2011 Evergreen Award Application Form by pr3GG4

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									2011 Evergreen Award Application Form


PLEASE COMPLETE ALL AREAS:                                        PLEASE SELECT THE COMMODITY AREA YOU
*Only type in the gray boxes*                                     WISH TO BE CONSIDERED FOR AS WELL AS
                                                                  THE SCHEDULE YOU OFFER PRODUCTS AND
                                                                  SERVICES THROUGH:
Company Name                                                         FURNITURE
GSA Schedule #                                                                Schedule 71
                                                                              Schedule 71 II K
Point of Contact
                                                                  ***************************************************************
Email Address
                                                                     FURNISHINGS
Address                                                                       Schedule 71 II K
                                                                              Schedule 72
City, State, Zip Code
                                                                  ***************************************************************
Phone Number                                                         TECHNOLOGIES AND ELECTRONICS

Fax Number                                                                    Schedule 36
                                                                              Schedule 58 I
Company Website
                                                                  ***************************************************************
***************************************************************
                                                                     SPORTS AND RECREATION
Please follow the below guidelines before submission:
                                                                              Schedule 78
1.   Companies for nomination must currently be on
     GSA contract.                                                ***************************************************************
     o Companies not on schedule will not be considered.              Are you also a small business? If so, what
                                                                          schedule do you hold a contract under?
2.   Category for consideration must be aligned with
     the schedule contract category.
                                                                              Schedule 36
     o Information on products and/or services with
         environmental attributes must be provided under
                                                                              Schedule 58 I
         designated GSA contract.                                             Schedule 71
                                                                              Schedule 71 II K
3.   Previous winners cannot submit an application                            Schedule 72
     within two years of receiving the Evergreen Award.                       Schedule 78
     o A list of past winners can be found at
         www.gsa.gov/evergreenaward                               Submit this Application Form, along with an optional electronic
                                                                  brochure in ONE PDF file and a high res JPG file of the
4.   An electronic brochure may be included with this             company logo via e-mail to IWAC.BD@gsa.gov.               Both
     application as a supplement.                                 attachments (PDF and JPG file) must have the file names as
                                                                  following:
5.   Complete the attached form with the positive
                                                                    Category_Company_2011 EvergreenAwardApplication.pdf
     changes that your company has made relative to                                       AND
     the categories listed.                                           Category_Company_2011 EvergreenAwardLogo.jpg

                                                                                        Example:
                                                                  Furniture_ABCCompany_2011EvergreenAwardApplication.pdf

                                                                  E-mail two attachments only to IWAC.BD@gsa.gov with “2011
                                                                  Evergreen Award Nomination” as the subject line no later
                                                                  than December 31, 2011. Paper copies/Faxes of application
                                                                  forms will not be accepted.
                                             WASTE PREVENTION

This category should reflect your reductions in the generational of waste through any change in the design,
manufacturing, or use of materials or products; and/or the amount of toxicity in waste materials before recycling,
treatment, or disposal.




                                                   RECYCLING

This category recognizes your outstanding activities, including outreach, collection, separation, and processing by
which products or other materials are recovered from the waste stream for use in the new products (other than fuel
for producing heat or power by combustion).
                                    AFFIRMATIVE PROCUREMENT

This category recognizes your most effective and innovative programs implemented for the purchase and
use of recovered materials.




                                 ENVIRONMENTAL PREFERABILITY

This category recognizes your best examples of acquiring, using, or validating products or services that
have a reduced impact on human health and the environment, when compared with competing products
or services that serve the same purpose; an outstanding improvement to a process that resulted in
significant monetary savings and benefit to the environment; product testing that led to the approval and
use of environmentally preferable or sound products and services.
                                                  MODEL FACILITY

This category recognizes an outstanding contribution to waste prevention, recycling and affirmative
procurement through leadership, investment in resources and change in culture.




                                               SUBMISSION DETAILS



                Submit this Nomination Form, along with an optional electronic brochure in ONE PDF file and
                         a high res JPG file of the company logo via e-mail to IWAC.BD@gsa.gov.
                        Both attachments (PDF and JPG file) must have the file names as following:

                                 Category_Company_2011 EvergreenAwardApplication.pdf

                                                           AND

                                    Category_Company_2011 EvergreenAwardLogo.jpg

                          Example: Furniture_ABCCompany_2011EvergreenAwardApplication.pdf


               E-mail two attachments only to IWAC.BD@gsa.gov with “2011 Evergreen Award Nomination”
     as the subject line no later than December 31, 2011. Paper copies/Faxes of application forms will not be accepted.

                          Evergreen Award applications will be reviewed by a selection team of
                             specialists with GSA’s Integrated Workplace Acquisition Center.
                    Winners will be announced at the 2012 Winter Quality Partnership Council meeting.

                  Please contact Eileen Sutton, eileen.sutton@gsa.gov 215-446-4836 with any questions.

								
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