5900-218 Application for Recognition for Accredited laboratories

OMB Control No. 2060-0528
Approval Expires 03/31/2011

United States

ENVIRONMENTAL PROTECTION AGENCY
Washington, DC 20460
Office of Atmospheric Programs
Application for Recognition of Certification Bodies
by EPA under the ENERGY STAR® Program
Version 1.1
This form is an application for recognition of Certification Bodies (CBs) by the U.S. EPA under the ENERGY
STAR program. To serve as an EPA-recognized CB for the ENERGY STAR program, please fill out and submit
this form to EPA by following the instructions below. Upon confirmation of EPA recognition, you may begin to
operate as an EPA-recognized CB for the ENERGY STAR program.

Instructions:
1. Read and understand the “Conditions and Criteria for Recognition of Certification Bodies for the ENERGY
STAR Program,” the full text of which is included under Section VI.
2. Complete the form. All fields are required unless stated otherwise.
3. Sign the form by either:
a. Inserting your digital signature; or
b. Printing out the form, signing it by hand, and scanning it into PDF format.
4. Email the completed form with the required attachment to:
ENERGYSTARVerificationProgram@energystar.gov.

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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I.

Certification Body Information
Organization Name:
Organization URL:
Address 1 (e.g., street address):
Address 2 (e.g., suite #):
City:
State:
Zip/Postal Code:
Country:
Primary contact first name:
Primary contact last (family) name:
Job title of primary contact:
Email:
Phone:
If mailing address of primary contact is different from the organization
address, please provide it here:
Address 1 (e.g., street address):
Address 2 (e.g., suite #):
City:
State:
Zip/Postal Code:
Country:
The following secondary contact information section is optional.
Secondary contact first name:
Secondary contact last (family) name:
Job title of secondary contact:
Email:
Phone:
If mailing address of secondary contact is different from the organization
address, please provide it here:
Address 1 (e.g., street address):
Address 2 (e.g., suite #):
City:
State:
Zip/Postal Code:
Country:

II.

General Requirements: Consistent with “Conditions and Criteria for Recognition of Certification Bodies for the
ENERGY STAR Program,” an EPA-recognized, accredited CB must maintain accreditation to ISO/IEC Guide 65,
“General requirements for bodies operating product certification systems,” by a signatory to the International
Accreditation Forum (IAF) Multilateral Recognition Agreement (MLA) that covers accreditation of product
certification bodies and operates in accordance with ISO/IEC 17011.
a. Name of Accreditation Body:
b. Accreditation effective date:
c.

Accreditation expiration date (if applicable):

d.

A digital copy of the CB’s accreditation certificate and scope of accreditation is included with this
application (check box to confirm).

e. Additional remarks (optional):

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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III.

Scope of Accreditation: Below, please select each ENERGY STAR product category for which the CB named
herein is accredited to operate its product certification system. Since EPA-recognition is per product category,
EPA will recognize this CB only for products listed on its Scope of Accreditation. If in the future you wish to certify
products not checked below, please resubmit this form with the additional products checked and your updated
Scope of Accreditation. Products listed in italics are currently undergoing specification development; they are
included here to provide interested CBs with notice of forthcoming ENERGY STAR product categories.

ENERGY STAR Product Categories
Appliances

Home Electronics

Clothes Washers

Audio/Video

Dishwashers

Set-top Boxes & Cable Boxes

Refrigerators and/or Freezers

Telephony

Water Coolers

Televisions
Battery Charging Systems (BCSs)

HVAC
Information Technology

Boilers
Central Air Conditioners and Air-Source Heat Pumps

Computers

Dehumidifiers

Displays

Furnaces

Imaging Equipment

Geothermal Heat Pumps

Computer Servers

Light Commercial HVAC

Enterprise Storage

Residential Ceiling Fans

Uninterruptible Power Supplies

Residential Ventilating Fans

Small Network Equipment

Residential Water Heaters

Lighting

Room Air Cleaners and Purifiers
Room Air Conditioners

Decorative Light Strings
Luminaires (including sub-components)

Climate Controls

Lamps

Commercial Food Service
Commercial Dishwashers
Commercial Fryers

Home and Building Envelope
Roof Products

Commercial Griddles
Commercial Hot Food Holding Cabinets

Other

Commercial Ice Machines

New Refrigerated Beverage Vending Machines

Commercial Ovens

Rebuilt Refrigerated Beverage Vending Machines

Commercial Refrigerators and Freezers

Lab-grade Refrigerators/Freezers

Commercial Steam Cookers
Pre-Rinse Spray Valves

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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IV. Required Documentation: Attach to this application a manual or procedural guide that describes your certification
program, as well as any other documents necessary to demonstrate that your organization meets the “Conditions and
Criteria for Recognition of Certification Bodies for the ENERGY STAR Program” (the complete text of which is in Section
VI of this application). Complete the table below by citing in the “Applicant’s Reference Document(s)” column the attached
document that fulfills the ENERGY STAR requirement noted at left. To facilitate application review, please record the
exact file name that is used in the attachment, and highlight the applicable text within the document or note in the table its
exact location.

