6-Environmental Record Affidavit.pdf
PDF 112 KB Posted
- Attached to
- IRON BRIDGE PUMP STATION REHABILITATION
- Solicitation number
- CIZ-DWU 25 523
- Issued by
- Uvalde County, Texas
About this file
This is an Environmental Record Affidavit form required for the Iron Bridge Pump Station Rehabilitation project in Wills Point, Texas. The affidavit serves as a compliance document for bidders and proposers to certify their environmental record status prior to contract award. Bidders must declare under oath whether they or their authorized representatives have received notices of violation, enforcement actions, or civil or criminal fines or penalties from any regulatory authority for violations of Environmental Laws—including the Clean Air Act, Clean Water Act, and state, federal, or local environmental regulations—within the three-year period preceding the affidavit date. The form requires the authorized representative of the bidding entity to either confirm no violations have been received or, if violations have occurred, to provide detailed documentation on a separate sheet listing all notices of violation, enforcement actions, and any compliance documents issued by regulatory authorities.
The affidavit must be completed, notarized by a Texas notary public, and submitted as part of the bidder's proposal package. The Environmental Record Affidavit demonstrates the bidder's commitment to environmental responsibility and compliance with applicable environmental laws. This document is part of a broader Contractor Environmental Packet that serves as a guideline for environmental responsibility rather than an exhaustive regulatory reference. Bidders who have environmental violations must fully disclose such violations with supporting documentation; failure to accurately complete this affidavit or intentional misrepresentation may result in proposal rejection or contract termination.
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Other files
| File | Type | Posted |
|---|---|---|
| 18-25 523 SPECIFICATIONS VOLUME 3 OF 4.pdf | ||
| 17-25 523 SPECIFICATIONS VOLUME 2 OF 4.pdf | ||
| 10-BEH-FRM-602.SAW.pdf | ||
| 2-BDPS-FORM-146 Non Disclosure Statement City of Dallas.doc | DOC document | |
| 3-BID-FRM-216 Change of MWBE Subcontractor Form.pdf | ||
| 13-BEH-FRM-607.SAW.pdf | ||
| 4-Bid Bond.docx | DOCX document | |
| 11-BEH-FRM-603.SAW.xlsx | XLSX spreadsheet | |
| 12-BEH-FRM-604.SAW.pdf | ||
| 1-Acknowledgement of Addendum.docx | DOCX document | |
| 7-Experience Record.pdf | ||
| 5-Bidders Affidavit.docx | DOCX document | |
| 19-25 523 DRAWINGS VOLUME 4 OF 4.pdf | ||
| 20-25 523 Bid Proposal Spreadsheet.xlsx | XLSX spreadsheet | |
| 21-25 523 SPECIFICATIONS VOLUME 1 OF 4.pdf | ||
| 9-OPS-FRM-640 -Team Make-Up and Local Workforce Form.xlsx | XLSX spreadsheet | |
| 8-Form 25 Cement Preference Certification.pdf | ||
| 15-BEH-FRM-610.SAW.pdf | ||
| 16-Bid Proposal Submittal Form.pdf | ||
| 14-BEH-FRM-609.SAW.pdf |
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Text version
ENVIRONMENTAL RECORD AFFIDAVIT
For purposes of this Affidavit:
(A) the term “Bidder/Proposer” includes any and all authorized officers, employees, agents, or other representatives of Bidder/Proposer working in that capacity on behalf of Bidder/ Proposer within the past three (3) years prior to the date of this Affidavit;
(B) the term “Environmental Laws” includes the (i) Clean Air Act, (ii) Clean Water Act, (iii) any rules, regulations, or ordinances promulgated pursuant to either of the above mentioned acts by State, Federal, or local regulatory authorities, or (iv) any other State, Federal, or local environmental law, rule, regulation, or ordinance related to the protection of the environment, including but not limited to solid waste disposal, hazardous waste disposal, illegal discharges of pollutants, and other similar environmental laws, rules, regulations, and ordinances.
I, ____________________________________________, the duly authorized representative of __________________________________________ (Hereinafter called the “Bidder/Proposer”), hereby swears (or affirms) on behalf of Bidder/Proposer the following:
(1) That Bidder/Proposer has received and read the Contractor Environmental Packet.
Bidder/Proposer also understands that the Contractor Environmental Packet is not intended to be all-inclusive, but rather a guideline for environmental responsibility.
[Strike the item indicated below that does NOT apply in this Affidavit.]
(2) That Bidder/Proposer has not been served with any notices of violation, or notices of enforcement, nor had any civil or criminal fines or penalties imposed by any regulatory authority for a violation of any Environmental Laws within the past three (3) years prior to the date of this Affidavit.
(3) That Bidder/Proposer has been served with any notices of violation or notices of enforcement or had any civil or criminal fines or penalties imposed by any regulatory authority for a violation of any Environmental within the past three (3) years prior to the date of this Affidavit as follows:
[If item (3) applies, use a separate sheet to list the notices of violation or enforcement, and any adjudication of actual violations, along with copies of any compliance documents issued by the regulatory authority in connection with the notices or actual violation, and attach the separate sheet to this affidavit.]
Subscribed to and sworn before me on this the ______ day of _________________, 20____.
[Seal] ___________________________________ Notary Public State of Texas
My Commission expires ________________
Environmental Record Affidavit (10-09-07 Edition)
File details come from the government source that posted it. Updated .