Pesticide Certification.pdf
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- Solicitation number
- RFB 605 2400000386 1
- Issued by
- Ohio County, Kentucky
About this file
This is a Pesticide Certification form required by the Kentucky Department of Transportation for contractors performing work under state contracts. The document outlines mandatory compliance requirements for any contractor engaged in pesticide activities that could impact waters of the United States. Contractors must acknowledge their understanding of and agreement to comply with the KPDES Pesticide General Permit (KYG99) and the Pesticide Discharge Management Plan (PDMP) specific to their project. The certification applies to all pest management activities including herbicide, insecticide, and fertilizer applications. Contractors are required to complete the form with project details, company information, contact information, and the specific types of pesticide application services to be provided, then sign and date the certification under penalty of law.
Contractors who violate any condition of the PDMP may be subject to substantial penalties or loss of contract. The PDMP document is available for contractor review through the Kentucky Transportation Cabinet's website. The certification requirement ensures that all contractors and their employees working on pesticide-related activities understand and will comply with environmental protection standards governing pesticide discharge management. Contractors are expected to inform their employees of PDMP requirements and maintain compliance throughout the duration of their contract work.
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Text version
CONTRACTOR CERTIFICATION
Contract Number: _______________________________________
Contract Name: _________________________________________
Contractor Representative: ________________________________
As a contractor, you are required to comply with the KPDES Pesticide General Permit, KYG99, and the Pesticide Discharge Management Plan (PDMP) for any work that you perform for the above designated contract. Any person or group who violates any condition of the PDMP may be subject to substantial penalties or loss of contract. You are encouraged to advise each of your employees working on this project of the requirements of the PDMP. A copy of the PDMP is available for your review at the link below:
https://transportation.ky.gov/Maintenance/Documents/Pesticide%20Discharge%20Management
%20Plans/D-3%20PDMP%20Complete.pdf
Each contractor engaged in pesticide activities in the pest management area that could impact waters of the United States must be identified and sign the following certification statement.
I certify under penalty of law that I have read and understand the terms and conditions of the
PDMP for the above designated project.
This certification is hereby signed in reference to the above named contract.
Company: _____________________________________________
Address: _____________________________________________
City/State/Zip:_____________________________________________
Telephone Number: ________________________________________
Type of pesticide application service to be provided:
Herbicide, insecticide, and fertilizer applications
Signature: _____________________________________________
Title: _____________________________________________
Date: _____________________________________________
File details come from the government source that posted it. Updated .