Form 5900-33 Energy Efficiency Program Sponsor Partnership Agreement

OMB Control No. 2060-0528

Instructions for Partnering with ENERGY STAR^®

_{As an Energy Efficiency Program Sponsor}

Organizations interested in partnering with ENERGY STAR as an Energy Efficiency Program

Sponsor should take the following steps:

1. Review the Energy Efficiency Program Sponsors Program Definitions and Program

Requirements documents.

2. Select the area(s) of interest for a new partnership on the Participation Form. Please select only the items in the first section under Energy Efficiency Program Sponsor.

3. Review, complete and sign the Partnership Agreement by checking the authorization box, entering the date of signature, and entering the contact information of the signatory.

4. Save your changes to the completed document and send it to the email address below.

If you are unable to send the document by email, please send a hard copy to the address listed below.

join@energystar.gov

Or

ENERGY STAR

c/o ICF International

1725 Eye Street, NW, Suite 1000

Washington, DC 20006

A copy of the signed Partnership Agreement will be returned to you for your records.

Change for the Better with ENERGY STAR

_{Program Definitions and Eligible Organizations}

Section 1. Energy Efficiency Program Sponsors

Eligible organizations: A regulated utility, publicly owned utility, or energy delivery company; a national, regional, state, or local government entity; an organization involved in coordinating and/or

administering energy efficiency or environmental education programs that promote ENERGY STAR. See Program Requirements for Energy Efficiency Program Sponsors for the Commercial & Industrial

Sectors and/or the Program Requirements for Energy Efficiency Program Sponsors (residential

_sector).

Section 2. Commercial and Industrial Service and Product Providers

Eligible organizations: An organization that offers energy-efficient products and/or services that agrees to promote and communicate ENERGY STAR to improve the energy performance of commercial buildings. Eligible organizations include: architects, and A/E firms, banks and commercial financial lenders, contractors, distributors, energy management service companies/consultants, energy service companies (ESCOs), engineers, equipment manufacturers, and unregulated energy retailers and marketers. See the ENERGY STAR Partnership Partner Requirements for Commercial & Industrial Service and Product Providers.

Section 3. Financing Partners

Eligible organizations for Mortgages for Energy-Efficient Homes: A mortgage lender offering special financing for ENERGY STAR qualified new homes. See Program Requirements for Lenders, Mortgages for Energy Efficient Homes.

Section 4. Home Builders/Developers and Home Energy Raters

Eligible organizations: A site-built home builder constructing traditional homes on site; a manufactured home builder providing factory-built, HUD code-based homes; a home energy rater

verifying the performance of ENERGY STAR qualified new homes. See the ENERGY STAR

_{Partnership Agreement for Home Builders and Verification Organizations.}

Section 5. Retailers/E-tailers and Buying Groups

Eligible organizations for Retailers/E-tailers: A retail organization selling, marketing, and promoting

ENERGY STAR qualified products. Retail organizations can include independent retailers, national chains, buying groups, and online merchants. See Program Requirements for Retailers/E-tailers.

Eligible organizations for Buying Groups: A retail organization selling ENERGY STAR qualified products. See Program Requirements for Buying Groups.

Section 6. Business Improvement

Eligible organizations: Any public or private organization can partner to improve its facilities by committing to continuous improvement of its energy efficiency. For Program Requirements see the Partnership Letter in the Business Improvement section of www.energystar.gov.

Section 7: Manufacturers

Eligible Organizations: A company that manufactures or private labels any product(s) that meet(s) the

current ENERGY STAR qualification criteria.

_{Partnership Agreement between}

_{ENERGY STAR}^® _and

_{(ENTER PARTNER NAME HERE)}

Through this agreement, (“ENERGY STAR Partner") joins in partnership with the US Environmental Protection Agency (EPA) and the Department of Energy (DOE) in one or more areas. ENERGY STAR Partner recognizes ENERGY STAR as a broad partnership designed to promote buildings, products, homes, and industrial facilities that use less energy while providing the same or better performance than conventional designs. ENERGY STAR Partner wishes to use the ENERGY STAR name and/or mark in association with qualified products or homes. ENERGY STAR Partner agrees to use the partnership and the ENERGY STAR

mark to promote energy efficiency as an easy and desirable option for organizations and consumers to prevent pollution, protect the global environment, and save on energy bills. ENERGY STAR Partner agrees that it is important to build and maintain the meaning of the ENERGY STAR mark as a trustworthy symbol that makes it easy to make a change for the better.

