6100-20 Partnership Agreement Certification Provider

OMB Control Number 2040-0272
Approval Expires 01/31/2010

Partnership Agreement:

Certification Providers
Section I: EPA WaterSense® Program Goals
The WaterSense program goals are to use water resources more efficiently to preserve them for future generations and
reduce water and wastewater infrastructure costs by reducing unnecessary water consumption. Through WaterSense,
EPA provides reliable information on high-performing, water-efficient new homes, raises awareness about the impor­
tance of water efficiency, helps consumers differentiate among new homes that use less water, promotes innovation in
residential construction, and supports state and local water-efficiency efforts.

Section II: Partnership Pledge
As a WaterSense program partner, _________________________________ (name of organization) shares EPA’s goals as
outlined above and is proud to commit to the following activities to further these goals:
1. Meet the responsibilities outlined in the WaterSense new home certification system, including, but not limited to,
certification of new homes and oversight of inspectors.
2. Sign and issue the WaterSense label certificate to builders of certified new homes and supply the builder partner
with guidance on proper use of the label and advertisement of WaterSense labeled new homes.
3. Notify EPA quarterly of any new homes that have been certified and labeled using a form provided by WaterSense.
4. Help EPA maintain program integrity by alerting EPA of possible misrepresentation(s) of the certification or pro­
gram marks. Adhere to WaterSense partner logo and label guidelines and ensure that authorized representatives,
such as advertising agencies or subcontractors, also comply.
6. Grant WaterSense permission to include partner’s name, including contact information, on a list of participating
partners on the WaterSense Web site, program materials, and announcements. Partners understand that from time
to time, EPA will be interested in profiling partner accomplishments in case studies and articles. If selected for such
promotion, partners will have the opportunity to provide input and review the final product prior to release to the
public in EPA printed or Web documents. Further, the partner understands that EPA might refer media contacts
interested in publicizing WaterSense to partners for information about certified new homes and accomplishments.

Section III: EPA WaterSense Program’s Commitments to Partners
1. Develop national specifications for water-efficient homes, products, and programs through an open, public
process. Supply materials related to the inspection and certification of new homes.
2. Increase awareness of the WaterSense brand by distributing key messages on the benefits of labeled new homes,
as well as the importance of water efficiency.
3. Provide current WaterSense program news, information, and reference documents (via the program Web site,
Helpline, e-mail, or other means), including training materials, inspection checklists, and guidance.
4. Provide WaterSense partners with public recognition for their involvement in the program and role in protecting
the environment through an online listing of partners, special awards, and other efforts.
5. Respond swiftly to partner requests for information or clarification on WaterSense policies.
6. Provide materials, templates, and program marks for promotional use, consistent with WaterSense program
guidelines.
7. Provide guidelines on appropriate use of the WaterSense label and advertisement of WaterSense labeled new
homes.
8. Review pre-press promotional items, draft Web sites, or other materials that use WaterSense marks, upon request.

EPA Form Number 6100-20

Section IV: General Terms and Disclaimers
1. The partner will not construe, claim, or imply that its participation in the WaterSense program constitutes federal
government (EPA) approval, acceptance, or endorsement of anything other than the partner’s commitment to the
program.
2. The partner understands that the activities it undertakes in connection with the program are voluntary and not
intended to provide services to the federal government. As such, the partner will not submit a claim for compensa­
tion to any federal agency.
3. The partner and WaterSense will assume good faith as a general principle for resolving conflict and will seek to
resolve all matters informally, so as to preserve maximum public confidence in the program.
4. Failure to comply with any of the terms of this partnership agreement can result in its termination and cessation of
access to the benefits of the program, including use of the program marks.
5. WaterSense will actively pursue resolution of noncompliance related to the use of the program marks.
6. Both parties concur that this agreement is wholly voluntary and may be terminated by either party at any time,
and for any reason, with no penalty. Termination will begin effective immediately upon written notice to or from
the WaterSense program. Upon the termination of this agreement, partners agree to remove program marks in a
timely manner, consistent with the WaterSense partner logo and label guidelines.
To be completed by EPA

Sheila E. Frace
Authorized EPA Representative (printed name): ______________________________________________________

Title: __________________________________________________
E-mail: __________________________________
Director, Municipal Support Division
[email protected]
Signature: ______________________________________________ Date: __________________________________
To be completed by partner

Authorized Company Representative1 (printed name): ________________________________________________
By signing this agreement, I certify that I have been approved by an EPA-approved program administrator and that at
least one quality assurance designee within my organization has attended the required training for certification providers
about WaterSense.
Title: __________________________________________________ E-mail: __________________________________
Signature: ______________________________________________ Date: ____________________________________
Organization Name:_________________________________________________ Web site: ______________________
Primary Contact: Dr./Mr./Mrs./Ms._________________________________________________ Suffix: ____________
Title: ______________________________ Dept: __________________ E-mail: ______________________________
Address: _____________________________________________ City/State/ZIP: ______________________________
Telephone: __________________ Fax: ___________________ Alternate Telephone: __________________________
Program Administrator: ________________________________________________ Approval Date: ________________
Quality Assurance Designee: ____________________________________________________________________________
Phone: ______________________________________ E-mail: ____________________________________________
How did you find out about this program? � Web site � Referral, Name:________________________________
� Periodical __________________________ � Workshop, Sponsor:______________________________________
� Mailing __________________________ � Other: ________________________________________________
Please identify where you provide services by country, metro area, state, or indicate “national” if you provide services
throughout the country.

The Authorized Partner Representative should be a person in the company with signing authority (e.g., vice president).

1

EPA Form Number 6100-20

Submit the Partnership Agreement (rewriteable PDF) to WaterSense via:
Fax: (703) 841-1440
Mail: WaterSense, c/o ERG, 2300 Wilson Boulevard, Suite 350, Arlington, VA 22201
Electronically: If you have Adobe Acrobat Standard or Professional, you can fill out the form electronically and e-mail
it to: [email protected]. Acrobat Reader users must print forms after filling them out and fax or mail them in.
Please contact the WaterSense Helpline at (866) WTR-SENS (987-7367) if you have any questions about eligibility,
partnership, or for general program inquiries.
After signing, EPA will send partners an executed copy of this agreement.

The public reporting and record keeping burden for this collection of information is estimated to average eight hours per response. Send comments on the Agency's
need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of
automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Avenue, NW,
Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed partnership agreement to this address.

EPA Form Number 6100-20