Material_Declration_form.xls

XLS spreadsheet 57 KB Posted Dec 15, 2015

Attached to: HARDWARE Federal contract opportunity
Solicitation number: FN1410-16
Issued by: Department of Justice Bureau of Prisons Federal Correctional Complex Allenwood

About this file

From the source

MATERIAL DECLARATION FORM

View the file

Other files for this federal contract opportunity

Other files attached to HARDWARE, newest first.
File	Type	Posted
FN1410-16_AMENDED_6.docx	DOCX document	Jan 15, 2016
FN1410-16_AMENDED_5.docx	DOCX document	Jan 8, 2016
fn1410-16__amend_4.pdf	PDF	Jan 5, 2016
FN1410-16_AMENDED_3.docx	DOCX document	Dec 30, 2015
FN1410-16__Spreadsheet_(NO_Govt_Est.).xlsx	XLSX spreadsheet	Dec 30, 2015
FN1410-16_AMENDED_2.docx	DOCX document	Dec 23, 2015
ermt_drawings_3.pdf	PDF	Dec 21, 2015
ermt_drawings_2.pdf	PDF	Dec 21, 2015
ermt_drawings_1.pdf	PDF	Dec 21, 2015
FN1410-16__Spreadsheet_(NO_Govt_Est.).xlsx	XLSX spreadsheet	Dec 18, 2015
MIMT_DRAWINGS.pdf	PDF	Dec 18, 2015
FN1410-16_AMENDED_1.docx	DOCX document	Dec 18, 2015
FN1410-16_SOL.pdf	PDF	Dec 15, 2015
sf_1449__FN1410-16.pdf	PDF	Dec 15, 2015

Show all 14

On GovTribe

Work with this file on GovTribe

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Declaration Form

Unicor Supplier Material Declaration Form

General

Company Name:

Representative's Name:

Date:

By completing this material declaration form, the company and representative stated above affirm that all information provided below is accurate, complete and consistent to the best of their knowledge. Please scroll right to see all columns.

Please see the "Instructions" and "Definitions" tabs for guidelines on how to complete this matrix.

An example is provided under the "Example" tab.

Required

Product Identification

Material Composition

Recycled Content, %

Material Efficiency

Chemical Information

Item #

Product Name

Type of Material

Grade

Total Weight (Unit of Measure)

Relative Weight

(% of total)

Finish

Post Industrial

(%)

Post Consumer

(%)

Manufacturing Operation(s)

Material Efficiency (%)

MSDS for Finished Product (Y/N)

MSDS for Component Materials (Y/N)

Instructions

Instructions for completing the CLIENT Supplier Material Declaration Form

Please complete the form under the tab "Declaration Form" to the fullest extent possible, following the guidelines provided below. Please see the tab "Example" for an example of the type of information that would be valuable.

Please remember to scroll down to the bottom of the spreadsheet to see all guidelines.

General
Company name	Enter the name of your company
Representative's name	Enter the name of the company representative completing the form
Date	Enter the date the form was completed and returned to CLIENT
Product Identification
Item #	Enter the item (part) # for the product supplied to CLIENT (as requested in the cover letter)
Product name	Enter the name of the product (part) supplied to CLIENT (as requested in the cover letter)
Material Composition
Note that a product may be comprised of more than one material; thus please record the information for each material in a separate row under that product name. For each material that comprises the product, the following information would be appreciated.
Type of Material	Describe the nature of the material by entering terms such as steel, aluminum, polypropylene, polyurethane, particleboard etc. Please be as specific as possible, for example: extruded aluminum, cast aluminum, nylon-6, low density polyethylene (LDPE). Please try and avoid generic terms such as "plastic".
Grade	Metal Grades: For steel, aluminum and other metal alloys, please enter the exact grade specification according to standardized grading systems (e.g. ASTM, AISI, JIS, EN, UNI etc.). Please indicate both the grading system acronym and number.
	Plastic Grades: Please identifiy each plastic by its specific ISO 11469 code to the fullest extent possible, i.e. "base resin", "filler", "plasticizers", and "flame retardants" (as applicable). For example: >PA6<, >PA6-GF30<, >PC+ABS<, >PC+ABS FR(40)< etc.
Total Weight	Enter the weight of the total part/component. Include the Units of Measure (e.g. kg; lbs; etc.)
Relative Weight	Enter the relative weight of each material comprising the part as a percentage (%) of the total weight of the product. The total weight of the part must equal the sum of the weights of each individual material comprising the part.
Finish	Indicate if the final product or any of its component materials have a finish, such as: wet paint; lacquers/varnishes/other wood finishes; powder coat; e-coat; chrome plating; nickel plating; anodization; passivation; etc. For chrome plating, indicate if hexavalent or trivalent chromium was used.
Recycled Content, %
For each material, please record "recycled content" and NOT "recyclable content" (see "Definitions" tab). Please enter a value for "post-consumer" and/or "post-industrial" under the respective column headings; DO NOT enter a value for "total recycled content".
Post consumer	Enter the post consumer content of the mateial as a percentage of the total weight of that material. Please see the definition of "post consumer" recycled content under the tab "Definitions".
Post-industrial	Enter the post industrial content of the material as a percentage of the total weight of that material. Please see the definition of "post industrial" recycled content under the tab "Definitions". Note: Material such as rework, regrind and scrap that is claimed and reutilized within the same process that generated it should not be counted towards post-industrial recycled content.
Material Efficiency
Material efficiency is intended to capture the utilization of raw material inputs within the finished component as sold to CLIENT. This may be captured at a process level and therefore available data may be applicable to a range of components.
Manufacturing Operation(s)	Identify the major manufacturing operation(s) performed on the material (e.g. sawing, routing, machining, forming, stamping, molding, cutting, sewing).
Material Efficiency (%)	Enter the total material efficiency for the major manufacturing operation(s) performed. Material efficiency is to include any substantial conversion of raw materials within your operations. See the "Definitions" tab for further guidance on material efficiency calculations.
Chemical Information
If available, please submit documents (e.g. Material Safety Data Sheets) to CLIENT along with this completed Supplier Material Declaration Form.
MSDS for Finished Product (Y/N):	Is there a Material Safety Data Sheet (MSDS) or Safety Data Sheet (SDS) that covers the finished product as supplied to, enter "Y" for "YES" and "N" for "NO". If the answer is "YES" please include the applicable MSDS/SDS when returning this form to CLIENT.
MSDS for Product Components (Y/N)	If there is no required MSDS/SDS for the finished product itself, would your company be prepared to share the MSD/SD sheets for the materials/components used internally to manufacture the product? Enter "Y" for "YES" and "N" for "NO". If the answer is "YES" please include the applicable MSDS/SDS when returning this form to CLIENT. As an example, an injection molded plastic part supplied to CLIENT may not be covered by an MSDS, but an MSDS is available for the plastic resin itself.

