Green Material Form (GMF)

LEED Compliance Technical Material Review Request Form for ALL PERMANENTLY Installed Materials
Project Name SEVEN Entertainment Complex - Yanbu Site Doc # 5YNBU05-YNBU-08-BUJV-AR-MAT-00013
Client Saudi Entertainment Ventures (SEVEN) Date 18/Jul/2023 Rev # 0
Consultant Egis To Qatar Green Leaders (QGL)
Contractor Al Bawani UCC Joint Venture (BUJV)
Requesting technical evaluation of Material
LEED Subject
Qatar Green Leaders (QGL) Submittal (MAS) for LEED compliance.
Consultant
SECTION 01
Material Name / Model MASONRY MORTAR-WP501 Usage Location Indoor & Outdoor
Material Description CEMENT MORTAR Product Application On-Site
CSI MasterFormat ® Division 04 Masonry Sub Division 04 20 00 Unit masonry
Supplier Name WUENSCH PLASTER FACTORY Supplier Location Jeddah-KSA
Manufacturer Name WUENSCH PLASTER FACTORY Manufacturer Location Jeddah-KSA
SECTION 02
Chillers, DX units, Pumps, AHU, FCUs, FAHU, Fans, AC units, Refrigerants, Motors, Water heaters, Interior Lights,
NOTE All fields marked with * are mandatory
Sanitary Fittings, Softscape etc. to be submitted with required packages along with this form for review
ASTM UniFormat II Classification for Building Elements (E1557-97) NOTE: Kindly ✓ the grey checkboxes in the respective rows on attachment of LEED compliant evidence with MAS
Element* Others Classification - Sub Classification -
Solar Reflectance Index (SRI) is required for all envelope finishes; roofing & site surface/hardscape materials
External Source of
Solar Reflectance Index (SRI)* Finishing?* N/A Initial SRI 3 Year aged SRI Information -
U-Value or R-Value is required for glazing & all other materials included in exterior walls & roof composition
Part of Building
U-value (or K-Value & Thickness)* No or Thickness
Envelope?* U-Value
SHGC required for ALL the external glazing & skylights K-Value (mm)
External Glazing Source of
Solar Heat Gain Coefficient (SHGC)* Material?* No SHGC Value Information -
Environmental Product Declaration (EPD). Select the type of EPD in the dropdown menu & PROVIDE supporting evidence

EPD* No EPD Criterion - EPD Validity

Compliant embodied carbon optimization report or action plan separate from LCA or EPD. ONLY reports verified by an USGBC approved party are compliant.
Embodied Carbon/LCA Optimization* No Report Type - Verification -Choose One-
Cost of the total value of PERMANENTLY installed building products in the project to be shared as either BOQ; Invoices or Receipts.
Locally sourced material?* No Material with EPR?* No Bio-Based Material?* N/A
Bio-based products and materials other
Is the material extracted, manufactured & Manufacturer participating in Extended
than wood must meet the Sustainable
purchased within 160 km from the project site? Producer Responsibility program
Agriculture Network’s standards
Recycled content as a percentage (%) of total material weight (Post consumer (Pre-Industrial) & Pre consumer (Post-Industrial) recycled content % separately
Post-Consumer Pre-Consumer Total Source of
Recycled Content (%)* No (%) 0.0 (%) 0.0 (%) 0.0 Information -
ONLY for wood products: Products using any of the programs to demonstrate the chemical inventory to at least 0.1% (1000 ppm)
FSC Certified Wood?* FSC
N/A Material Ingredient Reporting? No
Mix %
Confirm if the material is certified by Specify the type of material ingredient reporting.
Source of
Forest Stewardship Council (FSC): COC # Third party certification must be provided. Information -
Applicable for products that have a compliant material ingredient optimization report or action plan. ONLY reports verified by an USGBC approved party are compliant.
Material Ingredient Optimization* No Report Type - Verification -
Applicable for ALL materials on the building interior (everything within the waterproofing membrane). Both VOC content & VOC emission are mandatory for ALL wet-applied products on-site.
Emission
Low Emitting Materials* Criteria?*
Product
Yes Category? Adhesives & Sealants Compliance?
Emission
Lab Reports
VOC
(gm/l) 2.79 ✔
Note: The contractor shall assume full responsibility of the accuracy & consistency of all the provided data above.
Prepared by (Supplier) Prepared by (Contractor) Reviewed by QGL:
Name & Signature of Name & Signature of Contractor’s This material submittal has been reviewed
and the information has been logged into
Supplier’s Representative Representative
our LEED tracker. We have no objection to
proceed for formal submission to the
Ibrahim Badsha consultant.
QGL Comments: Digitally signed
1) VOC & TVOC emissions test reports are provided. by Eman Farag
2) The material has no recycled content. Date:
3) If available, kindly provide HPD report to claim MRc4 LEED credit. 2023.07.18
16:13:19
+03'00'
Action
Code
A - Approved B – Approved as Noted C – Revise / Resubmit D – Not Approved E – Further Info Required
For further assistance during filling this form, please contact Engr. Hussein (+974 30397671 ) hussein@qatargreenleaders.com
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