Home | Contact Us | Search

About SEC

Join SEC

Program
Requirements

Recognition

Resources

Partners Only

Listserv

FAQ

Baseline & Annual Reporting Form

March 8, 2011

This form is also available as a PDF document or a Word document.

INSTRUCTIONS:

Partners are required to complete the following form upon joining the State Electronics Challenge (SEC), and at the end of each year.

The Baseline Reporting Form should be submitted within 4 weeks of joining the SEC to . The information reported should be for the year prior to joining the SEC. Optional questions on the form can be skipped if necessary.
The Annual Reporting Form should be submitted annually to by January 31. The information reported is for the calendar year just completed.

The form is organized in four sections:

General Information
Acquisition & Procurement
Operation & Maintenance
End-of-Life Management.

Please complete all sections of this form, even if your organization did not focus on that area as an SEC Partner. Each section has one or two optional questions. Partners are encouraged to take a few minutes to answer one or more of these questions. They are designed to help tell the “story” behind the changes made.

This Annual Reporting data and optional responses will be used in several ways:

The data will be analyzed to assess the Partner’s progress and to generate estimates of the environmental benefits accruing from those actions. Each Partner will be informed of its results.
The data from all SEC Partners will be aggregated and publicly reported. Only aggregate data will be reported. Information specific to a Partner will not be released without the Partner’s express permission.
Responses to the optional questions will be compiled and used to illustrate the approaches taken by Partners to implement SEC program goals. NERC plans to share this information with other Partners to further assist them in program implementation.

No information provided to the SEC, including name, phone number, address, and email address, will be shared or distributed. All such contact information is for SEC internal use only.

If you have any questions or need help completing the form, contact or call 802-254-3636.

SECTION 1: GENERAL INFORMATION

SEC Partner Organization:

Contact:

Title:

Address:

City:

State:

Zip:

Phone:

Email:

Year for this Report ("Reporting Year"):

Reporting Year Began: (month)

Reporting Year Ended (month)

Optional Question A: Has your organization benefited from being a State Electronics Challenge Partner?

Yes

Don't know

Not applicable

How has the SEC assisted your organization in improving the management of its computer products, from purchasing through disposition?

Optional Question B: Do you have any suggestions for how the SEC could be improved?

SECTION 2: ACQUISITION & PROCUREMENT

1. How much did your organization spend on the procurement of Information Technology (IT) equipment in the reporting year?

2. Did your organization include Electronic Product Environmental Assessment Tool (EPEAT^®) registered computer products as a required or preferred standard in bids, contracts, and/or leases for IT equipment in the reporting year? (For more information on EPEAT, see http://www.epeat.net.)

Yes

Don't know

Not applicable

Optional Question A: If yes, how was the EPEAT requirement incorporated? Please provide the text that references EPEAT and describe the source (e.g., request for bids).

Optional Question B: If yes, please describe how this was accomplished. For example, who in the organization spearheaded the change? What challenges were faced?

3. For computer equipment purchased and/or leased in the reporting year, how many of the following units were:

	Desktop Computers *# of units*	CRT Monitors *# of units*	LCD Monitors *# of units*	Notebook Computers *# of units*
EPEAT^® Registered (Bronze)
EPEAT^® Registered (Silver)
EPEAT^® Registered (Gold)
EPEAT^® Registered (Rating Unknown)
Not EPEAT^® registered
Don’t Know

4. Did your organization include “green” procurement language in bids, contracts, and/or leases for IT equipment not currently registered by EPEAT (e.g., printers, copiers, facsimile machines, cell phones) in the reporting year?

Yes	Equipment Types:
No
Don't know
Not applicable

SECTION 3: OPERATION & MAINTENANCE

1. How many computers are currently in service at your organization?

Desktop computers

CRT monitors

LCD monitors

Notebook computers

2. Are ENERGY STAR® features enabled on computers and monitors at your organization?

Yes, only monitors

Yes, only computers

Yes, monitors and computers

Don't know

2a. Estimated percentage of enabled computers: %
2b. Estimated percentage of enabled monitors: %

Optional Question: What specific steps were taken in the past year to improve the power management of computer systems in your organization? What was the result?

3. What is the average lifespan of a computer at your organization?

Months

Optional Question: What steps were taken in the past year to increase the average lifespan of computers in your organization? What was the result?

4. How many printers are in operation within your organization?

4a. What percentage of printers in your organization is set to default to double-sided printing? % or Don't know

5. How many copiers are in operation within your organization? copier units

5a. What percentage of copiers in your organization is set to default to double-sided printing? % or Don't know

Optional Question: How many reams of paper did you reduce as a result of your organization's efforts to reduce paper use? (Note: you must provide this data if you would like us to calculate the environmental benefits of paper reduction.) reams of paper

SECTION 4: END-OF-LIFE MANAGEMENT

1. How did your organization manage computer equipment taken out of service in the reporting year? (Please use the table below to enter data on the number (#) of units. If your organization only has total weight, skip this question and enter that data in question 1a.)

	Desktop Computers *# of units*	CRT Monitors *# of units*	LCD Monitors *# of units*	Notebook Computers *# of units*
Transferred or donated for reuse
Sent for recycling
Sent for disposal (e.g., landfill, waste-to-energy)
In storage
Don't know

1a. How much mixed office electronic equipment (e.g., computers, printers, copiers) did your organization recycle in the reporting year? (Note: equipment reported here should NOT be reported above.) lbs

1b. How many mobile phones were recycled in the reporting year? (Note: equipment reported here should NOT be reported above. If you have the weight of mobile phones recycled and not the number of units, report mobile phone recycling in 1a.)

2. If your organization sent electronic equipment to be recycled, did you use a recycler certified to Responsible Recycling (R2) Practices or the e-Stewards Standard for Responsible Recycling and Reuse of Electronic Equipment®?

Yes

Don't know

Optional Question: What steps were taken in the past year to improve the end-of-life management of computer equipment in your organization? What was the result?

Enter the code as it is shown:
	This field helps prevent automated access.