6 Atch - RMDF Form.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 XUMU 18-1093B Replace VFD on AH 5 and dampers AH 1 and 2, Facility 7015.

X No materials identified at this time.

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.

____________________ RANDALL D. PICKARD 30 CES/CENMP 21 Mar 19 Procurement Originator Signature Name (Printed) Office Symbol Date http://www.epa.gov/cpg/products.htm

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.