ENERGY STAR
Requirements for
Certification Bodies

Applicant’s Reference
Document(s)

Internal
Use Only
Remarks

(example: File123.pdf, relevant info in
Section 6, page 9)

Conforms
(Yes/No)

2 a): Description of the CB’s data
review cycle time.

2 b) ii: Description of procedure to
verify partner claims as to which
models are part of a family and
which model may be a
representative model from a family
(please indicate N/A if you certify
no applicable product categories).

3 a) i: Description of the
verification testing program.

3 a) i (2): Description of the
procedure for determining the
number of models subject to
verification testing.

3 a) i (3): Description of the
procedure for selecting products
for verification testing.

3 a) i (4): Description of the
procurement procedure for
products selected for verification
testing.

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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ENERGY STAR
Requirements for
Certification Bodies

Applicant’s Reference
Document(s)

Internal
Use Only
Remarks

(example: File123.pdf, relevant info in
Section 6, page 9)

Conforms
(Yes/No)

3 b) i: Description of procedure for
re-evaluating products in event of
design changes.

3 c): Description of challenge
testing procedure.

3 d): Description of procedure for
resolving discrepancies that result
from re-testing.

Appendix A: Requirements
for CBs Operating a
Witnessed or Supervised
Manufacturer’s Testing Lab
(W/SMTL) Program
(please note “NA” if you do not
operate such a program)
1 a): Description of initial and ongoing auditing process of
WMTLs/SMTLs to ensure
compliance with ISO/IEC 17025.

1 e): Description of proficiency
testing procedure.

2): Description of WMTL program.

3): Description of SMTL program.

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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ENERGY STAR
Requirements for
Certification Bodies

Applicant’s Reference
Document(s)

Internal
Use Only
Remarks

(example: File123.pdf, relevant info in
Section 6, page 9)

Conforms
(Yes/No)

3 a) and 3 b): Description of
process for establishing
confidence in an SMTL.

V. Declaration:
By checking this box, I declare that I have read and agree to the terms of “Conditions and Criteria for
Recognition of Certification Bodies for the ENERGY STAR Program,” and the information submitted via this form
is, to the best of my knowledge, accurate and associated with the Certification Body named herein. I understand
that the ENERGY STAR program will associate all information in this form with this Certification Body. I
understand that if any of the submitted information is found to be inaccurate, the Certification Body will be
removed from the list of EPA-recognized Certification Bodies. I understand that intentionally submitting false
information to the U.S. government is a criminal violation of the False Statements Act, Title 18 U.S.C. section
1001.
You are required to provide your signature by either:
a. Inserting your digital signature in the box below, or,
b. Printing out the form, signing the signature box below by hand, and scanning the form into PDF format.
Responsible Corporate Official/Signatory:
Printed Name:
Job Title:
Date:

Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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VI.

Conditions and Criteria for Recognition of Certification Bodies for the ENERGY STAR
Program

