specs

Appendix D
CERTIFIED WOOD INFORMATION FORM
Date_____________ LEED SUBMITTAL NUMBER_______________
Project Name:
The undersigned Contractor certifies to the best of the Contractor's knowledge, information, and belief the information contained herein is true
and accurate.
Notes:
Make multiple copies of this form as needed.
1. All new wood to be listed line-by-line and include the following information,
2. Must include original manufacturer’s invoice which indicates FSC chain of custody #
3. Identify FSC-certified products (FSC Pure, FSC Mixed Credit, FSC Mixed [NN]%)
4. Furnish invoices for all wood products
5. Provide a letter from supplier stating that wood products provided are FSC certified.
Contractor Name / Address Legibly Printed Name
Contact Email Title
Telephone Fax Date
Total Construction Cost or,
Total material cost (exclude labor and equipment)
Signature
Total Cost of all wood based products
Product Name
Vendor Product Cost % Certified Wood
Forest Stewardship Council Chain-of-custody
certificate number