Definitions

Definitions
The following definitions have been adopted from the ANSI/BIFMA e3-2011e Furniture Sustainability Standard for purposes of the material information collected in this Supplier Material Declaration Form. Please consult and adhere to these definitions when entering the relevant information.
Recycled Content:
recycled-content materials	Materials that have been recovered or otherwise diverted from the solid waste stream, either during the manufacturing process (post-industrial) or after consumer use (post-consumer).
post-consumer	Generated by households, or by commercial, industrial, and institutional facilities in their role as end-users of the product, which can no longer be used for its intended purpose. This includes return of materials from the distribution chain.
post-industrial (pre-consumer)	Diverted from the waste stream during the manufacturing process. Excluded is reutilization of materials such as rework, regrind, or scrap generated in a process and capable of being reclaimed within the same process that generated it.
Additional Notes	"Recycled content" means the materials used to manufacture the part contain some percentage of that material recovered from the post-consumer or post-industrial waste streams. "Recycled content" does not pertain to whether or not the part is itself recyclable at the end of its useful life. THIS SUPPLIER MATERIAL DECLARATION FORM DOES NOT REQUIRE INFORMATION ON THE "RECYCLABLE CONTENT" OF EACH PART.
Material Efficiency:
material efficiency	Material Efficiency = [(Input Mass - Waste Mass) / (Input Mass)] x 100%
Additional Notes	This calculation is focused on the substantial conversion of raw material (e.g. sawing, routing, machingin, forming, stamping, molding, cutting sewing) and does not cover the extraction and intial processing of raw materials. Process aids and incidental consumables (e.g. gloves, sand paper) are not included in the calculation. Waste Mass includes materials sent to recycling.

Example

CLIENT Supplier Material Declaration Form

General

Company Name:

Representative's Name:

Date:

Please see the "Instructions" and "Definitions" tabs for guidelines on how to complete this matrix.

An example is provided under the "Example" tab.

Required

Product Identification

Material Composition

Recycled Content, %

Material Efficiency

Chemical Information

Item #

Product Name

Type of Material

Grade

Total Weight (Unit of Measure)

Relative Weight

(% of total)

Finish

Post Industrial

(%)

Post Consumer

(%)

Manufacturing Operation(s)

Material Efficiency (%)

MSDS for Finished Product (Y/N)

MSDS for Component Materials (Y/N)

xx-xx-1

Chair Base XP

Aluminum (cast)

A380

2.2 Kg

100%

powder coat

Casting

96%

xx-xx-2

1.5" Particleboard

48 lbs/sq foot

none

xx-xx-2

1.5" Particleboard

Composite Wood

92%

Chipping, Blending, Forming

90%

xx-xx-2

1.5" Particleboard

Urea-formaldehyde resin

Blending, Forming

90%

xx-xx-3

Gas Lift

2.6 lbs

xx-xx-3

Gas Lift

Steel

SPC2

73%

chrome (VI) plated

Assembly

98%

xx-xx-3

Gas Lift

Steel

S45C

15%

e-coated

Assembly

98%

xx-xx-3

Gas Lift

Nylon-6

>PA-6<

none

Assembly

98%

xx-xx-3

Gas Lift

Aluminum (wrought)

6061

none

Assembly

98%

File details come from the government source that posted it. Updated Nov 14, 2017.