In order to be recognized as a Certification Body (CB) for the ENERGY STAR Program, a CB shall agree in writing to the
following requirements:
1) General Requirements and Responsibilities
a) Maintain accreditation to ISO/IEC Guide 65, “General requirements for bodies operating product certification
systems,” by a signatory to the International Accreditation Forum (IAF) Multilateral Recognition Agreement (MLA)
that covers accreditation of product certification bodies and operates in accordance with ISO/IEC 17011.
Noteworthy elements of ISO/IEC Guide 65 include requirements that the CB shall:
i) Operate in a non-discriminatory manner so as not to impede or inhibit access by applicants.
ii) Make its services accessible to all applicants whose activities fall within its declared field of operation,
independent of the size or membership status of the applicant.
iii) Ensure that the relationship between it and each organization providing test data does not compromise the
CB’s independence.
iv) Be responsible for decisions relating to its granting, maintaining, suspending, and withdrawing of certification,
and make these decisions impartially.
v) Decide whether or not to certify a product on the basis of the information gathered during the evaluation
process.
vi) Have a legally enforceable agreement for the provision of certification activities to its clients. Contract and
agreements for certification shall take into account the responsibilities of the parties.
vii) Provide, regularly update, and make available upon request by EPA a directory of the products it has certified,
and their suppliers.
b) Demonstrate to EPA’s satisfaction adequate availability of personnel to the Agency and the ability to provide
requested information in a timely manner.
c) Apply the same conditions to the review of test reports from all EPA-recognized laboratories from which the CB
has agreed to accept data, regardless of the ownership of the laboratory.
d) Make available in written format to current or prospective clients all relevant aspects of the CB’s certification
program, and submit this information to EPA upon request. At a minimum, these shall include:
i) A copy of the form or template which serves as the legally enforceable agreement for the provision of
certification activities to the CB’s client; and,
ii) A description of the certification program.
e) Make available in written format to EPA a description of the management of competencies of personnel involved
in the certification process.
f) Maintain test reports for certified products for at least the longer of 5 years or the duration of certification, and
permit relevant EPA ENERGY STAR authorities to examine any information used in making certification
decisions, including test data.
g) Participate in meetings with EPA as EPA deems necessary to discuss changes to ENERGY STAR product
specifications relevant to certified products. EPA and the CB will jointly determine whether the meeting should
take place remotely (for example, by telephone) or in-person.
h) Forward any questions related to ENERGY STAR test methods to EPA for resolution, and abide by the decisions
of EPA relative to the resolution of those questions.
i) Allow EPA, at its discretion, to audit product certification and verification activities.
j) Notify EPA and any ENERGY STAR partner whose product(s) the CB has certified, of any suspension or
withdrawal of the CB’s accreditation.
k) Not use its own mark to indicate that a product is ENERGY STAR qualified.
2) ENERGY STAR Qualification
a) Provide EPA with a description of the CB’s data review cycle time in order to allow the estimation of its potential
impact on ENERGY STAR partners’ product introduction cycles.
b) Determination of qualification
i) Determine qualification by assessing whether the product meets the performance parameters described in the
relevant ENERGY STAR product specification. This assessment shall comprise a review of the test report of
each model intended for ENERGY STAR qualification.
ii) In the case of ENERGY STAR product specifications that permit the qualification of a group of models based
on the test report of a representative model, the CB shall have a procedure to verify ENERGY STAR partner
claims as to:
Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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(1) Which models are part of a single family; and,
(2) Which model may be considered a representative model of that family. 1
iii) Confirm that all data in the test report originated from an EPA-recognized laboratory with an appropriate
scope of accreditation. EPA-recognized laboratories include the following:
(1) All laboratories EPA has formally recognized as currently meeting the “Conditions and Criteria for
Recognition of Laboratories for the ENERGY STAR Program.” The terms of this document include
accreditation to ISO/IEC 17025 by an EPA-recognized Accreditation Body. EPA maintains an online list of
these laboratories. Therefore, confirming data have originated with such a laboratory shall consist of
confirming the presence of the laboratory on this list.
(2) All laboratories participating in the CB’s witnessed or supervised manufacturers’ testing laboratory
(WMTL/SMTL) program per the requirements described in Appendix A. The terms of this include
assessment to ISO/IEC 17025 by an EPA-recognized CB. Ensuring data have originated with such a
laboratory shall consist of the CB confirming the presence of the laboratory on its internal list of
WMTLs/SMTLs.
c) Report to EPA certified products and at a minimum the key data elements enumerated in the applicable ENERGY
STAR product specification(s). EPA will use this specific information to create the ENERGY STAR Qualified
Product Lists. EPA will ensure recognized CBs are provided with access to the necessary reporting tools,
including secure electronic channels, and guidance on how to use them. Electronic channels may include secure
FTP, an extranet system, and/or XML-based web services.
3) ENERGY STAR Verification
a) Verification Testing
i) Operate an ENERGY STAR partner-funded verification testing procedure that fulfills the verification testing
requirements enumerated as follows:
(1) Ensure products meet all product performance parameters as described in the relevant ENERGY STAR
product specification.
(2) Number of products:
(a) Annually test at least 10% of all ENERGY STAR qualified models the CB has certified or for which it
has received qualified product data.
(b) In the case of ENERGY STAR specifications that address multiple product types, the CB will annually
test at least 10% of each type.
(c) When determining the number of models subject to verification testing, the CB shall consider product
families as defined in the relevant product specification, and in consultation with EPA.
(d) In the event of significant product failures, EPA may advise the CB to increase the number of models
tested in subsequent years. The minimum number of products tested may differ by product category.
(3) Products shall be selected by the CB according to the following general guidelines:
(a) The CB shall select models for verification testing from the ENERGY STAR qualified models the CB
has certified;
(b) Approximately 50% of models to be tested shall be randomly selected; although, the more recently a
model has undergone verification or challenge testing, the less likely it should be selected in this
random selection process; and,
(c) The remaining models shall comprise referrals from EPA as provided, and models selected in
consideration of the following factors:
(i) Product classes from ENERGY STAR partners for which previous models failed verification
testing;
(ii) Referrals from third parties such as consumers, consumer groups or regulatory agencies
regarding the accuracy of ratings; and,
(iii) Models with high sales volumes if this data is available to the CB.
(4) Procurement of unit(s) for testing:
(a) The CB shall procure or obtain the unit(s) for testing, prioritizing the source of those units in the
following order (from most to least favored)
(i) Off-the-shelf (i.e., from the open market);
(ii) Warehouse (i.e., from a storage depot); or
(iii) Off-the-line (i.e., from the manufacturing facility).
NOTE: Off-the-line testing is only appropriate where pulling products from the shelf or from a
warehouse is not feasible. Examples include where the selected product is prohibitively expensive to
1

