Pesticide Certification.pdf
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- Solicitation number
- RFB-605-2500000697-1
- 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 engaged in pesticide activities that could potentially impact waters of the United States to review and sign a compliance document acknowledging understanding of the permit's terms and conditions. The specific type of pesticide application services to be provided include herbicide, insecticide, and fertilizer applications.
The certification form mandates that contractors review the complete PDMP available at a specified web link and understand that any violation of the plan's conditions may result in substantial penalties or contract termination. Contractors must identify themselves, provide company contact information, and sign the document, thereby legally certifying their comprehension of the environmental protection requirements associated with pesticide application activities. The document serves as a formal mechanism to ensure environmental compliance and contractor accountability in pest management operations that have potential water resource implications.
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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 .