office waste receptacles Plastic desktop accessories Plastic envelopes Plastic trash bags Printer ribbons Toner cartridges

Paper and Paper Products Commercial/industrial sanitary tissue products Miscellaneous papers (tray liners) Newsprint Paperboard and packaging products Printing and writing papers

Park and Recreation Products Park benches and picnic tables Plastic fencing Playground equipment Playground surfaces Running tracks

Transportation Products Channelizers Delineators Flexible delineators Parking stops Traffic barricades Traffic cones

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

Miscellaneous Products Awards and plaques Bike racks Blasting grit Industrial drums Manual-grade strapping Mats Pallets Signage Sorbents

I hereby certify the Statement of Work/Specifications for the requisition of products listed above complies with preference standards for recycled-content materials in force at VAFB.

Procurement Originator Signature Name (Printed) Office Symbol Date

LEARD.JOSHUA.JOE.118

8149231

Digitally signed by LEARD.JOSHUA.JOE.1188149231 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=LEARD.JOSHUA.JOE.1188149231 Date: 2014.12.05 14:43:29 -08'00'

Attachment 4 FA4610-15-R-0006

Note: Page 2 of the RMDF is required if item(s) are subject to the EPA-Designated Recycled Content Products, but are not procured.

Procurement Request / Project No.:

The contracting officer must place a written justification in the contract file, if an acquisition of EPA-designated products above the micro-purchase threshold does not contain recovered material.

The procurement originator and/or contracting officer must check the appropriate justification(s) listed below, provide a written explanation, and sign and date the form.

EPA Designated Recycled Content Item NOT being Procured:

___ Designated Item is not competitively available within a reasonable period of time.

(If contract is greater than $25,000, on DD Form 350, line B12F, choose “B.”)

Need Date: ______________ Date Available: ______________

___ Designated Item is at an unreasonable price (recycled item costs more).

(If contract greater than $25,000, on DD Form 350, line B12F, choose “C.”)

Price of Designated Item: __________________ Price of Non-Recycled Item: ________________

___ Designated Item does not meet Vandenberg’s performance standards.

(If contract greater than $25,000, on DD Form 350, line B12F, choose “D.”)

Describe the performance need, document and section number and explain briefly why a recycled-content product will not meet that need.

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

Procurement Originator Signature Date Contracting Officer Signature Date

Name (Printed) Office Symbol Name (Printed) Office Symbol

1. PURPOSE OF STATEMENT. This “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. Civil Engineering/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. This 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 cardholders will not complete this form and will use the “GPC Green Procurement Purchasing Log” instead.

b. Environmental Management will incorporate this RMDF into the VAFB Environmental Requirements Specification documentation. These specifications will be included in all service and construction contracts as well as all in-house work orders greater than $2,500.

c. 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. The OCR organizations listed above will be responsible for verifying the completed RMDFs.

d. If the procurement action does not include any CPG, biobased, Energy Star®, or FEMP Low Standby Power items, complete the “Green Procurement Waiver Statement” instead.

6. FILING PROCEDURE. The completed RMDF (and any amended RMDFs) must be included in the purchasing or contracting file. Contracting is responsible for ensuring that either a “Green Procurement Waiver Statement” or RMDF (and any amended RMDFs) is included in contracting files. A similar memo or email statement can be used in lieu of this statement.