The CB shall verify all such claims against EPA’s definition of what constitutes a family and a representative model. These definitions
are included in the relevant ENERGY STAR product specifications.
Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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purchase and/or transport, is made-to-order, or is otherwise unavailable through normal retail
channels.
NOTE: The CB shall be responsible for obtaining the unit for testing, and shall not allow the ENERGY
STAR partner to choose the testing sample.
(b) Partners whose products are selected for verification testing are required to:
(i) In the case of off-the-shelf procurement, provide a list of at least three locations where a unit(s) of
the product(s) to be tested may be obtained; or
(ii) In the case of warehouse or off-the-line procurement, provide access to the CB to select a unit(s)
of the product(s) for testing.
(5) Location of verification testing:
(a) Verification testing shall be performed at an EPA-recognized, third-party laboratory; or,
(b) If the unit is obtained off-the-line from the manufacturing facility, the verification testing may be
2
performed at an EPA-recognized, first-party laboratory provided that qualified CB personnel witness
the test.
b) Re-evaluation in the Event of Significant Changes
i) Have procedures to re-evaluate product performance in the event of changes that could affect the ENERGY
STAR qualification status of a product the CB has certified. 3 Consistent with this, the CB shall:
(1) Require the ENERGY STAR partner responsible for a product the CB has certified to inform the CB about
any changes to that product that could result in it no longer meeting the requirements of the relevant
ENERGY STAR product specification.
(2) Require, and evaluate the results of, retesting of the product’s relevant performance.
ii) Report to EPA any changes in product performance, including new test data.
(1) If the changes do not impact the ability of the product to qualify for ENERGY STAR, the CB shall report
the relevant data to EPA on the same schedule as information on newly certified products.
(2) If the CB has determined the product no longer meets the product performance requirements of the
relevant ENERGY STAR product specification, the CB shall notify the ENERGY STAR partner and EPA
within two business days.
c) Challenge Testing
i) Have in place a challenge testing procedure, and contractual provisions for challenge testing.
ii) A challenge may be initiated only when the CB has conveyed details of the challenge to the challengee, or
4
confirmed the challenger has independently done so, and the CB received the following:
(1) Identification of the challenged model number; and,
(2) Identification of the challenged parameters and the basis for the challenge. This basis may be but is not
limited to marketing material that claims better performance than the data the CB has on record, or the
results from a product test the challenger performs on its own, and for which it pays without
reimbursement by the CB no matter the results of the CB’s subsequent challenge test.
iii) Upon the failure of a product to meet the performance requirements of the relevant ENERGY STAR product
specification, the CB shall notify the ENERGY STAR partner and EPA within two business days.
d) Resolving Discrepancies: Have in place a procedure to resolve discrepancies between data resulting from
product re-testing (for any purpose, for example, verification or challenge testing), and the data previously
certified by the CB. In the case of a discrepancy, the CB shall report to EPA the test results, both initial and final in
5
case additional re-testing is performed, that are relevant to ENERGY STAR qualification. The CB shall also notify
EPA of the resolution of product re-testing, for example, decertification or recertification.

