Verification Form for ILHA StayGreen by 3WijU1Bi


									                         IHLA StayGreen Verification Form
              2012 Recycling/Waste Minimization Recognition Program
                     (Please type or print information requested)

Hotel Name:

                              (as you would like it to appear on your certificate)

Hotel Address:

In order for your hotel to be recognized for successfully implementing the IHLA
StayGreen 2012 Recycling/Waste Minimization program, you must verify that your hotel
has fully met the recycling criteria for at least four of the six items listed below. Please
indicate which of the six items have been successfully implemented by your hotel in a
recycling program by checking the box next to those items below.

Please provide copies of verification back-up materials such as invoices, contracts, etc.,
and/or describe the details involved with the successful implementation of the items
checked below such as the recycling system, source, location, frequency, date of
purchase/implementation, etc.

□      My hotel is continually operating a recycling/waste minimization program in which
       at least four of the six major recyclable items discarded by guests in hotel rooms,
       function areas, and public space, are collected, separated, and recycled rather
       than disposed of as general waste. Please check at least four of the six items
       recycled at your hotel from the list above:

               □       Newspapers
               □       Plastic Bottles
               □       Metal Cans
               □       Glass Bottles
               □       Cardboard/Paper
               □       Kitchen Oil and Grease

Verification details:

I hereby verify that the information and documentation provided above is accurate and
correct to the best of my knowledge and that our hotel has fully met all of the criteria for
recycling four of the six items in the list above such that our hotel has successfully
implemented the StayGreen 2012 Recycling/Waste Minimization program and should be
recognized accordingly by IHLA.

_______________________________                     ______________________________
Print General Manager’s Name                        Signature of General Manager


                                   For Internal Use Only

Date Received at IHLA Office: _____________________________________________
(Date and Initials)

Approval of Application: __________________________________________________
(Date and Initials)


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