Pesticide Certification.pdf
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- Solicitation number
- RFB-605-2500000624-1
- Issued by
- Rowan County, Kentucky
About this file
This is a Contractor Certification document from the Kentucky Transportation Department related to the KPDES Pesticide General Permit (KYG99) and the Pesticide Discharge Management Plan (PDMP). The document requires contractors performing work involving pesticide applications to certify their understanding and compliance with environmental regulations for pest management activities that could potentially impact waters of the United States. The certification specifically covers herbicide, insecticide, and fertilizer applications, and mandates that contractors review the full PDMP document available at a specified web link.
The certification form requires contractors to provide company details including name, address, contact information, and a signed statement affirming they have read and understood the PDMP terms. Contractors who violate the plan's conditions may be subject to substantial penalties or contract termination. The document serves as a legal certification and accountability mechanism to ensure environmental protection during pesticide-related work, with each contractor engaged in pest management activities required to complete and sign this standardized form before performing 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 .