Green Power Partnership - Local and State Government

OMB Control No. 2060-0578
Approval Expires 04/30/2009

Partnership Agreement

T

he EPA Green Power Partnership encourages the voluntary use of green power to reduce
the risk of climate change. Partners benefit from the use of green power, while supporting
the development of new, renewable energy in the United States.
With this agreement,

joins EPA's Green Power Partnership and commits to:
(Name of organization or entity)

• Buy green power that meets or exceeds Partnership requirements within six months of signing this Partnership Agreement.
• Report on green power purchasing activities annually.
• Use the Green Power Partner mark in a manner that is consistent with Partner mark use guidelines, available at
www.epa.gov/ greenpower/partner_corner.

In return, EPA commits to:

• Provide public recognition.
• Provide procurement and communications assistance, as requested by Partner.
• Provide a brief description of the Partner's green power commitment on the Green Power Partnership Web site.
General Terms:

• Either party can terminate this agreement at any time without prior notification or penalties and with no further obligation. EPA will
not comment publicly regarding the withdrawal of Partners.

• Partner agrees that the activities it undertakes connected with this voluntary agreement are not intended to provide services to the
federal government and that the Partner will not seek compensation from a federal agency.

• Partner agrees that it will not claim or imply that its participation in the Green Power Partnership constitutes EPA approval or
endorsement of anything other than its participation in the program and will not make statements or imply that EPA endorses the
purchase or sale of the Partner's products and services or the views of the Partner's organization.

• EPA may post information about the Partner's purchase publicly, but will honor all requests to keep the Partner's purchasing data
and/or electricity use confidential.

• EPA may use the Partner's logo in selected marketing materials. This added benefit is available only to Partners that have joined
the Green Power Partnership and have completed a green power purchase for all their U.S. facilities.

• EPA may periodically revise program benchmark levels or other eligibility requirements.
Authorizing Official:
On behalf of

, the undersigned understands and agrees to the terms of the Green Power Partnership.
(Name of organization or entity)

Signature: ____________________________________________ Title:

Print Name:

Date:

Primary Contact:

Public Relations Contact (optional):

Name:

Name:

Title:

Title:

Address:

Address:

City:

State:

Phone:

Fax:

E-mail:

Zip:

City:

State:

Phone:

Fax:

E-mail:

PLEASE FAX THE PARTNERSHIP AGREEMENT TO 202/343-2208

Zip:

Partner Information
1. Partner's electricity use:

kWh / year

2. Partner's green power commitment:

kWh / year

3. Partner Web page on green power use:
4. Completed green power purchase?

Yes

No

If yes, please provide the following information:
• Contract details

effective date:

• Green power products

term:

renewable electricity product

• Green power resource mix

% solar

• Product certification/verification

Yes

No

RECs

% wind

% biogas

years
on-site generation

% geothermal

% biomass

% hydro (small or low-impact)
If yes, by whom?

• Green power retailer(s) or provider(s)
• If we have additional questions, may we contact your provider(s) for additional information?

Yes

No

Key Partnership Requirements

Green Power Purchase Requirements
Green Power
Partner
Requirements
You must, at a minimum,
purchase this much green
power within one year of
joining the Partnership

Green Power
Leadership Club
Requirements
You must, at a minimum,
purchase this much green
power

2% of your use

20% of your use

10,000,001 - 100,000,000 kWh

3% of your use

30% of your use

1,000,001 - 10,000,000 kWh

6% of your use

60% of your use

10% of your use

Not Applicable

Your Organization’s
Baseload
If your annual electricity use
in kilowatt-hours is...

100,000,001 kWh

1,000,000 kWh
•

Partners must acquire electricity generated from
eligible renewable resources, which include solar,
wind, geothermal, biogas, eligible biomass, and
eligible hydropower.

•

Partner commitment can be met with any
combination of green power products (i.e., green
power, RECs, or on-site generation).

•

Partner purchases must be voluntary and incremental
to the renewable electricity included in the standard
electricity service.

•

Minimum Partner and Leadership Club purchase
requirements must be entirely met with power from
“new” renewable facilities (i.e., installed after 1/1/1997).

More details are available in the Program Requirements Memo, http://www.epa.gov/greenpower/documents/gpp_partnership_reqs.pdf
The government estimates the average time needed to fill out this form is 4.9 hours 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.

PLEASE FAX THE PARTNERSHIP AGREEMENT TO 202/343-2208

Office of Air and
Radiation (6202J)

EPA-430-K-05-013
www.epa.gov/greenpower
November 2006