6100-07 Partnership Agreement - Professional Certifying Organiza

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

Partnership Agreement:

Professional Certifying Organizations
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 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. Maintain at least one WaterSense labeled professional certification program in the United States.
2. Promote the value of water efficiency and WaterSense. Inform certification candidates about WaterSense as an
easy and desirable option for customers to reduce water use and save money.
3. Assist EPA in verifying certification status for individuals who have obtained WaterSense partnership.
4. Make WaterSense partner materials available to those professionals who earn or renew a certification through a
WaterSense labeled program.
5. Make available to EPA annual data on WaterSense labeled professional certification programs including the num­
ber of individuals who obtain these certifications.
6. Update EPA annually on the availability of professional certification programs and inform EPA in a timely manner if
labeled certification programs are discontinued and/or no longer meet applicable criteria, so that EPA can main­
tain an up-to-date list of labeled programs on the website and in other materials.
7. Adhere to all policies and procedures contained in the Program Guidelines.
8. Adhere to the WaterSense program mark guidelines and ensure that authorized representatives, such as advertis­
ing agencies, distributors, and subcontractors, also comply. Help EPA maintain program integrity by alerting EPA to
possible misuse(s) of the WaterSense program marks.
9. Grant EPA’s WaterSense program permission to include the partner organization’s name on a list of participating
partners on the WaterSense website, program materials, and announcements. The partner organization under­
stands that from time to time, EPA will be interested in profiling partner accomplishments in case studies and arti­
cles. If selected for such promotion, the partner organization will have the opportunity to provide input and
review the final print or Web document before EPA releases it to the public. Further, the partner organization
understands that EPA might refer media contacts interested in publicizing water efficiency to the partner organiza­
tion for information about certification programs 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 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 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. This recognition includes, but is
not limited to listing partners and WaterSense labeled products and programs on EPA’s WaterSense website.
EPA Form Number 6100-08

5. Respond swiftly to partner requests for information or clarification on EPA’s WaterSense program policies.
6. Review pre-press promotional items, draft websites, or other materials that use the WaterSense program marks,
upon request.

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 program marks.
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 WaterSense program. Upon termination of this agreement, partners agree to remove program marks in a time­
ly manner, consistent with the WaterSense program mark guidelines.
To be completed by partner

Authorized Partner Representative1 (printed name):______________________________________________________
Title: __________________________________________________ Email: ______________________________________
Signature:____________________________________________________________ Date:__________________________
Organization Name:_________________________________________________ Number of employees: ______________
Industry/SIC/NAICS code: ________________________________ Website: ____________________________________
Number of current certified professionals: ________________________________________________________________
Primary Contact: Dr./Mr./Mrs./Ms. ______________________________________________________________________
Title:_____________________________________________ Dept.: ________________________________________________
Email: __________________________________________________________________________________________________

Address: _____________________________________________City/State/ZIP: __________________________________
Telephone: _____________________________ Alternate Telephone:__________________________________________
How did you find out about this program? ❑ Website ❑ Referral, Name: ______________________________________
❑ Periodical: __________________________ ❑ Workshop, Sponsor:

________________________________________

� 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: ______________________________________
1The

authorized partner representative should be a person in the organization with signing authority (e.g., vice president).

EPA Form Number 6100-08

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 two 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 6100-08