EPA-430-K-05-013 Green Power Partnership: Partnership Agreement

OMB Control Number 2060-0578
Expiration Date: 5/31/22

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. To learn more visit www.epa.gov/greenpower.

By joining EPA’s Green Power Partnership,
Partners commit to:

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 organization.
• EPA may post and/or share information about the Partner’s
green power use publicly.
• EPA may periodically revise program benchmark levels or other
eligibility requirements.

• Use green power that meets or exceeds Partnership
requirements.
• Report on green power use annually.
• Use the Green Power Partner mark in a manner that is consistent with Partner mark use guidelines, available at www.epa.
gov/greenpower/green-power-partner-mark-use-and-displayguidelines

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 website.

Key Green Power Partnership Requirements
Your Organization’s Electricity Use

Green Power Partner Requirements

If your annual electricity use is...

You must, at a minimum, use this much green power

≥ 100,000,001 kWh

7% of your use

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

10% of your use

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

25% of your use

100,000* - 1,000,000 kWh

50% of your use

*Organizations that use more than 100,000 kWh are eligible for Partnership.
• Eligible green power includes electricity generated from solar, wind,
geothermal, biogas, and certain forms of biomass and hydropower.
• Green power must be sourced from eligible U.S.-based generation
facilities.
• Requirement can be met with any combination of green power
products (i.e., utility product, RECs, or on-site generation).

• Partner purchases must be voluntary and incremental to the
renewable electricity included in the standard electricity service.
• Requirements must be entirely met with power from “new”
renewable facilities (i.e., installed within the last 15 years).
• Partners may join organization-wide (U.S. operations only), at
the facility-level, or a logical aggregation of facilities less than
organization-wide.

More details are available in the Partnership Requirements Document, www.epa.gov/greenpower/requirements-green-power-partnership
PLEASE FAX PAGE 2 OF PARTNERSHIP AGREEMENT TO (617) 227-1025 (contractor in support of EPA)
OR EMAIL TO [email protected] (must be signed and scanned).

Authorizing Official:
On behalf of

, the undersigned understands and agrees to the terms of the 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:

Zip:

City:

Phone:

Phone:

Email (required):

Email:

State:

Zip:

Electricity and Green Power Information
Reporting Period: The electricity and green power information listed below covers the following 12-month period.
Reporting Period Start Date

Reporting Period End Date

Annual electricity use of participating entity:

kWh /year (must be > 100,000 kWh)

Purchased Green Power
Green power purchase:

On-site Use of Green Power
kWh /year

Resource type:

Contract details
Start date:

% biogas

kWh /year*

biogas

biomass

small hydro

End date (if applicable):

solar

geothermal
wind

Was the on-site unit installed in the last 15 years?

Green power resource mix
% biomass

% small hydro

% solar

% geothermal
% wind

Not certified

Installed capacity:

Yes

No

kW

Location of on-site generation (ZIP code):
Installation ownership:

Product certification (third party):
Green-e

Green power generation:

self

other

If other, by whom?

Other

* EPA will only count as green power kWh generated from on-site installations for which the participating entity owns the rights to the renewable energy credits (RECs).

If other, by whom?
Name of green power provider(s):
Green power product name(s):

Motivating factors behind your green power use (optional)

(check all that apply)

Brand or product differentiation

EPA recognition

Reduce carbon footprint

Cost stability or savings

LEED certification

Support economic development & job creation

Demonstrate environmental leadership

Meet sustainability goals

Support renewable energy development

Other
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0578). Responses to this collection of
information are voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid
OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to approximately 3 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 to the Regulatory Support
Division Director, U.S. Environmental Protection Agency (2821T), 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.
PLEASE FAX PAGE 2 OF PARTNERSHIP AGREEMENT TO (617) 227-1025 (contractor in support of EPA) OR
EMAIL TO [email protected] (must be signed and scanned).

EPA Form # EPA-430-K-05-013
IC