Section I: EPA WaterSenseSM Program Goals 

The EPA WaterSense program goals are to use water resources more efficiently to preserve them for future generations 

and reduce water and wastewater infrastructure cost by reducing unnecessary water consumption. Through this program, EPA will provide reliable information on high-performing, water-efficient products and practices, raise awareness 

about the importance of water efficiency, ensure water-efficient product performance, help consumers differentiate 

among products and programs that use less water, promote innovation in product development, and support state 

and local water efficiency efforts. 

Section II: Partnership Pledge 

As an EPA WaterSense program partner, _________________________________ (name of retailer or distributor) shares 

EPA’s goals as outlined above and is proud to commit to the following activities to further these goals: 

1. Sell, market, and promote products labeled under the EPA WaterSense program within 12 months of execution of 

this partnership agreement, through activities such as in-store promotions, bag stuffers, shelf talkers, advertising 

campaigns, and financial incentives for the sale of labeled products. Note: A draft or final specification for a 

product the partner sells or distributes must be available before signing this agreement. 

2. Adhere to WaterSense partner logo and label guidelines and ensure that authorized representatives, such as 

advertising agencies and contractors, also comply. Help EPA maintain program integrity by alerting EPA to possible 

misuse(s) of the WaterSense partner logo or label. 

3. Train sales staff and customer service representatives on the EPA WaterSense program. This training will include 

identification of WaterSense labeled products within the store and on company Web site; tips for selling labeled 

products; and information for answering questions about the WaterSense program. 

4. Promote the value of water efficiency and WaterSense labeled products on an ongoing basis as an easy and desirable option for customers to reduce water usage and save money. Where feasible, sponsor workshops for customers to educate them about WaterSense, water conservation benefits, and WaterSense labeled products. 

5. Feature the WaterSense partner logo on company Web site and in other promotional materials. 

6. On an annual basis, provide data to EPA on sales of water-efficient products or other market indicators to assist in 

determining the impact of the program in promoting labeled products. The data will be used by EPA only for program evaluation purposes and may be provided directly to EPA or to a third-party organization with the understanding that this organization will not release individual retailer/distributor data. 

7. Provide to EPA and update on a regular basis a list, by manufacturer model number, of all WaterSense labeled 

products carried. 

8. Grant the EPA WaterSense program permission to include company name on a list of participating partners on the 

EPA WaterSense Web site, program materials, and announcements. Also grant WaterSense permission to provide 

non-confidential information on labeled products or programs sold on the program Web site and in program 

materials. The company 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 company will have the opportunity to provide input and review the final product prior to release to the public in EPA printed or Web documents. Further, 

the company understands that EPA might refer media contacts interested in publicizing water efficiency to it for 

information about products 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 the EPA WaterSense brand by distributing key messages on the benefits of labeled products 

and programs, and the importance of water efficiency. 

3. Provide current EPA WaterSense program news, information, and reference documents (via the program Web site, 

helpline, e-mail, or other means), including a listing of labeled products and programs on the Web site. 

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 

Retailers and Distributors 

OMB Control Number 2040-0272 

Approval Expires 01/31/2010 

Partnership Agreement: 

EPA Form Number 6100-12 
includes, but is not limited to listing partners and labeled products and programs on the EPA WaterSense Web site. 

5. Respond swiftly to partner requests for information or clarification on EPA WaterSense program policies. 

6. Provide materials, templates, and logo for promotional use, consistent with the WaterSense program guidelines. 

7. Review pre-press promotional items, draft Web sites, packaging or other materials that use the WaterSense label, 

upon request. 

8. Provide tools for training sales staff on WaterSense labeled products and programs. Provide materials for partners 

to customize for consumer workshops. 

Section IV: General Terms and Disclaimers 

1. The partner will not construe, claim, or imply that its participation in the EPA WaterSense program constitutes federal government (EPA) approval, acceptance, or endorsement of anything other than the partner’s commitment to 

the program. 

2. The partner understands that the activities it undertakes in connection with the program are voluntary and not 

intended to provide services to the federal government. As such, the partner will not submit a claim for compensation to any federal agency. 

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 EPA WaterSense program. Upon termination of this agreement, partners agree to remove program marks in a 

timely manner, consistent with the WaterSense partner logo and label guidelines. 

To be completed by EPA 

Authorized EPA Representative (printed name): ______________________________________________________ 

Title: __________________________________________________ E-mail: __________________________________ 

Signature: ______________________________________________ Date: __________________________________ 

To be completed by partner 

Authorized Company Representative1 (printed name): ________________________________________________ 

Title: __________________________________________________ E-mail: __________________________________ 

Signature: ______________________________________________ Date: ____________________________________ 

Company Name:_________________________________________________ Number of employees: ____________ 

Industry/SIC/NAICS code: __________________________________________________________________________ 

Primary Contact: Dr./Mr./Mrs./Ms._________________________________________________ Suffix: ____________ 

Title: ______________________________ Dept: __________________ E-mail: ______________________________ 

Address: _____________________________________________City/State/ZIP: ______________________________ 

County: ________________________________________________ Web site: ________________________________ 

Telephone: __________________ Fax: ___________________ Alternate Telephone: __________________________ 

Primary function: ❑Marketing & Sales ❑Government Affairs ❑Other: ____________________________________ 

How did you find out about this program? ❑Web site ❑Referral, Name: ____________________________________ 

❑Periodical __________________________ ❑Workshop, Sponsor: ________________________________________ 

❑Mailing ______________________________________________ ❑Other: ________________________________ 

1

The Authorized Company Representative should be a person in the organization with signing authority (e.g., vice president). 

EPA Form Number 6100-12 

Cynthia A. Simbanin 

WaterSense Program Manager simbanin.cynthia@epa.gov 
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 Standard or Professional, you can fill out the form electronically and e-mail 

it to: watersense@epa.gov. Acrobat Reader users must print forms after filling them out and fax or mail them in. 

Please contact the WaterSense Helpline at (866) WTR-SENSE (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. 

EPA Form Number 6100-12 

The public reporting and record keeping burden for this collection of information is estimated to average 8 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 Partnership Agreement to this address.