•

•

• Use the Green Power Mark in a manner that is consistent with Partner mark use guidelines.

•

•

•

•

•

•

•

•

Name of individual agreeing to the terms:

 I understand and agree to the above requirements to become an EPA Green Power Partner.

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 information about the Partner’s green power use publicly.

EPA may periodically revise program benchmark levels or other eligibility requirements.

For more information on partnership requirements (including minimum green power use and eligible green power sources) go to:

http://epa.gov/greenpower/join/purchase.htm.

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 Web site.

In return, EPA commits to:

Provide public recognition.

Report on green power use annually.

The U.S. EPA's 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.

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

Use green power that meets or exceeds Partnership requirements.

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Primary Contact Public Relations Contact (Optional)

Salutation

Contact Name

Title

Street Address

City/State/Zip

Email Address

Phone Number

Partner Name

Website Link 

Green Power Related Web Page

(e.g. environmental or sustainability page)

Optional

Industry (select from picklist)

Annual Electricity Use (kWh/yr)

Scope of Reported Electricity Use (select from 

picklist)

Please Identify Reporting Facility or Group of 

Facilities (only if "Single Facility or Subset" is 

selected above)

(If other, please specify):

Reporting Period Start Date 

Reporting Period End Date 

Organizational Electricity Use

Contact Information

Green Power Partnership Yearly Reporting Form

This Yearly Report form should be used to update the EPA on your organization's green power usage. Please complete the report, save the file, and return 

to your account manager or James Critchfield at your earliest convenience. James Critchfield's email address is critchfield.james@epa.gov.

Organizational Information

All fields are required unless noted otherwise.

Reporting Period (Optional): The electricity and green power information contained in this report covers the following 12-month period. Partners may 

choose to report most recent calendar year, fiscal year, other 12-month period, or forward-looking data.

Motivating Factors (Optional): Check the motivating factors behind you green power use (check all that apply)

Cost stability or savings

Demonstrate environmental leadership

LEED certification

Meet sustainability goals

Support economic development & job creation

Support renewable energy development

Other

Brand or product differentiation EPA recognition Reduce carbon footprint

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yes

no

Green Power Provider(s)

One provider per row

Product Name

Optional

Green Power 

Purchase 

(kWh/year)

Biogas

(%)

Bio-mass 

(%)

Geothermal 

(%)

Hydro 

(%)

Solar 

(%)

Wind 

(%)

Unknown 

(%)

Total 

(%)

3rd Party 

Certified?

% New Renewables*

Contract 

Begin Date 

(mm/dd/yy)

Contract End 

Date 

(mm/dd/yy)

Is this provider also 

supplying your 

electricity?

0

0

0

Total: 0 * % of product from facilities placed in service within the last 15 years.

Onsite Generation Technology

One onsite installation per row

Green Power 

Production 

(kWh/year)

Rated Capacity 

(kW) Optional

Power 

Purchase 

Agreement 

Start Date 

(mm/dd/yy)

Power 

Purchase 

Agreement 

End Date 

(mm/dd/yy)

Total: 0 * EPA will only count as green power the kWh output from onsite installations for which the Green Power Partner owns the rights to the renewable energy certificates (RECs).

Total Green Power 0

Percent Green Power 0.00%

Select the appropriate check box(es) below:

Year Installed 

Optional

We are purchasing green power or renewable energy certificates (RECs) from a provider.

We are using green power onsite.

Location

(ZIP Code)

Optional

Product's Resource Mix (should total 100%)

3rd Party 

Ownership? 

Optional

Please update the information below with your current green power product purchase information. If you are purchasing more than one green power product or REC product, list each purchase on a separate row.

Please update the fields below with your current onsite green power use information. If you have more than one onsite system, list each installation on a separate row.

Only Complete if 3rd Party Owned System

3rd Party Owner 

Optional

Green Power Information

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You can find existing GPP profiles at:

Partner Profile (Optional)

Current Profile for Your Organization: 

All Green Power Partners have the opportunity to have a Partner Profile on the Web site. The Partner Pro

briefly a Partner’s organization, its decision to use green power, and its experience to date with green po

If you would like to create a Partner Profile, please draft a paragraph in the space provided below. EPA w

approve it prior to posting on the Green Power Partnership Web site. Note, EPA cannot endorse your gre

sure the profile does not include reference to the entity from which you are procuring your green power. 

description of your organization and try to address these questions:

 - How much green power is your organization using?

 - What was the driver behind your organization's switch to green power?

 - Any lessons learned during your green power commitment process you would like to share with other

 - What are the biggest benefits that have accrued to your organization since it switched to green power?

If you’d like to provide a quote about the benefits of green power for your organization, please include th

to.

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