Partner Commitments

ENERGY STAR Partner is committed to taking action in the area(s) indicated on the ENERGY STAR Participation Form. For the designated program area(s), ENERGY STAR Partner agrees to fulfill all requirements as outlined in the following supporting documents:

 ENERGY STAR Program Requirements, defining requirements for being recognized as a partner in each program area, such as manufacturing, selling, or promoting ENERGY STAR qualified products to consumers or organizations. Specific requirements include identifying a responsible party for each area of participation and updating EPA/DOE on the efforts undertaken through the partnership. Where applicable, these include ENERGY STAR eligibility criteria defining the energy and other performance specifications that must be met for use of the ENERGY STAR mark on and/or in association with buildings, homes, and products; and

 ENERGY STAR Identity Guidelines, describing how the ENERGY STAR name and mark may be used. Partner will adhere to these guidelines and ensure that its authorized representatives, such as advertising agencies, dealers, and distributors, are also in compliance.

EPA/DOE will undertake a variety of efforts to build awareness of the ENERGY STAR name and mark, maintain the credibility of the ENERGY STAR name and mark, and promote the benefits of energy-efficient homes, buildings, products, services, and industrial facilities. EPA/DOE will strive to:

 increase awareness of the ENERGY STAR name and mark across the residential, commercial, and industrial sectors by distributing key messages on the benefits of ENERGY STAR qualified buildings, homes, and products;

 make current versions of the ENERGY STAR Identity Guidelines and ENERGY STAR Program Requirements easily accessible through the Internet and other means;

 maintain a Web site where ENERGY STAR Partner can furnish information on its program efforts and responsible key contacts as outlined in the ENERGY STAR Program Requirements; and

 provide ENERGY STAR Partner with public recognition through the Internet and other mechanisms for its efforts in the ENERGY STAR Partnership and its role in protecting the environment.

Disclaimers

Partner will not construe, claim, or imply that its participation in the ENERGY STAR program constitutes federal government approval, acceptance, or endorsement of anything other than Partner’s commitment to the program. Partner understands its participation in the ENERGY STAR program does not constitute federal government endorsement of Partner or its buildings, homes, products, services, or industrial facilities. Partner understands that the activities it undertakes in connection with the ENERGY STAR program are voluntary and not intended to provide services to the federal government. As such, Partner will not submit a claim for compensation to any federal agency.

Dispute Resolution

Partner and EPA/DOE will assume good faith as a general principle for resolving conflicts under the ENERGY STAR program. Both parties will endeavor to resolve all matters informally, so as to preserve maximum public confidence in ENERGY STAR.

In the event informal channels do not produce a mutually agreeable resolution to a matter in dispute, either party to this agreement shall notify the other in writing as to the nature of the dispute, the specific corrective action sought, and their intent to terminate the Partnership Agreement, either as a whole or in part, unless specific corrective actions sought are undertaken:

 within 20 days of receiving formal notification from EPA/DOE indicating intent to terminate the Partnership Agreement, either as a whole or in part, Partner will reply, agreeing to either (1) undertake in a timely and effective manner the corrective actions sought by EPA/DOE, or (2) terminate the Partnership Agreement, either as a whole or in part;

 within 20 days of receiving formal notification from Partner indicating its intent to terminate the Partnership Agreement, either as a whole or in part, EPA/DOE will reply, either (1) agreeing to undertake in a timely and effective manner the corrective actions sought by Partner, or (2) explaining why such corrective actions cannot be undertaken;

 if Partner fails to respond within 20 days of receiving formal notification of EPA/DOE’s intent to terminate the Partnership Agreement, either as a whole or in part, or if Partner responds but does not agree to undertake corrective actions sought by EPA/DOE, or if Partner agrees but does not initiate the corrective actions in a timely manner, then this agreement is terminated, either as a whole or in part.

Entry into Force and Duration of Agreement

Both parties concur that this agreement and the terms outlined in the supporting documents will become effective when signed by both parties. This agreement may be updated at any time to add new areas for which ENERGY STAR Partner wants to be recognized as a partner. 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. Failure to comply with this Partnership Agreement, applicable Program Requirements, and Identity Guidelines can result in termination of this agreement and authorization to use the ENERGY STAR mark. EPA/DOE will actively pursue actions for resolving issues of noncompliance.

The undersigned hereby execute this Partnership Agreement on behalf of their party. The signatories of this agreement affirm that they have the authority to execute this agreement on behalf of ENERGY STAR Partner and EPA/DOE.

