OMB
Control
No.
XXXX­
XXXX
EPA­
XXX­
X­
XX­
XXX
Approval
Expires
XX/
XX/
XX
ENERGY
STAR
®
Indoor
Air
Package
Commitment
Form
By
completing
this
form,
our
organization
commits
to
participating
in
a
pilot
of
the
ENERGY
STAR
®
Indoor
Air
Package
Program.
We
have
read
and
understand
the
program's
specifications
(
attached)
and
agree
to:

 
Build
and
label
at
least
one
home
annually
that
is
verified
to
meet
the
specifications
of
the
ENERGY
STAR
®
Indoor
Air
Package;
 
Ensure
that
all
of
our
ENERGY
STAR
Indoor
Air
Package
homes
are
also
verified
to
earn
the
ENERGY
STAR
Qualified
Home
label;
 
Provide
marketing
materials
related
to
the
ENERGY
STAR
Indoor
Air
Package
to
EPA
for
review
and
approval.
EPA
will
review
within
three
working
days.
 
Monitor
the
results
of
our
efforts
to
build
and
market
qualifying
homes;
 
Provide
EPA
with
an
informal
evaluation
of
our
experience
during
the
pilot;
 
Use
the
ENERGY
STAR
Indoor
Air
Package
mark
consistent
with
the
requirements
of
the
ENERGY
STAR
brand
identify
guidelines
contained
in
the
document,
Using
the
ENERGY
STAR
Identity
to
Maintain
and
Use
Value;
and
 
Discontinue
our
use
of
the
ENERGY
Indoor
Air
Package
label
if
we
are
not
constructing
homes
to
the
label's
specifications.

We
understand
that
the
construction
practices
and
technical
specifications
that
comprise
the
ENERGY
STAR
Indoor
Air
Package
are
designed
to
contribute
to
improved
indoor
air
quality
in
new
homes
compared
to
standard
code­
built
homes.
However,
these
measures
alone
will
not
guarantee
that
homebuyers
will
not
experience
air
quality
problems
in
their
homes.
Rather,
the
Indoor
Air
Package
should
be
viewed
as
a
way
to
reduce
the
likelihood
of
experiencing
such
problems.
For
example,
factors
such
as
unforeseen
construction
issues
and
homeowner
behavior
may
negatively
impact
the
home's
indoor
air
quality
and
the
performance
of
the
measures
specified
in
the
Indoor
Air
Package.

We
understand
that
during
the
pilot
program,
EPA
will
 
Maintain
and
update
the
Indoor
Air
Package
technical
specifications
as
needed;
 
Develop
consumer
education
materials
(
such
as
brochures,
ad
templates,
banners);
and
 
Provide
recognition
to
participating
builders
through
EPA's
Web
site,
award
ceremonies
and
press
releases.
 
Provide
a
copy
of
this
commitment
form
signed
by
EPA's
authorized
representative
to
make
this
commitment
form
effective.

We
also
agree
that:

 
The
activities
we
undertake
in
connection
with
the
Indoor
Air
Package
Program
are
completely
voluntary
and
not
intended
to
provide
services
to
the
Federal
government.
As
such,
we
will
not
submit
a
claim
of
compensation
to
any
Federal
agency;
The
government
estimates
the
average
time
needed
to
review
and
fill
out
this
form
is
15
minutes
and
welcomes
suggestions
for
reducing
this
level
of
effort.
Send
comments
(
referencing
OMB
Control
Number)
to
the
Director,
Collection
Strategies
Division,
U.
S.
EPA
(
2822T),
1200
Pennsylvania
Ave.,
NW,
Washington,
D.
C.
20460.
 
We
may
not
construe,
claim
or
imply
that
our
use
of
the
ENERGY
STAR
Indoor
Air
Package
label
constitutes
federal
government
approval,
acceptance,
or
endorsement
of
our
company,
homes
or
services;
 
Based
on
the
results
of
the
pilot,
EPA
may
revise
the
program's
name,
specifications,
and
marketing
support;
and
 
If
the
Indoor
Air
Package
Program
is
offered
nationally,
we
will
update
our
ENERGY
STAR
Partnership
Agreement
to
continue
to
receive
recognition
for
our
participation.

Authorized
Company
Representative:

Printed
Name:
____________________________________________

Company
Name:
__________________________________________

Title:
____________________________________________________

Signature:
________________________________________________

Date:
___________________________________________________

Mail
this
completed
form
to:
OR
Fax
this
completed
form
to:

ENERGY
STAR
for
Homes
(
202)
343­
2200
US
EPA
(
mail
code
6202J)
1200
Pennsylvania
Ave,
NW
Washington,
DC
20460
Authorized
EPA
Representative:

Kathleen
Hogan
Director
Climate
Protection
Partnership
Division
Signature:
_

Date
_
