6100-07 Partnership Agreement Certified Professional

OMB Control Number 2040-0272
Approval Expires 06/30/2013

Partnership Agreement:

Certified Professionals

Section I: EPA WaterSense® Program Goals
EPA’s WaterSense program aims to use water resources more efficiently to preserve them for future generations and to
reduce water and wastewater infrastructure costs by reducing unnecessary water consumption. Through this program, EPA
provides reliable information on high-performing, water-efficient products and practices, raises awareness about the
importance of water efficiency, ensures water-efficient product performance, helps consumers identify products and serv­
ices that use less water, promotes innovation in product development, and supports state and local water efficiency efforts.

Section II: Partnership Pledge
As an EPA WaterSense program partner, _________________________________ (name of certified professional) shares
EPA’s goals as outlined above and is proud to commit to the following activities to further these goals:
1. Provide services to at least one customer in the United States or Canada.
2. Submit proof of certification received from an EPA WaterSense labeled professional certification program with this
partnership agreement.1
3. Apply water-efficient practices in accordance with the specifications for EPA’s WaterSense labeled professional cer­
tification programs.
4. Educate consumers on the value of water efficiency, the importance of saving water, and the meaning of the
WaterSense label.
5. Adhere to all policies and procedures contained in the Program Guidelines.
6. Adhere to WaterSense program mark guidelines and help EPA maintain program integrity by alerting EPA to possi­
ble misuse(s) of the WaterSense program marks.
7. Maintain certification through an EPA WaterSense labeled professional certification program to maintain
WaterSense partnership.
8. Grant EPA’s WaterSense program permission to include name of certified professional on a list of participating partners
on the WaterSense website, program materials, and announcements. The certified professional understands that from
time to time, EPA will be interested in profiling partner accomplishments in case studies and articles. If selected for such
promotion, the certified professional will have the opportunity to provide input and review the final print or Web docu­
ment before EPA releases it to the public. Further, the certified professional understands that EPA might refer media con­
tacts interested in publicizing water efficiency to partners for information about services and accomplishments.

Section III: EPA WaterSense Program’s Commitments to Partners
1. Develop national specifications for water-efficient products and programs through an open, public process.
2. Increase awareness of EPA’s WaterSense brand by distributing key messages on the benefits of labeled products
and programs, as well as the importance of water efficiency.
3. Provide current EPA WaterSense program news, information, and reference documents (via the program website,
Helpline, email, or other means), including a listing of labeled products and programs on the website.
4. Provide WaterSense program partners with public recognition for their involvement in the program and role in
protecting the environment through online listing of partners, special awards, and other efforts. This recognition
includes but is not limited to listing partners and labeled products and programs on EPA’s WaterSense website.
5. Respond swiftly to partner requests for information or clarification on EPA WaterSense program policies.
6. Review pre-press promotional items, draft websites, or other materials that use the WaterSense program marks,
upon request.
1

If certified prior to the effective date (the date the certification program received the label), please submit this Partnership Agreement upon renewal of
certification.

EPA Form Number 6100-07

Section IV: General Terms and Disclaimers

1. The partner will not construe, claim, or imply that its participation in the EPA WaterSense program constitutes fed­
eral government (EPA) approval, acceptance, or endorsement of anything other than the partner’s commitment to
the program.
2. Nothing in this agreement, in and of itself, obligates the EPA to expend appropriations or to enter into any con­
tract, assistance agreement, interagency agreement, or incur other financial obligations that would be inconsistent
with Agency budget priorities. The partner agrees not to submit a claim for compensation for services rendered to
EPA or any federal agency in connection with any activities it carries out in furtherance of this agreement.
3. The partner and the EPA WaterSense program 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 partner logo.
5. The EPA WaterSense program 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 EPA WaterSense program. Upon termination of this agreement, partners agree to remove program marks in a
timely manner, consistent with the WaterSense program mark guidelines.
To be completed by partner

Certified Professional (printed name): __________________________________________________________________
Title: _________________________________________ Email:________________________________________________
Signature: ______________________________________________ Date: ______________________________________
Company of Employment (if applicable): ________________________________________________________________
Address: _____________________________________________City/State/ZIP: __________________________________
Website: ____________________________________________________________________________________________
Telephone: _____________________________ Alternate Telephone:__________________________________________
Current Certification(s) and Certifying Organization(s): ______________________________________________________
__________________________________________________________________________________________________
Type of customers served (select all that apply) � Commercial � Residential

� Golf Course

Please identify where you provide services by county, metro area, or state.

__________________________________________________________________________________________________
__________________________________________________________________________________________________
Are you willing to provide services to builders developing WaterSense labeled new homes? � Yes � No
How did you find out about this program? � Website � Referral, Name: ____________________________________
� Periodical: __________________________ � Certification Program: ______________________________________
� Mailing: __________________________ � EPA Region: ________________ � Other:________________________
To be completed by EPA

Sheila E. Frace

Authorized EPA Representative (printed name): __________________________________________________________
Director, Municipal Support Division
[email protected]

Title: __________________________________________________
Email: ______________________________________

Signature: ______________________________________________ Date: ______________________________________
EPA Form Number 6100-07

Submit the Partnership Agreement (rewriteable PDF) to WaterSense via:
Fax: (703) 841-1440

Mail: WaterSense, c/o ERG, 2300 Wilson Blvd, Suite 350, Arlington, VA 22201

Electronically: If you have Adobe Acrobat, you can complete the form electronically and email it to: [email protected].

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 2.5 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
auto­ mated 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 Partnership Agreement to this address.

EPA Form Number 6100-07