TE-07 Sustainable Acquisition Exception Form.pdf
PDF 156 KB Posted
- Attached to
- Solicitation for Protective Coatings Federal contract opportunity
- Solicitation number
- W911S825BA015
- Issued by
- Department of the Army
About this file
The document is a Sustainable Acquisition Exception Form (HJB Form 225, MAR 2014) used by Joint Base Lewis-McChord to document exceptions to sustainable acquisition requirements. The form provides a structured method for requesting an exemption from standard sustainable procurement guidelines, with sections for documenting the specific requirement against which an exception is claimed, reasons for the exception, research conducted, and product information for non-compliant items. The form requires detailed justification demonstrating why compliant options are unsuitable, which can be based on factors such as cost, availability, functional requirements, or performance.
The form is intended to be submitted to the JBLM Sustainable Acquisition Program Coordinator, with supporting documentation such as catalog data, technical sheets, price listings, or life cycle cost calculations. Potential exceptions include deviations from requirements related to recycled materials, biobased content, water efficiency, energy efficiency, low-emitting materials, rapidly renewable materials, and sustainable wood products. The justification must provide comprehensive evidence showing why a non-compliant product or service must be used, following specific guidelines for cost comparisons and life cycle cost determinations as outlined in the form's instructions.
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Text version
HJB Form 225, MAR 2014
SUSTAINABLE ACQUISITION EXCEPTION
Joint Base Lewis-McChord, WA
POINT OF CONTACT AND ORGANIZATION INFORMATION
1. Name 2. Title 3. Telephone
4. Organization 5. E-mail 6. Fax
CONTRACT INFORMATION (if related to a contract action, otherwise leave blank) Contracting Officer, Contracting Officer's Representative, or Project Manager Contact Information
7. Name 8. Organization 9. Phone 10. Email
11. Address
Project/Service Information
12. Project/Service Name 13. Contract Number or Other Identifier
EXCEPTION
14. Requirement Against Which Exception is Claimed (Check all that apply)
15. Reason for Exception (Check all that apply and provide details at section 18)
Recycled/Recovered Materials Price/Cost Biobased Content Life Cycle Cost WaterSense (water efficiency) Performance/Functional Requirements Energy Star/FEMP (energy efficiency) Availability EPEAT Statutory Exemption Low Emitting Materials Rapidly Renewable Materials Sustainble Wood
RESEARCH
16. List All Products/Services Researched and Vendors/Sources Consulted in Making Exception Determination
PRODUCT INFORMATION
17. Non-Compliant Product or Service that Will be Used (Supply or attach product name, national stock number, product code, description and other identifying information, as applicable)
HJB Form 225, MAR 2014
18. Cost (per unit of measure)
JUSTIFICATION*
19. Supply information justifying the use of the exception below AND attach any supporting documentation
* Justification must demonstrate the unsuitability of all available compliant options based on cost, availability, functional requirements, or performance.
Cost comparisons must show that all compliant options are only available at an unreasonable price or have higher life cycle costs than a non-Energy Star/FEMP/WaterSense product.
Life cycle cost determination shall be per 10 CFR 436, subpart A (http://www.gpo.gov/fdsys/) or another method determined to be equivalent by the DoD.
For exceptions based on statutory requirements and/or requirements based on standing orders for the maintenance and operation of U.S. Armed Forces tactical equipment, attach a photocopy of the applicable regulation/military specification.
ORGANIZATIONAL APPROVAL (approving official signature below, if required by your organization --otherwise, leave blank)
Signature Date
Return form and copies of supporting documents to usarmy.jblm.imcom.list.dpw-green-procurement@mail.mil. If related to a contract, submit to appropriate contracting official with the above address in the cc line, or ask that they forward a copy to the JBLM Sustainable Acquisition Program Coordinator (Bldg 1210, 966-6466). Supporting documents can include catalog data, technical data sheets, price listings, life cycle cost calculations, etc.
| 1 Name: |
| 2 Title: |
| 3 Telephone: |
| 4 Organization: |
| 5 Email: |
| 6 Fax: |
| 7 Name: |
| 8 Organization: |
| 9 Phone: |
| 10 Email: |
| 11 Address: |
| 12 ProjectService Name: |
| 13 Contract Number or Other Identifier: |
| 17 Cost per unit of measure: |
| Check Box 4: Off |
| Check Box 5: Off |
| Check Box 3: Off |
| Check Box 1: Off |
| Check Box 2: Off |
| Check Box 6: Off |
| Check Box 7: Off |
| Check Box 8: Off |
| Check Box 9: Off |
| Check Box 10: Off |
| Check Box 11: Off |
| Check Box 12: Off |
| Check Box 13: Off |
| 18 Supply Information: |
| 16 Non Compliant Product or Service: |
| 16 List All Products/Services Researched and Vendors/Sources Consulted: |
| Date (MM/DD/YYYY: |
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