Certified Pesticide Applicator Licensing Form.pdf

This is a Certified Pesticide Applicator Licensing Form for PennDOT's On Call Vegetation contract (RFQ #12-0) in Pennsylvania's Engineering District 12-0, covering Fayette, Greene, Washington, and Westmoreland counties. The form is a mandatory submission requirement for contractors bidding on vegetation maintenance services, which include general cleanup, herbicide application, mowing, landscape installation, and vegetation maintenance at various state facilities and route areas. Failure to complete and upload the form renders the submittal non-responsive. The form requires documentation of up to ten certified pesticide applicators, with each applicator's full name as it appears on their license, certification number, associated business license number, applicable category(ies), and license expiration date.

This contract is designated as a Small Business Procurement under Pennsylvania's Small Business Procurement Initiative (SBPI), and only DGS-certified small businesses are eligible to submit bids and receive awards. All bids must be submitted electronically through the Commonwealth's SRM system via the PA Supplier Portal at www.pasupplierportal.state.pa.us. The pesticide applicator licensing documentation must be endorsed by the contractor's business license number, ensuring that qualified, certified personnel will perform herbicide application and related services under this on-call arrangement. Contractors experiencing technical difficulties with the bidding portal should contact the Supplier Service Center at (877) 435-7363, option #1.