ENERGY STAR Program in the Commercial and Industrial Sectors - Public Sector Entities

<Organization Letterhead>

<Date>

Ms. Jean Lupinacci

Director, Commercial & Industrial Branch

ENERGY STAR

U.S. Environmental Protection Agency

1200 Pennsylvania Avenue, NW (6202J)

Washington, DC 20460

Dear Ms. Lupinacci:

With this letter, <Organization Name> joins ENERGY STAR^. We are making a fundamental commitment to protect the environment through the continuous improvement of our energy performance. We believe that an organization-wide energy management approach will help us enhance our financial health, increase our value, and aid in preserving the environment for future generations. In partnership with ENERGY STAR, we will specifically:

• Baseline, track, and benchmark our organization’s energy performance by using tools such as those offered through ENERGY STAR;

• Develop and implement a plan to reduce energy intensity across our facilities and operations by following the energy management strategy provided through ENERGY STAR; and,

• Educate our staff and the public about our partnership in ENERGY STAR, and highlight our achievements with recognition offered through ENERGY STAR.

We understand that our commitment to assess and improve the energy performance of our organization is supported by the strategic resources and tools offered through ENERGY STAR. In addition, we are aware that ENERGY STAR presents opportunities to be recognized for success. To be eligible for recognition, we will share with EPA our progress and milestone achievements under ENERGY STAR. As a partner, we agree to follow all applicable terms and conditions governing the use of the ENERGY STAR logos, which are registered trade and service marks.

<Organization name> looks forward to our partnership with ENERGY STAR.

Sincerely,

<Name of Chief Executive

or Chief Financial Officer>

<Title>

<Organization Name>

Attachment

OMB Control No. 2060-0347

Attachment to Partnership Letter

Organization Information

Please complete this sheet and send it along with the signed partnership letter. Thank you.

Chief Executive

Name & Title: _______________________

Mailing Address: _______________________

_______________________

_______________________

E-mail Address: _______________________

Phone Number: _______________________

Facsimile: _______________________

Energy Manager Communications Director (if applicable)

Name & Title: _______________________ Name & Title: ___________________

Mailing Address: _______________________ Mailing Address: ___________________

_______________________ ___________________

_______________________ ___________________

E-mail Address: _______________________ E-mail Address: ___________________

Phone Number: _______________________ Phone Number: ___________________

Facsimile: _______________________ Facsimile: ___________________

My Organization’s Primary Business or Function (check one):

__ Commercial Real Estate

__ Corporate Real Estate

__ K-12 Education

__ Higher Education

__ State Government

__ Local Government

__ Federal Government

__ Healthcare

__ Hospitality & Entertainment

__ Manufacturing/Industrial, please describe your business, including the NAICS codes which best apply to your industry: __________________________________________________________

__ Religious (Congregations)

__ Retail

__ Other. Please describe: _____________________________________

Total amount of building/facility square footage my organization…

Owns _________________________________________________________

Leases from others _________________________________________________________

Manages but does not own _________________________________________________________

Franchises to others _________________________________________________________

Other. Please describe: _________________________________________________________

How did you learn about Energy Star?________________________________________________________

The government estimates the average time needed to fill out this form is 30 minutes and welcomes suggestions for reducing this level of effort. Send comments (referencing OMB control number) to the Director, Collection Strategies Division, U.S., EPA (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.

EPA Form 5900-19