Recycle_Form.doc
DOC document 61 KB Posted
- Attached to
- 03-0706 SVS - CSP_Cashless System
- Solicitation number
- 0000000815
- Issued by
- Sacramento County, San Francisco City, California
About this file
This is a State of California Integrated Waste Management Board form (CIWMB 74) for Postconsumer-Content Certification, which is part of the State Agency Buy Recycled Campaign (SABRC). The form requires state agencies to report and verify recycled content purchases across 11 specified product categories. Businesses must certify in writing to the contracting officer the minimum percentage of postconsumer recycled-content material in products sold to the State, even if the product contains no recycled material.
The form details 11 product categories with specific minimum postconsumer content requirements: Paper Products (30%), Printing and Writing Papers (30%), Mulch/Compost Products (80% recovered material), Glass Products (10%), Lubricating Oils (70% re-refined), Plastic Products (10%), Printer/Duplication Cartridges (10% or remanufactured), Paint (50% or 10% with restrictions), Antifreeze (70%), Tires (must be retreaded), Tire-Derived Products (50%), and Metal Products (10%). The certification must be provided under penalty of perjury, though agencies may waive the requirement if the recycled content can be verified through written advertisements, product labels, catalogs, or manufacturer websites.
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Other files
| File | Type | Posted |
|---|---|---|
| 03-0706_Attachment__1_Solicitation_Terms.docx | DOCX document | |
| 03-0706_DR_815_Form.pdf | ||
| 03-0706_RFQ_Letter.pdf | ||
| Attachment__2_Correctional_Institution_Terms.docx | DOCX document | |
| Bidder_Declaration_GSPD105.pdf |
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Text version
STATE OF CALIFORNIA
California Integrated Waste Management Board To be completed by the State agency
| CIWMB 74 (Revised 4/07 for State Agencies) |
| OFFICE LOCATIONS: |
| Postconsumer-Content Certification |
| Purchasing Agent: |
| PO #: |
| Phone: |
| E-mail: |
The State Agency Buy Recycled Campaign (SABRC) is a state mandated program that requires the reporting of all purchases made within 11 specified product categories. All state agencies are required to verify the recycled-content of all products purchased within each of these categories. Please follow instructions below. You may not have to submit this form if you have alternative resources to track your recycle content product information.
All businesses shall certify in writing to the contracting officer or his or her representative the minimum percentage, if not exact percentage, of postconsumer recycled-content (PCRC) material in the products, materials, goods, or supplies offered or sold to the State regardless of whether the product meets the minimum content requirements specified in law (see reverse side). The certification shall be furnished under penalty of perjury. The certification shall be provided regardless of content, even if the product contains no recycled material. A State agency may waive the certification requirement if the percentage of postconsumer material in the products, materials, goods, or supplies can be verified in a written advertisement, including, but not limited to, a product label, a catalog, or a manufacturer or vendor Internet website.
Contractor/Company Name_________________________________________________________________________________
Address_____________________________________________________________________Phone_____________________
Purchase Order #
RFQ #
RFP #
IFB #
Cal Card Order #
DATE
| Product or Services Description |
| 1Percent Postconsumer Recycled-Content Material |
| 2SABRC Product Category Code |
| Meets SABRC |
Public Contract Code sections 12205 (a) (1), (2), (3) and (b) (1), (2), and (3)
Pursuant to Public Contract Code 12205(a)(1), I certify under penalty of perjury under the laws of the State of California that the above information is true and correct.
Print Name
Signature
Title
Date
(See footnotes on the back of this page.)
FOOTNOTES:
1. “Postconsumer recycled-content material” is defined as products that were bought, used, and recycled by consumers. For example, a newspaper that has been purchased, recycled, and used to make another product would be considered postconsumer material.
2. “Product category” refers to one of the categories listed below, into which the reportable purchase is best placed.
3. If the product does not belong in any of the product categories, enter “N/A.” Common “N/A” products include wood products, natural textiles, aggregate, concrete, and electronics such as computers, TV, software on a disk or CD, and telephones.
