2009c2.0CI Doc Materials Submittal Cover Sheet

7/24/2019 2009c2.0CI Doc Materials Submittal Cover Sheet

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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEETUSGBC LEED-CI v2.0 RATING SYSTEM

Instructions to Contractor/Installer: For each matera!" #!ea$e com#!ete the %o!!o&'( '%ormato' ' a!! a##!ca)!ecate(ore$. U$e a**to'a! $+)mtta! $heet$ a$ 'ee*e*. Attach c+t $heet$" !etter$ %rom ma'+%act+rer$" a'*,or othe$+##ort'( '%ormato' a'* $+)mt %or reve&. The Co'tractor $ho+!* +$e th$ $heet ' co'+'cto' &th the Matera!$Trac'( E/ce! $#rea*$heet to *oc+me't the matera!$ a'* #ro*+ct$ $e!ecte* a'* '$ta!!e* ' the #roect.

roect Name: 111111111111111111111111111 Com#a': 11111111 1111111111111111111111111111111111111

S('e* ) 3#r't4: 1111111111111111111111111 S('at+re: 1111111111111111111111111111 Date: 11111111111

LEED Materials Credits (Divisions 2 10 and 12)

Please list the material cost charged to the client excluding any equipment rental or installation.Please provide a copy of the invoice.

Product / Material Manufacturer/Vendor Material Cot

LEED MR c3: Resource Reuse (Divisions 2 10 and 12)

Has the material/product been salvaged, refurbished or reused?

Material Origin of material Sa!va(e*" Re%+r)$he*" or Re+$e*5

I confirm that appropriate backup documentation has been provided

LEED MR c!" Rec#cled Content (Divisions 2 10 and 12)

Does the material/product contain post-consumer or post-industrial content? Yes / No

ro*+ct , Matera! erce't #o$t-'*+$tra! erce't #o$t-co'$+mer

New Construction Program, Harvard Green Campus Initiative

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If only select components of a product contain recycled content, see LEED-CI v..! "eference #uide forinstructions to calculate total product recycled content $%ased on relative material &ei'hts(.

I confirm that appropriate backup documentation has been provided.

LEED MR c$" Locall# Har%eted/E&tracted Material (Divisions 2 10 and 12)

)ere the ra& materials e*tracted/harvested and the final product manufactured &ithin +!! miles?

ro*+ct , Matera! Locato' o% e/tracto' D$ta'ce 3m4 Locato' o% ma'+%act+re D$ta'ce 3m4

sehttp//indo.com/distance/to confirm linear distance $as-a-cro& flies( from site.


LEED MR c'" Rapidly Renewale Materials(Divisions 2 10 and 12)

Does the product/material contain rapidly rene&a%le materials?

Raw Materials % of Rapidly Renewable Co$t

. . .

. . .

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LEED MR c(" !"C Certi#ed $ood (Divisions 2 10 and 12)

Does the material/product contain Forest Stewardship Council (FSC) certified wood?

Component % of Material Chain-of-Custody Certificate #: Co$t


LEED E% c&'1" LowEittin* Materials+ ,d-esives and "ealants (,nyw-ere w.in oisturearrier)

Do the adhesives and sealants comply with the LEED-CI v2.0 VOC limits?

Product Name Ma'+%act+rer VOC Content (grams / liter)


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VOC limits can be found athttps://www.usgbc.org/ShowFile.aspx?DocumentID=1095pages 67 & 68.


LEED E% c&'2" LowEittin* Materials+ /aints and Coatin*s (,nyw-ere w.in oisturearrier)

Do the paints and coatings comply with the LEED-CI v2.0 VOC limits?

Product Name Ma'+%act+rer VOC Content (grams / liter)

VOC limits can be found athttps://www.usgbc.org/ShowFile.aspx?DocumentID=1095pages 69.


LEED E% c&'3" LowEittin* Materials+ Carpet

Does the carpet meet the Carpet and Rug Institutes Green Label Plus IAQ testing requirements?

Does the cushion meet the Green Label IAQ testing requirements? Yes / No

Are adhesives free of VOCs? Yes / No

Product Name Ma'+%act+rer CRI Gree' La)e! !+$ Cert%cato'N+m)er


LEED E% c&'&" LowEittin* Materials+ Coposite $ood and ,*ri#er

Does the material/product contain any added urea-formaldehyde resins?

Product/Manufacturer Yes or No?


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LEED E% c&': LowEittin* Materials+ "ystes !urnitureIs the product Greenguard certified?

Product/Manufacturer ero* o% Ma'+%act+re AND Te$t Date,Cert%cato'ero*



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2009c2.0CI Doc Materials Submittal Cover Sheet