Pre-service indemnification

COVID-19

Pono Home values your health and wellness, as well as that of our employees. In the era of COVID-19, we are taking extra precautions. We have adopted the safety protocols of Hawaii Energy for all of its certified Clean Energy Allies. The protocols include safety measures for stopping disease transmission as much as possible. Our staff will wear masks, gloves, and other forms of personal protective equipment, and will be washing hands frequently, as well as keeping our products and tools clean.

We also recognize that, no matter how careful we are, bad things may happen. Thus, we now require you to sign this indemnification prior to our performing any services for you.
Have you or others in your household had close contact with a person with confirmed or suspected COVID-19?
- Yes
- No
Have you or others in your home traveled outside of the island in the last 14 days?
- Yes
- No
Are you or others in your home currently ill or experienced any of the following COVID- 19 symptoms (i.e. fever, cough, shortness of breath, chills, repeated shaking with chills, muscle or body aches, headache, sore throat, fatigue, sore throat, congestion or runny nose, nausea/vomiting, diarrhea, new loss of taste or smell)?
- Yes
- No
Are there any individuals 65 years or older at the residence?
- Yes
- No
Are there any individuals with weakened immune systems or chronic medical conditions (i.e. heart disease, lung disease, diabetes, kidney disease, asthma, smoking)?
- Yes
- No
We apologize for the inconveniece, but to protect all of our customers, we are unable to serve you until the answers to the first three questions are all no; and for the last two questions, until state department of health COVID-19 guidelines have changed. Please continue with this form, and we will contact you to schedule/reschedule your service.
Indemnification: I, the undersigned, hereby unconditionally and irrevocably release, waive and forever discharge Pono Home, Inc. and its affiliates, directors, owners, members, shareholders, and employees of the from any and all causes of action, claims and damages, including attorneys’ fees, whether known or unknown, foreseen or unforeseen, presently asserted or otherwise arising through the date of his or her signing of this Indemnification clause (a legal and binding Waiver and Release Agreement), concerning Pono Home services including but not limited to home energy conservation education and energy efficiency audit and retrofit services. This release includes, but is not limited to any claim arising under any state or local laws, ordinances or regulations (including, but not limited to, any state or local laws, ordinances or regulations requiring that advance notice be given of liability claims). I also declare this to be a legal and binding digital signature and waive any right to require paper copies or printed signatures. In the case of any disagreements or challenges that arise, I agree to a) try to settle things amicably, lacking that, b) to be bound to a decision by a JAMS arbitration process and waive any rights I have to seek out other legal processes, including any and all lawsuits. I understand that the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious and that it may be impossible to determine who has it and who doesn't, given the current limits of virus testing. I confirm that I am not presenting any symptoms including but not limited to fever, shortness of breath, dry cough, runny nose or sore throat. I verify that I have not traveled outside Hawaii for the last 14 days, and if I have, I have let the Pono Home service technician know. In the interest of public health, I agree to let Pono Home know immediately if I do later have symptoms and/or test positive for COVID-19.*
Sign above, using / in front and end of your name. For instance, Scott Cooney would sign this /Scott Cooney/
Where do you live?
- Molokai
- Oahu
- Big Island
- Maui
- Lanai
Your email*
Phone
Name
First Last
Further guidance and information

Our safety protocol for on-site visits and promise to you
1. Your safety is our #1 priority
2. Every employee has the authority to stop work (turn down the job) when there is a reasonable concern that illness, serious injury, or death might occur performing the job.
3. We will wear appropriate personal protective agreement (PPE). We will put on a cloth face covering at a minimum for face protection, disposable shoe covers, and disposable nitrile gloves before entering the home and wear PPE the entire time while working on-site. PPE is to protect the customer as well as our personnel.
4. Initially, we will try to use your cell phone to communicate with the customer – including notifying them we have arrived at their home and when you need to speak with them during the visit.
5. Inform your customer that your employees practice social distancing. If we must knock on the door, we will step back at least 6 feet after doing so. If they have not done so already, have the customer clear a walk path, as necessary, and make sure they isolate household members while the service is being performed. Maintain social distancing for the duration of the on-site visit.
6. Avoid contact with any surfaces unrelated to the service. Wipe down any surfaces with EPA registered disinfectants that are appropriate for the surface.
7. Upon leaving each residence, remove the shoe covers and gloves (avoid touching the outside of any portion of the shoe covers and gloves). Properly dispose of the shoe covers and gloves upon departing each residence.
8. Wash hands with soap and water for 20 seconds immediately after exiting home/finishing work. If handwashing is not possible, use hand sanitizer with at least 60% alcohol content.

COVID-19

Further guidance and information

Our safety protocol for on-site visits and promise to you