LEED Materials Documentation Submittal Cover Sheet_Lucketts.pdf

MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
Instructions to Contractor / Installer: For each material, please complete the following information in all applicable
categories. Use additional submittal sheets as needed. Attach cut sheets, letters from manufacturers, and/or
other supporting information and submit for review. The General Contractor should use this sheet in conjunction
with the Materials Tracking Excel spreadsheet to document the materials and products selected and installed in the
project.
Company: ____________________________________________
Date: _______________________
Signature: ____________________________________________
Submitted by (print): ____________________________________
LEED Materials Costs (Divisions 2 – 10)
1. List the material cost which include all taxes and transportation costs incurred by the contractor but exclude any
cost for labor and equipment once the material has been delivered to the site.
2. Provide a copy of the invoice.
Product / Material Manufacturer/Vendor Material Cost ($)
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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
LEED MR credit 3: Materials Reuse (Divisions 2 – 10)
List all material / product that have been salvaged, refurbished or reused on this project.
Salvaged Material
Onor
Off-
Site
Modification made to the On-site Materials or
Source of Off-Site Salvaged Materials
Replacement
Value ($)
I confirm that appropriate backup documentation has been provided (check box).
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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
LEED MR credit 4: Recycled Content (Divisions 2 – 10)
Does the material / product contain postconsumer or preconsumer content?
Yes / No
For product composed of multiple materials, calculate assembly recycled content using the percents by weight of the
post-consumer recycled content and the pre-consumer recycled content in the assembly.
Components
Weight (lbs)
Postconsumer
Preconsumer
% Weight (lbs) % Weight (lbs)
I confirm that appropriate backup documentation has been provided (check box).
LEED MR credit 5: Regional Materials (Divisions 2 – 10)
Are the materials and products extracted, harvested or recovered as well as manufactured within 500 miles?
If a portion of the material qualified for regional materials, list only that portion and associated cost satisfying the
credit requirement.
For assemblies or products manufactured within the 500-mile radius but containing only some components that also
were extracted within the 500-mile radius, use multiple lines. Base the proportionality of such products’ cost on the
weight of their various components.
Product
Manufacturer
Distance between
Project &
Extraction/Harvest
(miles)
Product
Cost ($)
Value Qualifying as
Regional ($)
I confirm that appropriate backup documentation has been provided (check box).
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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
LEED MR credit 6: Rapidly Renewable Materials (Divisions 2 – 10)
Are the materials or products made from plants that are typically harvested within 10-year or shorter cycle?
For assembly rapidly renewable content, the fraction of the assembly that is considered rapidly renewable is
determined by weight. That fraction is then applied to the material cost to determine the renewable value.
Product Company Product ($)
%
Renewable
Renewable
Value ($)
I confirm that appropriate backup documentation has been provided (check box).
LEED MR credit 7: FSC Certified Wood (Divisions 2 – 10)
Are the new wood-based products and materials certified in accordance with Forest Stewardship Council (FSC)
principles and criteria?
Only for materials permanently installed in the project.
In the case of an assembly, only the percentage of FSC-certified wood can be applied toward the credit. Determine
the amount of new wood as a percent of the total weight, volume or cost and the amount of FSC-certified wood as a
percent of the total weight, volume or cost.
Wood Product
Vendor
Material
Value ($)
Percent
Wood
(by
weight)
Value of
Wood ($)
Percent
Certified
Wood
(by
weight)
Value of
Certified
Wood
($)
FSC chain-ofcustody
certificate
number
I confirm that appropriate backup documentation has been provided (check box).
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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
LEED EQ credit 4.1: Low-Emitting Materials - Adhesives and Sealants
Do the adhesives and sealants (inside of weatherproofing system and applied on-site) comply with the LEED NC
v2.2 VOC limits?
Adhesives, sealants and sealant primers comply with South Coast Air Quality Management District (SCAQMD) Rule
#1168. Aerosol Adhesives comply with Green Seal Standard for Commercial Adhesives GS-36.
Product
Manufacturer
VOC
Content
(g/L less
water)
VOC Limit
(SCAQMD Rule
1168 or Green Seal
GS-36)
I confirm that appropriate backup documentation has been provided (check box).
LEED EQ credit 4.2: Low-Emitting Materials - Paints and Coatings
Do the paints and coatings comply with the LEED NC v2.1 VOC limits?
Architectural paints, coatings and primers comply with Green Seal Standard GS-11. Anti-corrosive and anti-rust
paints complied with Green Seal Standard GC-03. Clear wood finishes, floor coatings, stains, sealers, and shellacs
comply with South Coast Air Quality Management District (SCAQMD) Rule 1113.
Product
Manufacturer
VOC
Content
(g/L less
water)
VOC Limit
(SCAQMD Rule
1113 or Green Seal
GS-11 or GS-03)
I confirm that appropriate backup documentation has been provided (check box).
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MATERIALS DOCUMENTATION SUBMITTAL COVER SHEET
Lucketts Community Center
USGBC LEED NC v2.2
LEED EQ credit 4.3: Low-Emitting Materials – Carpet Systems
1. Does the carpet meet the Carpet and Rug Institute’s Green Label Plus requirements? Yes / No
2. Does the cushion meet the Carpet and Rug Institute’s Green requirements? Yes / No
3. Do carpet adhesives have less than 50 g/L VOC? Yes / No
Product Name
Manufacturer
I confirm that appropriate backup documentation has been provided (check box).
LEED EQ credit 4.4: Low-Emitting Materials - Composite Wood and Agrifiber Products
1. Does the composite wood and agrifiber product contain any added urea formaldehyde resins?
2. Does the laminate adhesive use to fabricate on-site and shop-applied composite wood and agrifiber assemblies
contain any added urea formaldehyde resins?
Composite wood and agrifiger products are defined as: particleboard, medium density fiberboard (MDF), plywood,
wheatboard, strawboard, panel substrates and door cores.
Product/Manufacturer
Yes or No?
I confirm that appropriate backup documentation has been provided (check box).
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