2

For the purpose of the ENERGY STAR program, EPA defines a first-party laboratory as a laboratory that is owned and/or operated by
the manufacturer or private labeler of the product being tested.
3
A laboratory’s change in accreditation or WMTL/SMTL status would be considered relevant to the qualification status of products the
laboratory tested only during the effective period of the factor(s) that led to the change in the laboratory’s status.
4
The CB shall not oblige the challenger to convey details of the challenge to the challengee.
5
When the CB reports this data to EPA, it shall follow the rounding and qualification rules enumerated in the applicable ENERGY
STAR specification.
Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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Appendix A: Requirements for the operation of a Witnessed Manufacturers’ Testing Laboratory (WMTL) or
Supervised Manufacturers’ Testing Laboratory (STML) program
A CB, per ISO/IEC Guide 65, may operate a testing program to accept test data from a manufacturer’s first-party
laboratory that participates in a WMTL or a SMTL program only if the CB adheres to the requirements enumerated below.
Note, the CB shall not enroll as a WMTL any laboratory EPA has formally recognized as currently meeting the “Conditions
and Criteria for Recognition of Laboratories for the ENERGY STAR Program,” since this recognition obviates the need to
establish confidence in the laboratory via the level of witnessing inherent to a WMTL program. Instead, the CB shall enroll
such a laboratory as an SMTL, and the procedure the CB follows to do so shall entail fewer steps than in the case of nonaccredited laboratories.
To operate a testing program to accept test data from a manufacturer’s first-party laboratory that participates in a WMTL
or a SMTL program, the CB shall:
1) General Requirements:
a) Ensure through an on-site initial assessment and periodic auditing that the WMTL or SMTL is able to demonstrate
its facilities are in compliance with all relevant requirements of ISO/IEC 17025 and the applicable test method(s),
and that the laboratory personnel conducting the testing have the necessary competence and expertise.
Consistent with this, the CB shall have and follow written procedures for evaluating laboratory facilities;
environmental controls; personnel and training; testing and calibration equipment types and accuracy; calibration
procedures; written test procedures, set-up, measurement technique(s) and documentation systems; quality
assurance programs; and other elements as required in the relevant ENERGY STAR product specification;
b) Document and maintain reports of its assessments and periodic auditing of the WMTLs/SMTLs in the programs it
operates;
c) Have and follow procedures to monitor the impartiality of WMTLs/SMTLs on an ongoing basis. Document review,
consistent with the requirements of ISO/IEC 17025, shall include but may not be limited to the following:
i) Organization chart showing that the responsibilities, authorities, and inter-relationships of all personnel who
manage, perform or verify laboratory results are free from influence that may adversely affect the quality of
their work;
ii) Dates of internal audits, audit findings, and any corrective actions taken;
iii) Any customer complaints and corrective action taken;
iv) Original testing records containing sufficient information for repeatability, including the names of staff who
participated;
v) Evidence that laboratory employees participate in and regularly pass ethics and compliance audits; and,
vi) Evidence that mechanisms for reporting and responding to attempts to exert undue influence on test results
are in place.
d) Maintain records that demonstrate the test data originating with the WMTL/SMTL are unbiased.
e) Operate proficiency testing when EPA/DOE deems it necessary to ensure consistent results between the
WMTL/SMTL and an EPA-recognized third-party laboratory.
f) Provide EPA with a list of each WMTL/SMTL testing products pursuant to ENERGY STAR qualification, and
updates to this list on an ongoing basis as the CB enrolls laboratories in its WMTL/SMTL program. This list shall
included the following information on each WMTL/SMTL:
i) The date of the WMTL/SMTL agreement between the WMTL/SMTL and the CB;
ii) The manufacturer’s name and the address of its headquarters; and,
iii) The ENERGY STAR product categories covered by the agreement.
g) Assume full responsibility for the validity of the test results.
2) Requirements specific to the operation of a WMTL program:
a) Supervise and check all critical aspects of the tests;
b) Witness the final data acquisition;
c) Ensure that the CB personnel who witness the test(s) have the necessary competence and expertise to carry out
tests to the relevant ENERGY STAR product specification; and,
d) Ensure that all tests are carried out by personnel of the WMTL in accordance with the applicable requirements.
3) Requirements specific to the operation of an SMTL program:
a) Witness testing and all other elements that contribute to the establishment of confidence in the SMTL’s quality
processes;
b) As the CB gains experience with and confidence in the SMTL, supervision may gradually shift away from
witnessing tests;
c) At least once per year, audit the SMTL’s procedures on-site against the requirements of ISO/IEC 17025 and the
applicable test method(s). During visits, the CB shall:
Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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i) Supervise product testing; and,
ii) Review relevant test reports in progress; and,
d) Maintain records of:
i) The dates and elements of performed supervision, including what tests were observed; and,
ii) Observations made and advice provided to the SMTL during visits.

End of text of “Conditions and Criteria for Recognition of Certification Bodies for the ENERGY STAR Program”

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Toll-free number: 1-888-STAR-YES

Web site: http://www.energystar.gov
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