OMB Control No. 2060-0528 Approval expires 03/31/11 Instructions For Partnering With ENERGY STAR® As A Manufacturer Of ENERGY STAR Qualified Products Organizations interested in partnering with ENERGY STAR as a Manufacturer of ENERGY STAR Qualified Products should take the following steps: 1. Review the Manufacturer Definition on page 2 below. 2. Review the Product Specifications, Eligibility Criteria, and Partner Commitments documents on www,eneravstar.gov. Go to the Partner Resources page and select 'Product Specifications' where you will find a detailed list of all eligible products with the corresponding documents. 3. Select the area of interest for a new partnership and indicate your product on the enclosed Commitment Form. Please ONLY select the relevant product you manufacture in Section 7 under Manufacturer of ENERGY STAR Qualified Products. 4. Review, complete and sign the Partnership Agreement. 5. Return the Partnership Agreement and Commitment Form to ENERGY STAR at: join@energv w or ENERGY STAR c/o ICF International 1725 Eye Street NW, Suite 1000 Washington, DC 20006 If you are a manufacturer of CFLs, clothes washers, dishwashers, refrigerators and/or freezers, room air conditioners, windows/doors/skylights, or residential water heaters please return your materials to: partnership® /star, gov or ENERGY STAR c/o D&R International 1300 Spring Street, Suite 500 Silver Spring, MD 20910 ENERGY STAR will accept hard or electronic copies of the Partnership Agreement. A copy of the signed Partnership Agreement will be returned to you for your records. Change For the Better With ENERGY STAR EPA Form No, 5900-33 ENERGY STAR Partnership Agreement 1 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 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 ofwww.eneravstar.gov. Section 7: Manufacturers Eligible Organizations: A company that manufactures or private labels any product(s) that meets the current ENERGY STAR qualification criteria. EPA Form No. 5900-33 ENERGY STAR Partnership Agreement 2 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 ENERGY STAR PARTNER 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 Commitment 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, build- ings, 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. EPA Form No. 5900-33 ENERGY STAR Partnership Agreement 3 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 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. EPA Form No, 5900-33 ENERGY STAR Partnership Agreement 4 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 Partnership Agreement Signatory for ENERGY STAR: Signature(s): Name(s): Title (s): Date(s) Jerome P. Dion, Manager Kathleen Hogan, Director Building Technologies Program, U.S. Department of Energy Climate Protection Partnerships Division, U.S. Environmental Protection Agency Partnership Agreement Signatory for (Enter Partner Name Here) ~ 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. 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, V\foshington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. EPA Form No. 5900-33 ENERGY STAR Partnership Agreement 5 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 ENERGY STAR PARTNER ENERGY STAR Commitment Form: Program Area(s) Where ENERGY STAR Partner Commits to Fulfill Program Requirements Partner Name: Date: Partner agrees to fulfill the Program Requirements Promote ENERGY STAR as an ENERGY Efficiency Program Sponsor in the: ~ Consumer Product Market ~ Residential New Construction Market ~ Existing Commercial Buildings Market ~ New Commercial Buildings Market ~ Industrial Market *Such as states, utilities, or regional program coordinators. Help Clients Improve Their Energy Performance Commercial and Industrial Service and Product Providers, supporting the: ~ Existing Commercial Buildings Market ~ New Commercial Buildings Market ~ Industrial Market Offer Commercial Financing ~ Mortgages for Energy-Efficient Homes * Please refer to the ENERGY STAR Partnership Agreement for Lenders. Label and Promote ENERGY STAR Qualified Homes ~ Home Builders/Developers ~ Home Energy Raters * Please refer to the ENERGY STAR Partnership Agreement for Home Builders and Verification Organizations. Promote ENERGY STAR Qualified Products ~ Retailers/E-tailers ~ Buying Groups Deploy ENERGY STAR Qualified Set-top Boxes ~ Cable, Satellite, and Telecom Service Providers Label and Promote ENERGY STAR Qualified Products Appliances ~ Clothes Washers ~ Dishwashers ~ Refrigerators and/or Freezers ~ Room Air Conditioners Commercial Food Service Equipment ~ Commercial Dishwashers ~ Commercial Fryers ~ Commercial Hot Food Holding Cabinets ~ Commercial Ice Machines ~ Commercial Solid Door Refrigerators/Freezers ~ Commercial Steamers each program area checked below. Home Electronics ~ Audio Equipment and DVD Products ~ Digital-to-Analog Converter Boxes (DTAs) ~ Set-top Boxes ~ Telephony ~ Televisions and VCRs Heating, Ventilation, and AC Products ~ Boilers ~ Central ACs and Air-Source Heat Pumps ~ Furnaces ~ Geothermal Heat Pumps ~ Light Commercial HVAC ~ Programmable Thermostats ~ Residential Ceiling Fans ~ Residential Ventilating Fans Home and Building Envelope Products ~ Residential Insulation Products ~ Roof Products ~ Windows, Doors and Skylights ~ Window Components Lighting Products ~ Decorative Light Strings ~ Residential Light Fixtures ~ Screw-Based Compact Fluorescent Lamps (CFL) Office Equipment ~ Computers ~ Imaging Equipment ~ Monitors Other Products ~ Battery Charging Systems (BCSs) ~ End-Use Products with Qualified EPSs ~ External Power Supplies (EPSs) ~ New Refrigerated Beverage Vending Machines ~ Rebuilt Refrigerated Beverage Vending Machines ~ Residential Dehumidifiers ~ Room Air Cleaners ~ Water Coolers ~ Residential Water Heaters ~ Through our partnership with ENERGY STAR, we also commit to improve the energy performance of our own facilities. EPA Form No. 5900-33 ENERGY STAR Commitment Form 6 ------- OMB Control No. 2060-0528 Approval expires 03/31/11 Partner Name: Date: Please provide contact information for each program area selected on the previous page. (Make extra copies of this page when joining multiple program areas.) ENERGY STAR Program Area: Responsible Agent of Company: Primary Contact (if different): Contact Name: Title: Company: Address: City: State: Zip: Country: Phone: Fax: E-mail: Additional Contact (marketing, etc.): Additional Contact (if appropriate): Contact Name: Title: Company: Address: City: State: Zip: Country: Phone: Fax: E-mail: Please return to the attention of: ioin@eneravstar.aov or ENERGY STAR c/o ICF International 1725 Eye Street NW, Suite 1000 Washington, DC 20006 Fax: (202) 862-1144 If you are a manufacturer of CFLs, clothes washers, dishwashers, refrigerators and/or freezers, room air conditioners, windows/doors/skylights, or residential water heaters, please return your materials to: DartnershiD@eneravstar.aov or ENERGY STAR c/o D&R International 1300 Spring Street, Suite 500 Silver Spring, MD 20910 Fax: (301)588-0854 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. EPA Form No. 5900-33 ENERGY STAR Commitment Form 7 ------- |