4. Reused or refurbished products, there is no minimum content requirement. (PCC 12209 (l))
| Code |
| Product Categories |
| Product Examples |
| Minimum Postconsumer Content Requirement |
Examples are inclusive but are not limited to the individual product.
| 1 |
| Paper Products |
| Paper janitorial supplies, cartons, wrapping, packaging, file folders, and hanging files, building insulation and panels, corrugated boxes, tissue, and toweling. |
| 30 percent by fiber weight postconsumer fiber. |
| 2 |
| Printing and Writing Papers |
| Copy, xerographic, watermark, cotton fiber, offset, forms, computer printout paper, white wove envelopes, manila envelopes, book paper, note pads, writing tablets, newsprint, and other uncoated writing papers, posters, index cards, calendars, brochures, reports, magazines, and publications. |
| 30 percent by fiber weight postconsumer fiber. |
| 3 |
| Mulch, Compost, and Co-compost Products |
| Soil amendments, erosion controls, soil toppings, ground covers, weed suppressants, and organic materials used for water conservation; yard trimmings and wood byproducts that are separated from the municipal solid waste stream or other source of organic materials such as biosolids or other comparable substitutes such as livestock, horse, or other animal manure, food residues or fish processing byproducts; mechanical breakdown of materials. |
| 80 percent recovered material that would otherwise be normally disposed of in a landfill. |
| 4 |
| Glass Products |
| Windows, test tubes, beakers, laboratory or hospital supplies, fiberglass (insulation), reflective beads, tiles, construction blocks, desktop accessories, flat glass sheets, loose-grain abrasives, deburring media, liquid filter media, and containers. |
| 10 percent postconsumer, by weight. |
| 5 |
| Lubricating Oils |
| Intended for use in a crankcase, transmission, engine, power steering, gearbox, differential chainsaw, transformer dielectric, fluid, cutting, hydraulic, industrial, or automobile, bus, truck, vessel, plane, train, heavy equipment, or machinery powered by an internal combustion engine. |
| 70 percent re-refined base oil. |
| 6a |
| Plastic Products |
| Printer or duplication cartridges, diskette, carpet, office products, plastic lumber, buckets, wastebaskets, containers, benches, tables, fencing, clothing, mats, packaging, signs, posts, binders, sheet, buckets, building products, garden hose, and trays. |
| 10 percent postconsumer, by weight. |
| 6b |
| Printer or Duplication Cartridges |
a. Have 10 percent postconsumer material, or
b. Are purchased as remanufactured, or
c. Are backed by a vendor-offered program that will take back the printer cartridge after their useful life and ensure that the cartridge is recycled and comply with the definition of recycled as set forth in section Public Contract Code 12156.
| 7 |
| Paint |
| Water-based paint, graffiti abatement, interior and exterior, and maintenance. |
| 50 percent postconsumer paint (exceptions when 50 percent postconsumer content is not available or is restricted by a local air quality management district, then 10 percent postconsumer content may be substituted). |
| 8 |
| Antifreeze |
| Recycled antifreeze, and antifreeze containing a bittering agent or made from polypropylene or other similar non-toxic substance. |
| 70 percent postconsumer material. |
| 9 |
| Tires |
| Truck and bus tires, and those used on fleet vehicles and passenger cars. |
| Retreaded: Must use an existing casing that has undergone retreading or recapping process in accordance with Public Resource Code (commencing with section 42400). |
| 10 |
| Tire- Derived Products |
| Flooring, mats, wheelchair ramps, playground cover, parking bumpers, bullet traps, hoses, bumpers, truck bedliners, pads, walkways, tree ties, road surfacing, wheel chocks, rollers, traffic control products, mudflaps, and posts. |
| 50 percent recycled used tires. |
| 11 |
| Metal |
| Staplers, paper clips, steel furniture, desks, pedestals, scissors, jacks, rebar, pipe, plumbing fixtures, chairs, ladders, file cabinets, shelving, containers, lockers, sheet metal, girders, building and construction products, bridges, braces, nails, and screws. |
| 10 percent postconsumer material, by weight. |
For additional information, please visit www.ciwmb.ca.gov/BuyRecycled/StateAgency/
File details come from the government source that posted it. Updated .