_{Partnership Agreement Signatory for ENERGY STAR:}

Signature:

_{EPA Use Only}

Name: Title:

Date:

Elizabeth Craig, Director

Climate Protection Partnerships Division, U.S. Environmental Protection Agency

_{Partnership Agreement Signatory for}

By checking this box I affirm that I have read and understand the terms of this Partnership

_{Agreement and am authorized to bind this organization to the terms of the Partnership Agreement.}

_(Date)

Name:
Title:
Address:
City:
State:
Zip
Country:
Phone:
Fax:
E-mail:
Web site:

The public reporting and recordkeeping burden for this collection of information is estimated to average 4.2 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 Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

_{ENERGY STAR}^® _{Participation Form}

Partner Name: Date:

Partner will participate in the programs checked below.

Promote ENERGY STAR as an Energy

Efficiency Program Sponsor* in the: Home Electronics

Consumer Product Market Audio/Video Equipment

Residential New Construction Market Set-top Boxes Existing Commercial Buildings Market Telephony New Commercial Buildings Market Televisions Industrial Market

* Such as states, utilities, or regional program coordinators Heating, Ventilation, and AC Products

Boilers

Help Clients Improve Their Energy Performance Central ACs and Air Source Heat Pumps

Commercial and Industrial Service and Product Providers Furnaces

supporting the: Geothermal Heat Pumps Existing Commercial Buildings Market Light Commercial HVAC New Commercial Buildings Market Residential Ceiling Fans Industrial Market Residential Ventilating Fans

Offer Consumer Financing* Home and Building Envelope Products

Mortgages for Energy-Efficient Homes Residential Insulation Products

*Please refer to the ENERGY STAR Partnership Roof Products

Agreement for Lenders. Windows, Doors and Skylights

_{Window Components}

Label and Promote ENERGY STAR Qualified Homes*

_{Home Builders/Developers} ^{Lighting Products}

Home Energy Raters Decorative Light Strings

*Please refer to the ENERGY STAR Partnership Integral LED Lamps

Agreement for Home Builders and Verification Luminaires

^{Organizations.} _{Screw-Based Compact Fluorescent Lamps (CFLs)}

Promote ENERGY STAR Qualified Products ^{Office Equipment}

Retailers/E-tailers Computers

Buying Groups Imaging Equipment

_Displays

Deploy ENERGY STAR Qualified Set-top Boxes

Cable, Satellite, and Telecom Service Providers Other Products

Battery Charging Systems

Label and Promote ENERGY STAR Qualified Products Computer Servers

Residential Appliances New Refrigerated Beverage Vending Machines Clothes Washers Rebuilt Refrigerated Beverage Vending Machines Dishwashers Residential Dehumidifiers

Refrigerators and/or Freezers Room Air Cleaners

Room Air Conditioners Uninterruptible Power Supplies

_{Water Coolers}

Commercial Food Service Equipment Commercial Dishwashers Commercial Fryers

^{Commercial Griddles} Through our partnership with ENERGY STAR, ^{Commercial Hot Food Holding Cabinets} we also commit to improve the energy Commercial Ice Machines performance of our own facilities.

Commercial Ovens

Commercial Refrigerators and Freezers

Commercial Steamers

Partner Name: Date:

If your organization has different contacts for multiple products or program areas (for example: appliances and home electronics, or manufacturing and retail sales), please fill out a separate Participation Form for each set of contacts. The stand-alone Participation Form can be found at www.energystar.gov/join.

_{ENERGY STAR Program Area:}

Contact Name: Title: Company: Address:

City: State: Zip: Country: Phone: Fax:

E-mail:

Contact Name: Title: Company: Address:

City: State: Zip: Country: Phone: Fax:

_E-mail:

Responsible Agent of Company: Primary Contact (if different):

Additional Contact (marketing, etc.): Additional Contact (if appropriate):

_{Return completed Participation Form to:}

Product Type	E-mail Address	Mailing Address
CFLs, clothes washers, dishwashers, integral LED lamps, freezers, refrigerators, residential water heaters, room air conditioners, windows/doors/skylights	partnership@energystar.gov	ENERGY STAR c/o D&R International 1300 Spring Street, Suite 500 Silver Spring, MD 20910
All other ENERGY STAR qualified products	join@energystar.gov	ENERGY STAR c/o ICF International 1725 Eye Street, NW, Suite 1000 Washington, DC 20006

The public reporting and recordkeeping burden for this collection of information is estimated to average 0.25 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 Ave., NW, Washington, D.C.

20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

3

EPA Form No. 5900-33

ENERGY STAR Partnership Agreement