Pesticide Certification.pdf
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- Solicitation number
- RFB-605-2500000563-1
- Issued by
- Calloway County, Kentucky
About this file
This document is a Contractor Certification form from the Kentucky Transportation Department related to the KPDES Pesticide General Permit (KYG99) and Pesticide Discharge Management Plan (PDMP). The certification requires contractors performing pesticide-related work to comply with environmental regulations for activities that could potentially impact waters of the United States. The form mandates that contractors read and understand the PDMP terms, with a specific focus on herbicide, insecticide, and fertilizer applications.
The certification includes provisions for substantial penalties or contract loss for non-compliance, and requires contractors to review the detailed PDMP documentation available online. Contractors must complete the form by providing company details, contact information, and signing an acknowledgment of understanding the regulatory requirements. The document serves as a legal certification that the contractor is aware of and will adhere to specific environmental protection guidelines when conducting pesticide-related work under the contract.
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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 .